Thank you so much! We are in LA. The docs here (UCLA and Cedars) say the prostatectomy is not an option because of adhesions and difficulty getting to the prostate. They say that if they do it, they run a high risk of incontinence. He had radiation once and the cancer came back (Gleason 4+3). He is taking hormones, and the PSA is coming down but has terrible side effects. We are considering either a Tulsa Procedure or a second round of radiation (salvage). Both are risky. He is 78 and otherwise in good health. Plays golf 5 days per week, travels and has a very positive attitude. I think surgery may be an option - but not here; a consultation with your doctor may be a great option us. We cannot find a surgeon in LA that has done the prostate removal with a patient on a j-pouch! Thanks again.