Question: Dear MD, My dad is a 74 year old male, in excellent health, except for a most recent diagnosis of Prostate Cancer. I understand that this cancer is treatable, but I have to say I am very worried that my dad may have an atypical, aggressive cancer. He is going for a bone and CT scan next week, but his biopsy results are not looking that great; with high Gleason scores, and also a possible perineural invasion. I am attaching his results, and am hoping that someone could let me know what to do next (i.e. prostectomy and/or radiation, and/or hormonal therapy, etc). Also, does radiation work well with aggressive prostate cancers; as equally as it would with less aggressive ones? Final Diagnosis: 1.) Prostate-left apex-biopsy -Prostate tissue with a small focus of atypical glands. 2.) Prostate-left mid-biopsy -benign prostate tissue 3.) Prostate, left base, biopsy -Adenocarcinoma of the prostate. Gleason score 4 +3= 7 involving 20% (1.5 mm in length) 1 of 2 core(s) 4.) Prostate, right apex, biopsy. -Adenocarcinoma of the prostate. Gleason score 4 +5=9 involving 95%, 95%, and 60%). (5.5 mm, .5mm, and 4 mm in length) of 3 of 3 core(s). -Perineural invasion is identified. 5.) Prostate, right, mid, biopsy -Adenocarcinoma of the prostate. Gleason score of 4+5=9 involving 95% (7 mm in length) of 1 of 2 core(s) -Adenocarcinoma of the prostate. Gleason score of 4 +3=7 involving 80% (8.5 mm in length) of 1 of 2 core(s) - A total of 2 of 2 cores involved in carcinoma. 6.) Prostate, right base, biopsy -Adenocarcinoma of the prostate. Gleason score of 4 +4=8 involving 85 and 70% (10 mm and 7 mm in length) of 2 of 3 core(s). Thanks! XXXX