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When your G score is 8 or 9, the chance of the PCa being outside the prostate is high. Surgery will not get all the cancer in these cases. So, if you are going to use EBRT to kill these starting nodes (not detectable) then you might as well just do it all in one shot. Doing both surgery and EBRT just increases the side affects. The over all goal of PCa treatment is to kill the cancer with minimum side affects.
This site only represents a very small fraction of the million plus men living after they were diagnosed with prostate cancer, some of whom chose to have treatment, including surgery. There are only 43 stories from men diagnosed prior to December 1999 and only 16 of those chsoe surgery, so that is a very small data base.
I was merely responding to your statement that you had not read of anyone dying within ten years of surgery and trying to show you that even in this small data base there is one case, while, as shown in many studies there are more such cases in the general, diagnosed, population.
As Bill G says, there is an inherent bias in any study on the outcomes of therapies because of extraneous factors such as stage, age and other health issues.
There is no long term study that I am aware of that shows any specific therapy to be superior to another. Treatment should be chosen to match the diagnosis, or as Dr Strum says - ASSESS STATUS BEFORE DETERMINING STRATEGY
The paper I was thinking of is "Radical Prostatectomy For Clinically Advanced (cT3) Prostate Cancer Since the Advent of Antigen Testing: 15 Year Outcome" British Journal of Urology International 95, 751-756, doi:10.1111/j.1464-410x.2005.05394.x.
In this retrospective study from the Mayo Clinic of 841 men going in with cT3, 90% were not dead from prostate cancer 10 years after their prostatectomy. Presumably life expectancy is a little better now which would lead to my observation that I don't know of anyone that has died within 10 years of getting their prostate out including the large support group I attend.
I am not promoting surgery, I just suggested it as an alternative to getting the hormone treatment that was causing a lot of problems. I completly agree that I would be looking for the absolute best sugeon I could find to do the operation if I was to get surgery given the pathology.
I think the suggestion for surgery is based on a faulty reading of the statistical situation. Those who are treated with surgery are typically those with a fairly early stage cancer. Thus their outcomes will look statistically better, just because they are getting treatment for milder cases. You should stick with the treatment that is most appropriate for your particular case.
Joe thank you for your reply, the first urologist, who also did my biopsy, was not keen to operate and sent me to an oncologist for a second opinion, after 1 3/4 hours with this man where he painted in plain and concise language what I faced, the options and the outcomes, I went home to chew over for the weekend as to the treatments available and the consequences of the various treatments. I decided to take the ADT, bracytherapy HDT & EBRT as this seemed the best way to kill all the cancer, my CT scan and bone scan was clear. The oncologist agreed with my choice and that in his opinion this would achieve the best outcome.
I have yet to see him again as to the necessity of ADT for 18 months, this opinion was given to me by the 2nd urologist that I saw, he is the one that will be doing the bracytherapy.
The side effects of the ADT if I know the mood swings will lighten or desist with time I will tough it out, the general tiredness? or lethargy? I can endure,the joint pains I have to wait and see if they worsen I train 4 nights per week, I hold a 3rd degree black belt in martial arts and instruct 2 nights per week the other 2 nights I am a student of ju jitsu, I am 64 years of age. Diet reform is something I went into almost immediately and feel that this has helped somewhat if only to give me a focus on something apart from my fears and woes.
I have yet to travel as far down the road as you have and can't help but be aprehensive as to what may happen to bladder and bowels, of course I have utterly no libido nor erectile function, this has not helped with those bloody mood swings, I do miss those intimate moments with my wife.....sorry just had a mood swing... must go now