Treatment Decision - Radical Prostatectomy versus Radiation Therapy

Could you ask the doctors what the treatment you’re having to your prostate to resolve your problem is called. Never heard of scraping it, is there a medical explanation/name for the treatment/surgery?

Good to hear the healing explanation, wasn’t sure what I missed about the radiation procedure.

Scott
The ellipses show the possible spread of the data.
When you take lab data and plot it on a graph, it doesn’t form a perfect line. Instead there is some randomness to the line. When you look at it it looks like a cloud of dots that form what looks like a line.
So the bigger the elipse, the higher the possible spread based on the data available.
If there were many more data points on the graph its possible that the ellipses would shrink and become more line like

Oh, I remember what you’re going thru very well. I was diagnosed in Sept’22, Gleason 4+3/7, psa 6. After testing my cancer was just over the “line”. My surgeon determined that I was not a good candidate for surgery. After transfer to my oncologist, he wanted to do brachytherapy but my pubic bone was in the way, which left radiation. The choice was long term or short term radiation with ADT. I opted for the short (5 sessions) and hormones. I received a total of 3 shots, 2 Elligard, 1 Firmagon. The shots were not fun and my testosterone is still low 18 months out. However, my results were excellent. After treatment my psa is .23 and I’m recovering very well, enough that my tests and visits are now extended to 6 mths. The overall treatments were not bad, however my biggest gripe is not being told of side effects or how long they would last. Stay steady brother, stay calm and you can do this.

I'm in a similar place. Diagnosed in August with Gleason 4+3=7 (intermediate unfavorable) but a PET scan shows no spread. Age 66. I was torn at first but a couple of things swayed me to surgery. I'm in a support group and among the about 20 guys not one chose radiation. I also was told that if surgery is not successful I can go to radiation, but if radiation is not successful the damage makes surgery more difficult. It's apparent there is no definitive choice, but I'm preparing for surgery on Nov. 11. Good luck whichever route you choose.

I too was Recently diagnosed and now stuck in that frustrating "no man's land" between surgery and radiation therapy. I am 75 years old in very good health, I don’t take any medications for anything. after blood test showed an increase in my PSA to 15 but no concerns about family history. PSMA PET/CT showed no evidence of seminal or lymph node involvement, no metastasis symptoms. initial perneaural biopsy showed Gleason - 4+4 from biopsy; meeting with radiologist this Friday. Like you my initial response was let’s just remove the damn thing.

My brother had a Gleason 4+3 and had radiation at 76 1.5 years ago. It seems to be quite successful. 5 sessions of SBRT. What was your Gleason? Did you have decipher testing? Those two things can change what you do. Have you had genetic testing? If you are BRCA2 they frequently recommend surgery.

Free genetic testing here, takes about three weeks and the genetic counselor will call you

Prostatecancerpromise.org

Make sure you don’t select the option for your doctor to be involved, that will delay it a lot.

At 75 many doctors recommend that you do not have surgery, too hard on the body at that age. I know I’m 76 now and quite healthy so I probably could handle it. Much depends on your health.

My Gleason was4+4. Genetics is negative.

Doug,
Yes, sucking the energy out is right! It was the biggest decision I ever made. I should say "we" because my precious wife suffered through each decision point as my sounding board. There were periods of what I called "analysis paralysis" and then I'd break through.

Now as for your decision, one size doesn't fit all. I'm talking sex and incontinence mainly. You have to "know thyself" as some famous Greek said. So for us, we took the "get it out of there" option. I don't believe you have given your age but I had surgery at 78 years old and would do it again in a heartbeat. My ultra-sensitive PSA test at 3 months was 0.006 and time will tell if they got it all. I'm down to 1 pad per day and improving and ED has required adjustment but is tolerable.

Here is a link to my COMMENT with my detailed story under the heading "Is 76 years too old for surgery" or words to that effect.

Best wishes to you, whatever your decision. You CAN do this!
https://connect.mayoclinic.org/comment/1075893/

I just had surgery a month ago. Was better in about 3 weeks. Had catheter in for ten day. I have some leakage but not bad. Should go away in 3 months. Healing good. Spent one night in the hospital. Nerve sparing surgery went very well. My surgeon had done over 300 robotic removal surgeries. Just wear a pad most of the time. First couple of day after catheter had a little trouble controlling urinating but that went away. I still urinate a few time at night. I just get up and go. I thought that might go away since I don’t have a prostate. Hoping that gets better. Raking and mowing the lawn now after 4 weeks

Thanks to everyone for the comments and insights. Really helps to know that others have experience that I can learn from. Have a few more questions in to my doctors and will be making a treatment decision early next week. Ready to get into the "doing something" phase.

Doug