Prostate Cancer Survivors






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Re: Deciding between radical prostatectomy and radiation

Rob; We have all been where you are right now and I don't know if anyone can honestly give you a definite answer as to what is best for you. Only you can decide that with the help of caregivers and your own research which you are doing by posting here. We have opinions and experiences to relate but know this is a crap shoot at best for anyone.
My layman's thoughts are this; Age can be a decision consideration. Younger age (sixty or less in this arena) seems to provide better results from surgery as far as side effect seriousness. "Youth" heals better and faster. Surgery gives immediate and factual results both with outcome evaluation and side effects. Surgery outcome to some degree is dependent upon surgeon skill, find an experienced one with good "reviews". Surgery leaves options for second "curative" treatment if it fails. Surgery is serious with in your face results but is tolerable to be sure. It does have a long healing period after as with most surgery. Physical examination of the gland after removal gives good indication of the anticipated success of the procedure in getting rid of the cancer and that is after all, the main goal here.
Radiation is far easier than surgery and is said to give equal results as surgery. Side effects are minimal at first but can surface much later on. Results are not as immediately conclusive as with surgery since PSA often takes a long time to reach a level point. No physical exam of the gland is possible. No second curative procedure is usually available after radiation if it fails.
There are an infinite number of things to consider and there are NO good choices. I have had both procedures and if you want, I would be very happy to exchange e-mails to answer any more specific questions you might have as you make your way through this. Just click on the (e-mail) sign at the bottom of the post here. Jon.

Re: Deciding between radical prostatectomy and radiation

Jon it sounds like you are a great authority on the subject having lived both procedures. I'm lucky in that I'm just Gleeson 6, but I know it's just a matter of time. So, if radiation fails to stop the cancer spread, removal is an option. I assume with that much time passing there is a greater chance of it spreading. We all hope for a PSA of -0- after surgery.

Rob, good luck with your journey.


Re: Deciding between radical prostatectomy and radiation

Paul; It appears by your post that you misunderstood about options after treatment.? Surgery is generally not considered a good option after radiation since it causes a lot of scar tissue that makes surgery very difficult. If having a second curative option is your choice, then surgery first is the way to go leaving radiation as a backup if the surgery fails. Jon.

Re: Deciding between radical prostatectomy and radiation

Jon, thank you for the clarification. I did not understand that at all. So even these fancy Protron, and IMART treatments cause scar tissue. With my Gleeson 6, the doc is just doing AS. I'm just a few weeks post diagnosis.
For those that choose radiation, if later decide on removal of the prostrate then a nerve sparing surgery become impossible, and perhaps not at all. Yikes!