Posted 9/16/2021 11:00 AM (GMT -6)
Sorry you have to be here, but glad you've "landed" with this group. This is where you will find a (mostly) unbiased range of opinions and real experiences.
My biopsy report was similar in score to yours, only I had just 4 positive cores. I opted for treatment due to the presence of that pesky G4 in my single 3+4 sample.
Halbert speaks truth in advising you to listen to your urologist until he/she tries to push to immediate surgery. You have time. . . even up to several months, to decide. I can't cite the studies, but when I was deciding upon my own treatment, others showed me research studies that concluded that with a 3+4 diagnosis, even waiting 3 or 4 months to begin treatment had no impact on eventual outcome. In my case, I was diagnosed in mid-July and treated in mid-to late November. All is well, so far.
Halbert also raises a very important point. There are many types of radiation treatment that are applicable to G3+4 pathology. Do the searches on this site to find their names. (Some popular ones that come to mind are IMRT, SBRT, BT, HDRBT, and there are others. I will not try to explain them all to you, as you are just beginning the quest for knowledge. Just know that most, if not all, of the radiation treatments will have very close to (or even exactly) the same cure rates as surgery, but each treatment modality will have a different side effect profile. (Yes, I really did use the word "cure." We can have that discussion a bit later on.) My advice is to read about each treatment modality and its side effects. Since they mostly all have similar outcomes, you can base your choice first on which ones have side effects that you feel you can live with, as you will be living with them for many years.
If you are considering radiation (disclaimer -- I had CyberKnife SBRT), be VERY sure that if you are interested in a particular type of radiation treatment, you must speak with a practitioner who actually can deliver that type of treatment. I know that the acronyms don't mean anything yet, but if you speak with an IMRT practitioner and ask about SBRT (two greatly different modes of external beam radiotherapy), that doc will tell you something like "Radiation is radiation. I'll tell you about what I will do for you, and that will do the job just fine." But he will not tell you any real experiential information about the mode that really interests you. He can't, as he doesn't have that specific experience. Very few radiation oncologists specialize in multiple modes of delivery. Important point.
I met with my uro/surgeon and three radiation oncologists before I narrowed things down to one RO and the CyberKnife process. It was, in my opinion, well worth the time. Before starting treatment, I was very comfortable with the mode of treatment (radiation, rather than surgery), they sub-type of treatment (SBRT), and the doctor/facility that would manage my treatment. That process did a lot for my peace of mind as I went into treatment.
Hang around with us. Ask a bunch of questions. There are no bad questions, and this is one of the best places on the internet to get straight, honest answers from individuals who have walked paths very much like yours.