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Surgery or Radiation?

Prostate Cancer | Last Active: May 30 3:05pm | Replies (43)

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@vircet

@ava11 What treatment did you have? I hope your choice went well.
I just found this thread a month after I had my 5-fraction (5 x 8 Gy = 40 Gy) SBRT, and after I read the @brianjarvis post shown below: No statistically significant difference in outcomes between surgery and radiation -- as my doctors said.
I'm 68. My initial choice was RARP surgery, but my family was quite concerned about it. After doing more research/readings, and consultations with my PCP, medical oncologist, and radiation oncologist, I finally chose SBRT. (The urologist who did my biopsy does open surgery with another surgeon in a regional hospital. He referred me to the MO and RO in a cancer center where they do about a thousand prostate SBRTs annually, and more for other types of cancer.)
It's been a month and two days now since my last (5th) radiation treatment. Except for the loss of libido, I have not encountered the side effects that I have prepped my mind for, like hot flushes, fatigue, depression, etc. associated with ADT Orgovyx that my RO said we would see if I could stop after 8 months or a year.)

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Replies to "@ava11 What treatment did you have? I hope your choice went well. I just found this..."

@ava11 I found your updates already in this new thread: https://connect.mayoclinic.org/discussion/prostate-mri-results-one-year-after-sbrt/
Thanks for updating our community.

You’ll find many studies showing success rates comparing surgery with radiation being statistically equivalent no matter which treatment is chosen (https://www.nejm.org/doi/full/10.1056/NEJMoa2214122).

And that paper studied outcomes even before today’s availability of precision radiation, PSMA PET scans, and other modern technologies.

It mostly comes down to side-effects and quality-of-life (or as that paper concludes, “… the choice of therapy involves weighing trade-offs between benefits and harms associated with treatments for localized prostate cancer.”).