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Why would my doctors recommend surgery over radiation?

Prostate Cancer | Last Active: Feb 10 6:38pm | Replies (36)

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@heavyphil

Well, looks like you've made up your mind about having surgery. At a 3+3 my personal feeling (having gone thru surgery for a 4+3) would be to go with CuberKnife. Yes, yes everyone is gonna scream at me for saying this - especially since we all know how hard it is to make a treatment decision - but the side effects of surgery are very impactful no matter who performs it since every patient is different. I am still impotent and sometimes incontinent and I had one of the best surgeons in the world (supposedly!!!)
But it is your LIFE which carries the most concern, not the side effects, right? When I had my surgery 5 yrs ago at age 64 (I now have recurrence and am facing radiation and ADT) a study had just come out which compared the 10 year outcomes for surgery vs Cyberkife: they were exactly the same! In other words, your chances of success and failure were equal.
I chose surgery because as most have pointed out, you CAN have radiation after surgery but the reverse is not really true. So a recurrence would mean hormones and possibly chemo for the rest of your life. However, I did NOT have the benefit of genetic testing at the time ad my only criteria was the Gleason score. Today, there is the Decipher test (which most hospitals can order) which uses your biopsy sample to determine how aggressive your cancer really is and if it is the type that will metastasize. Don't know if you've had this test but if you have not, I URGE you to have it so you can really make an informed decision.
I personally know two people who've had biopsies (one of them a 4+3) and on the basis of their Decipher score, Sloan Kettering recommended Cyberknife - and they are a very conservative institution. I was really reluctant to weigh in on your question because of the anguish involved in the final decision but I decided that the more you hear, the better.....your surgeon is not going anywhere and at a 3+3, neither are you - HA!! Best of luck with whatever you decide!!

AL

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Replies to "Well, looks like you've made up your mind about having surgery. At a 3+3 my personal..."

You were so thorough on your comments. Good job on educating all of us. My husband, Jim, is set up for the pacer surgery on 3-14-24. He will do a CT and MRI scans on 3-15-24. I'm presuming that Proton Beam therapy will begin the following week. After reading everything on hormone therapy, he has decided not to have it. They are recommending 18 months of Eligard. He thinks that the potential side effects of possible stroke and heart attacks for all the hormone medications is not worth the risk. He hasn't informed the radiologist yet. Has anyone done the proton Beam therapy without hormones? He was originally going to have a RP but the surgeon said that his prostate is on the large side and he couldn't guarantee that he wouldn't have major urine challenges. The surgeon is the person that recommended radiation. He is 73 and in very good health otherwise.