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Significant disagreement between 1st and 2nd opinions, what to do?
Prostate Cancer | Last Active: 3 days ago | Replies (16)Comment receiving replies
Please don’t think that surgery is a definitive treatment for PCa! Doesn’t matter which TopDoc expert does the procedure; surgery has a 30-35% failure rate ((recurrence after surgery) and has a significant impact on your quality of life - impotence, incontinence, etc.
No treatment is without failures -none of them. All in all, if your cancer is confined to the gland (cannot guarantee this either), an excellent treatment is 5 sessions of SBRT using MRI guided technology: it has documented less marginal tissue damage, leading to better quality of life. Proton therapy is also excellent, but I am not aware of any head to head comparisons of it with MRI guided photon therapy but others on the forum may know of them.
Your overall strategy of being cautious before diving into anything is excellent, but this is a slippery adversary and there are NO guarantees of cure with any of the current treatment modalities.
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While I am fully aware that radical prostatectomy is not guaranteed to cure my cancer, hearing that 30-35% percent of RP patients experience a recurrence does surprise me a bit, if that is indeed what you meant. Does surgery equate to RP, or is it a broader category? And am I correct in assuming these percentages include all RP's, regardless of whether or not cancer had spread beyond the gland?
I'm sure I am guilty of some level of rosy thinking about my own case, but I'd be curious if people disagree with my perception that RP has the best chance of being a one-and-done treatment for a cancer that has not moved beyond the prostate? Probably too many variables to say with any certainty (and again, there is the unpleasant issue of continuing follow-up biopsies with focal therapies).
I'll just say it...radiation really scares me. I can't help thinking that a precisely wielded scalpel
will be more likely to remove all that is needed without going beyond what is needed than some poisonous, semi-predictable, particle-emitting chernobyl-seed being plunked down into a cozy warm bed of fragile soft-tissue. However, I need to learn, so I will take your advice and read about real people's experience with the treatments you mention. Thank you, Phil.