I'm not understanding the diagnosis.
T4 is a stage, not a risk, and is advanced cancer and not curable. But I suspect you don't really mean T4.
Gleason 4+3 is grade group 3.
So, what's the staging, and what does the 4 relate to (PIRADS)?
Difficult to answer the rest without understanding the diagnosis.
You mention Lupron, but that's a brand of Luprorelin sold in the US (it's called Prostap in the UK). If your dad is in the US, treatment customs can be different.
We don't have accurate data comparing VMAT alone, with HDR Boost (VMAT + HDR), both plus hormone therapy. HDR Boost is intended for high risk patients with local or locally advanced cancer and no mets. It's thought to be at least as good as VMAT alone but with fewer side effects, but the data to prove this doesn't exist. This will be the results of the PIVOTALboost trial, when it completes. (I had this treatment.)
HDR Boost isn't suitable if there's any lymph node involvement - in that case you would have VMAT alone (plus chemo, plus hormone therapy).
I aimed to get my PSA ≤ 0.1 before starting radiotherapy, but you mustn't delay radiotherapy unless PSA is dropping at a significant rate, and not everyone will be able to get their PSA that low on hormone therapy. In the US, neoadjuvant hormone therapy (hormone therapy before radiotherapy) sometimes includes Abiraterone to get PSA lower, but that's never done in the UK.
Really need to know your dad's diagnosis better, to know his staging and which risk group he's in, and hence if HDR Boost would be viable.
Edited by member 30 Nov 2020 at 19:32
| Reason: Not specified