I am so sorry to hear of your husband's diagnosis. I had a Gleason score of 10 myself so I understand the fear that you and your husband feel with a high Gleason score.
There are any number of possiblities as to what will happen and you just have to take them each one step at a time.
The first step is to get through the surgery and see what the doctors learn from that. At a minimum they will remove billions of cancerous cells from your husband and also learn a great deal about
exactly where the cancer is located which will greatly aide in future treatments. It is possible (although perhaps not likely from what your doctor has told you) that the cancer is contained in the prostate. It is also possible that it has spread, but not far, such as to the adjacent seminal vesicles. Finally, it may have spread further out into the body such as to the lymph nodes or even to the bones. Each situation will suggest different treatment options. This is why having the surgery will be a big help. You will learn a lot of information about
location and pathology of the cancer.
If the cancer has spread outside of the prostate, I believe that the primary follow-up treatment options are generally hormone therapy, chemo, and radiation. Your doctor may suggest one, two, or even all three of these treatment options. Since my own situation has not yet indicated the need for further treatment after my surgery, I am not as well educated in these treatments as others who write on this site and I will let people who know more than I give you more information on these treatment options. You can learn a lot about
different treatment options just by looking at other postings on this web site (or on other sites like Tamu suggested.) Also, if you have not already done so, you might want to buy or check out from your library Dr. Patrick Walsh's book on prostate cancer. It has a lot of good information.
If you do follow one or more of these treatment options after your husband's surgery, you may also want to consider whether or not it would be best to switch to an oncologist or other doctor. Many of us start out with our hometown urologist and then move to someone with more of a speciality in prostate cancer and particularly one who treats prostate cancer with the exact type of treatment that you are considering. Of course, if your current doctor is knowledgable about
various treatments and is giving you all the information that you need and desire, then you may prefer to remain with him/her.
You do not mention if your husband has had any type of bone scan or other whole body scan to try to determine if the cancer has spread. If you have had this done, post the results for other respondents to see. If not, I encourage you to ask your doctor about
this. It is normally done, particularly in cases of higher Gleason cancers like your husband's and mine, to help determine if the cancer has spread to the bones or other areas of the body. Again, this will help determine the best treatment regimine.
Do not despair. The treatments today are much more advanced and effective than when your husband's parents had cancer. As I am sure that your doctor will tell you, even people with advanced prostate cancer can survive for many years.
DIAGNOSIS: 09/25/06 at age 49. PSA 4.6. PSA free 2%. Gleason 10 (first graded as 8, subsequently re-graded as 10.) Clinical stage T2a.
SURGERY: 11/08/06. Radical retropubic at Johns Hopkins (half way across the country for us.) Surgical pathology was stage T3a with positive margins but negative seminal vesicles, negative lymph nodes, negative on bone scan.
RECOVERY: Catheter was in for 26 days (not fun) due to blood in urine.