Decision on moving forward

Can you provide us with more information? What were your biopsy results? What was you Gleason Score? With additional information, we can have a good discussion on your particular case.

Like Dave said, ADT is given to reduce PSA levels prior to Radiation. I really don’t have any idea how much and whether a steep drop going from a 79 to 4 would is normal or not. As said maybe the 79 was not accurate if such a steep drop is not normal. Likewise maybe the 4 is off. I would want to know how much of a decrease is expected. On a whole different note, knowing your cancer appears limited to within the capsule that could open up the surgery option to reconsider.

yes, a robotic laparoscopic prostatectomy. I just had mine 6 weeks ago. I am 71 and had Gleason 8 (4+4) core. It appeared contained in capsule from the PET scan, but when Surgeon got it, learned it had just barely left the capsule and he was able to get negative margins. Had nerve sparing, single port entry with also puboprostatic ligament sparing which helps considerably with incontinence along with Retzius sparing which also helps. I had very minimal leaking and gone after two days. Walking a mile a few days after surgery with my catheter in a bag. It also gives me the opportunity for salvage radiation if that were needed, that although salvage prostatectomy can be done, it is only by certain skilled surgeons.

No. The two main side effects of prostate surgery are incontinence and ED issues. Today versus years ago, these are both minimized. That being said, you have to pick the right surgeon, even if it means traveling away from your locality for the surgery because their are different approaches to the laparoscopic surgery. There is single port entry (newer approach) versus three or four entry incisions. One will often hear about nerve sparing, but not the puboprostatic ligament or Retzius sparing( again newer techniques). Feel free to google these things, but the bottom line is you get to pick your surgeon and don’t hesitate to research the best prostate surgeon’s at the major cancer centers in your area or major hospitals that might have prostate cancer as a specialty area they are involved in.
For me, it seems the first major side effect of incontinence I avoided due to I believe my surgery technique and am optimistic on the ED side, already taking a small dose of sildenfil (viagra) with the dose scheduled to be increased and I see and can feel things in the morning that seem to be awakening as the nerves heal.