Radical prostatectomy (RP) vs radiation post age 70

6 week post RP PSA results back. < 0.01. 😀

I was G9, CRPC, 74 when RP, now 77. surgery was a breeze, catheter was an inconvenience but ok, 13 months of ADT and Erleada was not too bad, PSA .01 for last 24 months. I recommend RP. But for the PC you might be good for another 20 years so do the best for a good long term plan. Good luck!!

RP@age 74. Very mild incontinence initially, completely gone within 3-4 months. Did Kegel's 1 round a day is all. ED gone after 9-10 months. 8'd say 80-90% of good surgical candidates @ our age have similar results. Problem is, you don't know which category you're in until after the operation and recovery. God odds, but not 100%.

I had surgery at 72, 12 years ago. I suffer from ED (mostly due to age) and mild incontinence when sexually excited and at orgasm. See my post elsewhere here to see how we deal with post surgery issues and still enjoying our sex life.

Hello to any who chose radiation:
I have decided that the sbrt radiation MRI guided was the best for me.
70 years old, athletic, concerned about body functions. I have a 3 + 4 in a small percentage, psa 7.6, and a DNA score that influenced all the Drs to uniformly suggest surgery, and only after my research and presenting the data on radiation did some agree with the radiation choice.

How long ago did you finish treatment?
How did you feel after each treatment?
How did the fiducial and Spaceoar go?
Body functions all well (as Milans above)?
Wishing you all the best!
Thank you for sharing - all helpful and appreciated.

I had surgery in November. 71 years young, G9 with slight extension. I consider myself very healthy; exercise daily. I started Kegel exercises the 5 weeks before my surgery. Surgery went well. No complications. After my catheter was removed, I was told to do Kegels every hour, 10 fast and then 10 with a 4/5 second hold. I did them every hour I was awake. I had ZERO incontinence issues. Even my surgeon was surprised. My first two blood tests, including one this past week, were < 0.01. Praying for more of the same in the future. If you do your Kegels, have a great surgeon, make some changes in your diet and exercise, plus some faith, you’ll do fine. Best wishes.🙏🤞

stevpr8:
1) I finished 5 hypo fractional treatments February 15 2023
2) On the third treatment I started to feel a restriction with urine flow. I was prescribed Flomax before any radiation and started it on the third treatment. Flow returned by the next day.
3) I did not necessarily need the fiducials but the Dr. requested it and since she was doing the spaceoar at the same time, I had no issue. They had a spaceoar technician in the operating room and all went smoothly (its worth going to the spaceoar web site or calling them, to educate yourself. There is also a new one called BioProtect.)
4) I had no pain or bleeding. No ed but the energy in the orgasms were less but that has improved. Urine flow is generally good, good being defined as what it was before I had the radiation which was slightly restricted.

To this day, I believe the choice of the narrow margin Mridian machine was KEY to limiting healthy tissue exposure and therefore, side effects. All the best and good luck to you. One day at a time.

I had two sessions of HDR Brachytherapy at 70. There is no great choice, only a selection of which risks to avoid. No cath at home. No pain. No inconvenience in my schedule beyond having someone drive me home both times. No incontinence, no ED. But the inflammation after burning out your prostate does put more pressure on the urethra and it took longer to pee for many months. In the worst cases, up to 90 seconds to empty my bladder (but generally less). On the other hand, the radiation exposure does increase my risk of cancers in about 20 years (at 90+). Like you I am healthy and not obese so surgery was a good option for me. But the increased risk of ED, incontinence, plus wearing a cath for 10 days were factors for me.