Don's Home Health Cause of Death Cancer Prostrate Mayo Clinic Tom's summary

My understanding is that surgery is prostatectomy. This is often followed by radiation therapy to make sure cancer cells in the surrounding tissue are killed. PET scans revealed some cancer cells around Don's prostate so I'd expect them to do the radiation therapy after surgery for him.

Hormone therapy essentially starves the cancer cells of the hormones (testosterone, mostly) that make them replicate quickly. This is most often done to shrink the cancer before radiation therapy comes in to kill the rest of it.

The trial is for hormones and targeted therapy followed by surgery. This means in addition to the regular hormone therapy there will also be drugs specifically targeted to the type of cancer cell in Don's body. This is why they wanted to do the blood test: to figure out the genetic profile of Don's cancer cells and target more effective drugs. This would hopefully kill the cancer cells in the surrounding tissue so that when they come in for surgery, there would be no need for follow-up with radiation therapy.

All of the options are likely to be effective (or else they would not recommend them), but all carry risks and side effects. Most or all of these options will involve sexual side effects either during the treatment, or following the treatment, or both.

There are more detailed options (what specific hormones/hormone blockers; different surgical approaches; different ways to target radiation).