Was sent by GP doctor to Urologist who was at one time a surgeon, and has now gone into Brachytheraphy. My cancer is high intermediate. Not knowing anything about PC, he at first indicated all that would be needed was seed implants. The next thing I know I am receiving a 4 month shot of Lupron and he is talking 5 weeks of RT followed by the seed implant. Doc has extensive record (approximately 1000 implants) and claims a success record of up to 90% at 10 years. This appears better to me than what I have seen on stats with surgery. However, I am getting the impression this also includes harmone theraphy -so in that regard the stats may be skewed.

I am scheduled to go to a renowned robotic surgeon next week for consultation. My question for anyone who can shed light or has already walked this path is the mental wrestling match over direction. Here is what I see as the plus & minus of weighing surgery against the theraphy described above.

• First - Doing radiation + seeds + harmones is shooting the tiger all at once and hoping he dies. It is a shotgun approach since I won't really know if my cancer is out of the capsule or not, and if it will come back. If it does come back, the basic only option after all this radiation is harmone theraphy (since my insides will be too scarred for further radiation).
• Second - The theraphy described seems a little gray since the harmones will push low PSA scores, but those can be construed to make one think they are cured when all they are doing is suppressing.
• Third - is there a sense of some comfort after surgery in seeing the pathology report and knowing something of where you stand - ie: in relation to positive margins, and cancer spread?
• Fourth - Would it be better to have the surgery to see what the pathology says - that way the possibility of radiation for salvage is still available?
• Fifth - Is there a little peace of mind knowing you have the screwed up prostate with cancer removed versus still there?
• Finally - It appears that surgery has far more side effects than radiation (although I have heard some tough stories on radiation also), but is there really that big a difference?

Thanks for any thoughts on these things