My 50 year old husband has a PSA of 22 and Gleason of 7. The current recommendation is a radical Prostatectomy but we are told that doesn't guarantee he will not need chemo in the future. I'm so confused. None the less we are going to seek a second opinion. We're trying to decide between trying to get into John Hopkins or Cancer Treatment Center of America. Any input/advice is appreciated.

We are in Southeastern Virginia. However, we are willing to travel for treatment on a reoccurring basis. Yes, we've seen a RO who can do the pellets but he recommends surgery as well. Sorry I don't have the biopsy info w/me and I'm at work. I'll post it later. It's so much information and we are both overwhelmed. I crash read a book last night and I'm sure I missed important info. Will read it again.

Johns Hopkins would be a fine choice and is relatively convenient for you.

See my profile and you will see that I effectively used radiation. My urologist/surgeon said no to surgery as it would not be curative and I would also need radiation. That could be your risk as well with a high risk diagnosis. The last thing you want from treatment side effects is a combination of surgery and radiation. That is the worst combination. If anyone is saying you will need radiation after surgery, that is the time to decline surgery. The most effective combination for your risk level has been shown to be a combination of brachytherapy (preferably HDR) and external beam radiation (IMRT/IGRT/SBRT).

We have two major centers in Atlanta that use this method, so I was lucky. Places like Johns Hopkins are very surgery biased, and excellent at it. The Cancer Treatment Center of America in Atlanta lists HDRBT as a therapy method. Is that the one you are looking at? Regarding permanent seeds, there is a leader here in Atlanta that pioneered seeds and IMRT together. Also a great clinic in Wheeling West Virginia. Duke University has a good reputation for PCa work and is closer. I suggest you do some research with them to see what types of treatments they offer.

That the radiation oncologist that uses seeds recommended surgery surprises me and my guess is that he really isn't a PCa specialist. Whether it is surgery or radiation you want to find practitioners that are truly specialists and focus their practice on PCa.