1. < Prostate Cancer

Newly Diagnosed: Removal vs Radiation

Posted by survivor5280 @survivor5280, Oct 28, 2024

Hello, I suppose I'm exactly sure where to start this. I'm already a cancer survivor from 9 years ago, only to find out I now have prostate cancer (no metastasis detected, this is new).

My PSA's were off the chart so the biopsy was next, which revealed low Gleason scores in all but one core, which was a 7 (I would have to check if it was 3+4 or 4+3, but it's still 7). The core was sent for a Decipher which came back as high risk 0.68 out of 1.0.

Prior to getting the Decipher results (this morning) my regular urologist recommended removal, as I'm only 54 years old and he felt it was a good fit as I am young enough to recover from it and said that radiation can cause long term effects that I might not see until I'm much older.

In this same topic, my second urologist (long story, I have two at the moment) reviewed with me the Decipher score + my Gleason and also recommended removal.

Of course this terrifies me. The process itself, another robotic removal just like my kidney, isn't nearly as horrifying to me as the side effects of losing your prostate (ED, incontinence, dry orgasms, etc).

The consensus is for a prostatectomy, but I'm curious to hear others experience in this regard and if they felt they chose the right path given the circumstances. I know that there's no way to know exactly how aggressive the cancer is until the whole thing comes out, but I want to believe there are intermediary things that can be done to see if they help first - but I was told that generally once you do the radiation then prostatectomies are generally off the table.

I was hoping to find a support group locally where I could talk to others, but sadly in an area even as large as mine, it's very challenging to find one (for some reason).

Thank you.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

restlessandwild | @restlessandwild | Dec 14, 2024

I had four step recovery plan.

1) Heal from surgery (I had big bleeding after my stiches were removed (too early), several extra days in hospital)
2) Get rid of catheter (only one week, I hated it)
3) Get continense back, several months
4) Get erection back - it took about a year

Im 55years young, That was my recovery list most important first. Erection was only forth... Even its very important...

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jc76 | @jc76 | Dec 14, 2024
In reply to @northoftheborder "The trouble with isolated studies — no matter how credible the source — is that they..." + (show)
@northoftheborder

The trouble with isolated studies — no matter how credible the source — is that they more often uncover an accidental correlation rather than a direct causation: e.g. men who enjoy eating a lot of eggs and men who have a higher risk of advanced PCa have some other, unknown trait in common (genetic, physical, or otherwise).

(Also, CoPilot can be a useful tool, but apply a lot of healthy scepticism to its results. Generative AI mindlessly parrots information on the web, right or wrong, and then introduces its own errors to make it a bit like a game of broken telephone. Experimenting with ChatGPT, I've been able to generate exactly opposite responses about PCa just by rephrasing my question slightly. 😕)

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@northoftheborder
I agree.

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bjy1955 | @bjy1955 | 3 days ago
In reply to @peterj116 "I went with surgery. I also had Gleeson 7 (4+3) and I'm 60 years old. I..." + (show)
@peterj116

I went with surgery. I also had Gleeson 7 (4+3) and I'm 60 years old.
I looked at surgery vs radiation & among other things, it seems that surgery can cause bladder incontinence but radiation could cause bladder AND bowel incontinence.
Bowel incontinence was a hard No for me.

Also, I've read that if you go for radiation & they don't get all of the cancerous cells, surgery later becomes salvage surgery.
My understanding is that the radiation may cause parts of the prostate to turn to mush & the later surgery will then involve scraping the mush from the prostate cavity.
That's probably as accurate & successful as it sounds.

I also wasn't keen on multiple days off work for numerous radiation sessions.

That's my uneducated understanding, anyway.
What do I know... I'm just sitting here peeing myself.

Good luck.
You've come to the right place for guys who understand what you're going through.

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I was basically told the same thing, so I also underwent radical prostate removal. The surgery went fantastic, everything turned out great (with the exception of no nerve sparing possible). I too was afraid of the possibility of bowel and bladder problems. I do have basically a permanent light bladder leakage problem (this I was told to expect) but it's manageable using discreet pads, and as far as ED....... it's a fact. BUT 100% of cancer was removed (I was told), and tests have proven that to be so. 1 day in hospital and 1 week being careful at home and I'm back to enjoying life without the worry (plus no extra medication needed, just pee pads). I was 65 at the time of surgery.

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dailyeffort | @dailyeffort | 3 days ago
In reply to @mspotter1956 "Thank you for your reply, good to know. The AI recently provided very depressing stats about..." + (show)
@mspotter1956

Thank you for your reply, good to know. The AI recently provided very depressing stats about surving prostate cancer, which are no where near what they really are....

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Hi muspotter1956,

Just was reading through some older posts and wondered how you were doing? Did you get into the clinical trial you mentioned and, if so, which arm were you assigned to?

Like you, I opted to move my diet away from red meat, highly processed foods, dairy, saturated fats and eggs. How are you doing with the diet changes? I have adapted to the point that I truly prefer my current foods to those that I left behind. As far as giving up eggs goes, people always say you don't have to because... Perhaps that is true, they might not cause prostate cancer, but at their recent prices, I will be able to pay the cash price for Orgovyx, should I ever need it, with the money I have saved eating a nicely seasoned Southwest Tofu and Veggie Scramble each morning it their place. The white tofu is turned the color of eggs with some turmeric and the scramble has 2 cups of seasoned sauteed fresh veggies ( mushrooms, green and red peppers, onions, carrots, celery and broccoli) seasoned with chili, onion and garlic powder, oregano, black pepper and chipoltle pepper. This way I get a good start on my intake of veggies for the day and the pound of tofu actually helped me INCREASE my already good bone density during the two years I was on Lupron + abiraterone.

I hope you are doing well and look forward to some updates from you as you move ahead with life, if you are up for it.
Bill

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1 reply
mspotter1956 | @mspotter1956 | 2 days ago
In reply to @dailyeffort "Hi muspotter1956, Just was reading through some older posts and wondered how you were doing? Did..." + (show)
@dailyeffort

Hi muspotter1956,

Just was reading through some older posts and wondered how you were doing? Did you get into the clinical trial you mentioned and, if so, which arm were you assigned to?

Like you, I opted to move my diet away from red meat, highly processed foods, dairy, saturated fats and eggs. How are you doing with the diet changes? I have adapted to the point that I truly prefer my current foods to those that I left behind. As far as giving up eggs goes, people always say you don't have to because... Perhaps that is true, they might not cause prostate cancer, but at their recent prices, I will be able to pay the cash price for Orgovyx, should I ever need it, with the money I have saved eating a nicely seasoned Southwest Tofu and Veggie Scramble each morning it their place. The white tofu is turned the color of eggs with some turmeric and the scramble has 2 cups of seasoned sauteed fresh veggies ( mushrooms, green and red peppers, onions, carrots, celery and broccoli) seasoned with chili, onion and garlic powder, oregano, black pepper and chipoltle pepper. This way I get a good start on my intake of veggies for the day and the pound of tofu actually helped me INCREASE my already good bone density during the two years I was on Lupron + abiraterone.

I hope you are doing well and look forward to some updates from you as you move ahead with life, if you are up for it.
Bill

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I received the Tulsa Pro Whole Gland Ablation of the Prostate on March
12th. It was a complete success. My bladder/urinary control is almost back
to normal. My erectile function will normalize within 3 to 6 months, it is
now slowly improving.

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