Why would my doctors recommend surgery over radiation?

I also was a 4+3 in 2 cores and 3+4 in two out of 30 cores. My prostate must be bigger than yours but my PSA was only 2.9 and had been for 5 years in the 2.3 to 2.9 range. I elected the 5 proton radiation treatments because I am 74. If it comes back in 15 years that makes me 89. I don't want to die in a nursing home.

I made the decision to have my prostate removed. Best decision I could have made. Gleason 3+4, PSA UNDER 6 for the ten years that I tracked it, MRI PIRAD 4, and not liking that surgery after radiation might not be an option. I was having alot of troubling since as it turned out I had alot of benign tumors impending flow. My bladder had "folded" into itself due to 100+ gram enlarged prostate.

June 8th '23 Dr Pathak, Jax Mayo removed prostate, 10 or so lymph nodes, seminal vesicles, all with no margins! Found one cancerous lesion with no margins found anywhere. Cancer was 5% of prostate and was close to the edge of prostate.

I just couldn't sit well with the idea of watching. Felt like waiting for the bilges of the ships, I used to Captain, to really fill up high before pumping them out!

I wish you luck and good health with your surgery. Best to get the one pair of rats out of the attic before they start their extended family.

One last thing. I was fortunate to have a great surgeon and Mayo staff, minute incontinence (3 months of Kegals before surgery), no margins, no impotent (generic Cialis 5 mg) AND -3 hours between trips to bathroom.

It's a hard decision to make about surgery. Expect success and be patient. Never let the failures and side effects stop you! Be patient.

Thank you for the words of encouragement.

Having a surgeon recommend radiation is a cause for celebration believe me! They almost always recommend the knife (if all you have is a hammer…)
The hormone decision is a tough one - facing it myself. Since my cancer came back after surgery it must be pretty tough so I am not taking any chances - gonna do them along with radiation to weaken this thing as much as possible and hopefully kill it. I am working closely with cardiologist and he gave me BP and cholesterol meds and aspirin to lessen effects of hormones on the rest of the body and hopefully prevent stroke or heart attack. If your husband has a high Gleason or Decipher score that would be the best indicator of how aggressive his cancer is. You don’t want to go thru proton therapy and then NOT kill the cancer….then it’s a life of hormones, right?
He really has to talk to the radiologist and get as much info as he can. Best of luck to you both!
AL

I am 70 years old just had MRI Fusion perineal biopsy, 23 cores total 6 were Gleason 4+3 Grade 3 w/ 70% 3 were Gleason 3+4 Grade 2 40% Mayo doctors are talking surgery, or I guess I could do Proton Radiation, both have side effects, Why is no one talking about the HiFu ultrasound, Tulsa Pro or Brachytherapy, all seem to have less side effects, I only have a lesion / small tumor on one side so would be a good candidate for focal therapy, I've even read about laser focal therapy which uses heat to destroy only the small ( 12mm) cancer area. While there are sucess stories for RP and Radiation, there are also horror stories, and I would never consider hormone therapy, just too many negatives. Quality of life is more important to me than quantity, and if can get 5-10 more good years I'm happy

I think HiFu and Tulsa pro you have to pay out of your pocket. It is also many treatments, not just one and done. I looked into it. Promising, need cash up front

I am gleason 9 CR PC diagnosed at 74 ( 3 years ago ) I had 6 months of ADT and Erleada, then RP then 6 more months of the meds. The surgery and the meds were all manageable and in hindsight , I think that the doctors recommended the right procedure. My PSA is .01 and I am hoping for more years with my friends and family Good luck to you

Hello, I have been newly diagnosed in the last month. I am curious to know what treatment option you have decided to go with. What gleason score did you get? Thanks.

You can choose what ever treatment you want. Some of the other treatments are not covered by insurance. Some of the other treatments want cash up front and are still considered not as effective. Some are free because they are experimental. The choice is your but May not be offered by your doctors.

Having radiation first severely limits the treatment of robo surgery should the cancer return after the initial treatment, however, having robo surgery first will not limit the later use of radiation. That is the reason that I elected robo surgery. The surgery was not painful and recovery was fast. It must be done by an experienced surgeon at a high quality facility. Good Luck