Hi Badger47, and welcome to the forum, I was in a similar position to you at diagnosis, and my prostate reduction was carried out by a TURP procedure in Jan 2022, with no retention problems since.

from what I know a prostatectomy isn't usually an option once your cancer has spread, being Gleason 10, my treatment was to control my cancer only I've been on hormone therapy HT for 31 months and had radiotherapy RT April 2022, "aggressive 73gy", to whole pelvic area, I had cancer in 5 organs and 8 lymph nodes, my last scan showed cancer in one node only.

There is a new ish treatment for metastatic prostate cancer called triplet therapy, 2 types of HT and a short course of chemotherapy, which is worth studying/asking your oncologist about, and is showing better results than surgery and HT/RT

If your lymph node involvement is 4 or less, you  could be suitable for SABR at some time too.

Good luck for your appointment with your surgeon, bt please remember a surgeon will always recommend surgery, so talk to your oncologist before making your final decision, best wishes. Eddie

Thank you very much for your comments.  Very useful in gaining insight to any decision. 

Your welcome

Hi Badger,

The advice I received was for radiotherapy. I'm 66 with locally advanced (just on the outside of prostate) Gleason 9, no spread. Surgery was not an option, advice is to nuke lymph nodes and prostate for a cure. Yours seems similar, with nuking your nodes as well as your prostate likely. Radiotherapy or hormone therapy seems likely to be needed with surgery anyway, if your nodes are involved, as they can't guarantee getting it all with just surgery. I've found great advice in Youtube videos from the Prostate Cancer Research Institute in America. Some bits not relevant to the UK - we have the NHS and choice is less available - but on the whole very helpfull.  Also, ask yourself if surgery is the best option at your age, bearing in mind the affect of operations the older we get, incontinence etc. PC is slower moving than other cancers, and other ailments maybe of more concern in your immediate future.