Radical prostatectomy (RP) vs radiation post age 70

The data suggests that roughly 80% of people have no ongoing issues. 20% do. If it were me, I wouldn’t get too wrapped up in individual experiences but ask yourself how you feel with those odds. Life is a gamble and both approaches have their limitations. I wish you the best.

Are there benefits of RP over
Radiation?

72 at surgery. Excellent surgical recovery and continence.
Gleason 9.
I wanted the cancer removed and felt that RP gave me a chance at a long term cure.
Also reserved radiation for secondary treatment if needed. And for me, secondary treatment was needed.
I would opt for surgery again if I had the choice.
Begin PT w/ professional Kegel exercise training before surgery if possible.
Must note that many men have done well with radiation as their primary treatment.
Best wishes in making your choices and for a good result.

One of the benefits is the availability of Radiation after RP should it become necessary. If you have radiation first, it's likely that the tissue will become damaged to some degree so should you have a recurrence the operation as a secondary treatment becomes somewhat more difficult and specialized.
That was the deciding factor for me...and I had a recurrence, simply went or the 39 radiation treatments and ADT. Doing okay for now.

Best of Luck to you!

I was 74 a year ago when I had surgery. Full continence came back after 4 months, full erectile function after 9-10 months. My surgeon says my recovery was aided by my "normal" BMI of 22.5 and my habits of exercising 10 hours a week running biking swimming weight lifting (my resting heart rate is in the 40s). I would add daily attention to pelvic floor muscle physical therapy and penile rehab also probably helped.

Good morning. I am 71. In excellent health. Diagnosed with 3+4=7 in one core and lesser cancer in another of 14 taken. I quickly decided on removal in November. My doctor emphasized doing Kegel exercises. I did them daily for the 5 weeks prior to my surgery. My surgery went fine. My pathology report showed my cancer at 4+5=9 and right at the capsule. After removal of my catheter my doctor increased my Kegels to twice every hour. 10 quick and then 10 with a 4-5 second hold. I did them every hour I was awake. I had ZERO incontinence. Even my surgeon couldn’t believe it. My first blood test for PSA came back undetectable. My second is today. Praying for more of the same. I know every man can have different results. But seeing that you and I seem very similar I see no reason why your outcome isn’t as good as mine. A skilled surgeon, doing those Kegels, and prayer. Best of luck! 🤞🙏🏻

I had Robo RP 33 months ago when I was 74. G9, locally advanced , CR. I elected surgery as I wanted to preserve the option of radiation in the future as CR , G 9 means to me that this cannot be cured and I will be on several different types of treatments until all of them stop working. I am completely continent but have ED. I handled the surgery and 13 months of ADT and Erleada satisfactorily. In hindsight, I think that my treatment was the right way to go.

Would you mind sharing who your surgeon is? Was it at MAYO? Thanks!

Milans: I had the same choices as you did. I chose a narrow margin, Radiation machine specifically with 2 mm margins to avoid over exposure to my healthy tissue. It had a built-in MRI so that what you could see is what you could treat with automatic shutoff and dynamic planning. Most of the other radiation treatments use 3 to 5 mm margins. I had five hypo fractional treatments. I had some urinary restriction, but that was taken care of by Flomax. I had no ED issue, pain issue, no catheter issue to deal with and was happy with my treatment. Like many, I was happy with my choice and would do it over again if I had a biological reoccurrence. I consulted with five radiation oncologists, one urologist and spent a good deal of time on this web site, before I made my decision. I also had spaceoar inserted.

Milans: I had the same choices as you did. I chose a narrow margin, Radiation machine specifically with 2 mm margins to avoid over exposure to my healthy tissue. It had a built-in MRI so that what you could see is what you could treat with automatic shutoff and dynamic planning. Most of the other radiation treatments use 3 to 5 mm margins. I had five hypo fractional treatments. I had some urinary restriction, but that was taken care of by Flomax. I had no ED issue, pain issue, no catheter issue to deal with and was happy with my treatment. Like many, I was happy with my choice and would do it over again if I had a biological reoccurrence. I consulted with five radiation oncologists, one urologist, spoke to several service/manufacturers in the industry and spent a good deal of time on this web site, before I made my decision. I also had spaceoar inserted.