As I understand it (I am not a doctor), the prescribed
treatment is very standard.

At age 77, radiation is more often prescribed than surgery -
which can be harder for a man of that age to recuperate from.

Gleason 7 means that the cancer is "intermediate risk", i.e.
above "low risk" and hormone therapy is often prescribed as
a "pre-adjuvant" (an associated treatment given before the
main treatment) therapy either a) to shrink the prostate in order
to make the target for radiation smaller and easier to
treat, or b) to weaken the tumor cells to make the radiation
more effective, or both.

This is very likely the right thing for your father from a medical
point of view.  As for the psychological aspects, it might be
ideal if you could discuss them with the doctor.  But whether
you can do that might depend on your father giving the
doctor permission to talk to you.

The hormone therapy has some physical effects - hot flashes
and loss of libido, and may have psychological effects.
Some men do get depressed while under hormone treatment.

The radiation therapy, assuming it's external beam radiation,
is completely painless.  It's normally administered in doses
lasting a couple of minutes a day, 5 days a week, for about
8 weeks.  It can have some physical side effects, including
sunburn like skin irritation, inflamed hemorhoids, difficulty
urinating, impotence, and blood in the semen.  The side
effects might begin about 4 weeks or so into the treatment
and get worse as the treatment goes on, but start to get
better as soon as it's over.

Implanted seed radiation ("brachytherapy") is an alternative
in which only one procedure is performed - which might be
easier for your father to take rather than going to the treatment
center every day for 8 weeks - however, unlike external beam
radiation, it's an inpatient hospital procedure requiring
anaesthesia and probably an overnight stay.  Some of the
side effects - difficulty urinating, impotence, and bloody
semen are also possible with this treatment.  The actual
radiation is released slowly, over a period of weeks or
months and the side effects, if he has them, may not
begin until some time after the implant and continue for
some weeks or a couple of months.

Again, as I understand it, with a PSA of 11.6 and Gleason
of 7, there's a good chance that the cancer is growing and
could kill your father within 5 years or so.  He might have
no symptoms for another 2-4 years, but if the cancer does
spread, the symptoms can be horrifying and the death
very difficult and painful.  So "watchful waiting" is a
significant risk, even at your father's age.

Another alternative is hormone therapy alone - which on
average will suppress the cancer for several years, after
which it will likely start to grow again.  This is NOT curative
but may enable your father to live long enough to die
of something else before any real symptoms develop.
However, hormones do have side effects and HT alone
given over a several year period will prolong the effects
well beyond the effects of the treatment prescribed by
the doctor.

Still another alternative is radiation alone.  If given as
brachytherapy, your father would go into the hospital
for a one day/night stay and not have any other treatment.

The chance for a cure is less than with the treatment
prescribed by the doctor, but there is still a decent
chance for a cure, and the treatment may be the
easiest to take.

If it were me with the cancer, I'd go with the doctor's
recommendation - which is probably the best chance
for a cure.  But clearly the other issues you raised are
complicating factors that need to be considered.

These choices are very difficult and there is no way
to know which one is best.

I hope that helps.

Best of luck to you and your Dad.

   Alan

Yes.  The hormones tend to make the cancer more vulnerable to radiation, and
radiation is more tolerable than surgery.  I have been called
obsessive/depressive myself ;-}  but if your father listens to some nuts who
think radiation grows in you like a disease, he might get a little resistant.
Tell him, "Being exposed to radiation does NOT make you radioactive!"  I have
found that that impression is the most popular among laymen.  Sunburn -is-
radiation poisoning!  We get over that pretty easily, every summer.

Hi Nick,
I am 61 (was 60 at the time I was diagnosed). I was PSA 14+, Gleason 3+4,
bones clean, microscopic lymph node penetration.
My treatment has consisted of Zoladex since February, five weeks of EBRT
that concluded May 14, followed by 110 PD-103 seed (brachy) implants on June
10.
The side affects are bearable. Fifteen days after my brachy (yesterday), I
went on a six mile hike in the Cascade mountains. The main downside for me
is I have forgotten what it means to be able to sleep more than 2 to 3 hours
at a stretch without having to get up to pee - and that's on a good night.
Libido? I just hope it will return once I'm off the Zoladex.
It could be worse. At 77 he's faced with a battle he can win and be around
to enjoy the people in his life that love him. He's had 17 more years than
me without this curse and I enjoyed 17 years more than other contributors to
this newsgroup.

I hope he can learn to cope with the hand he's been dealt. If he wants
someone to talk to, e-mail me and we can exchange phone numbers.

BTW - Alan's synopsis is excellent!

Good luck,
Larry