Thank you for the compliments. I fully understand what you mean when you talk about getting back to what you were before the cancer. I too enjoyed a few pints with friends as soon as I could.
From the time I found out my PSA was over 20, to the time I was officially diagnosed, I worked on getting my MD from Google U and Youtube institute of Technology on everything prostate cancer related. I was quite surprised too, by the difference in treatment recommendations between the UK, Germany, and the USA.
Prior to my surgery, I had a PSMA pet scan done. This had shown the possible spread of the cancer to my lymph nodes. The lymph nodes were still localized in the prostate area. I spoke with the head of the Urology department at the hospital where I had my surgery and he explained that, although it has metastasized and escaped the prostate, it is not considered metastatic due to its close proximity to the prostate . I suppose this is why it was considered stage 4a, which is the last stage that can be treated with curative intent. I was surprised when the board recommended adjuvant radiation so quickly however. They, as well as my local Urologist, all believed that in my case, that the chances of reoccurrence was very high. Their philosophy was to hit it hard while the cancer is weak.
After my initial consultation with the head of the Urology department, he explained that by me starting Bicalutamide immediately, it would likely reduce the chance of the cancer spreading further while awaiting surgery, but mostly, they wanted to give it time to shrink the tumor a bit, so they would have a better chance of achieving negative margins. The surgeon was able get the negative margins.
The downside to all of this, is there is a chance of overtreatment. For me, I was ok with this risk. There is also the risk that if it returns, I will have a somewhat limited choice of options going forward. Still, with the advancements in the scans, which are much better at pinpointing where the cancer is, there is still a good chance they can use spot radiation. Time will tell.
Cheers