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← Return to prostatectomy vs radiation?
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The idea that “if you choose radiation first, you cannot have surgery later” has some truth to it, but is old-school and doesn’t consider modern treatment techniques.
If there is local recurrence after initial radiation, these days choice of treatment would depend on the nature of the recurrence; there are other options - focal therapy (e.g., cryo), brachytherapy, SBRT, and yes even re-radiation (w/rectal spacer) in some cases. Dr. Rossi answers a question about this in his presentation during the 2023 Mid-Year PCRI conference: https://www.youtube.com/live/WTqPnSRYtW4?feature=share
—> Starting at time: 4:53:00.
(I personally know two guys who had their prostate cancer recurrence re-treated with SBRT, because the recurrence was a single spot.)
So, I wouldn’t let the old school “no options if recurrence after initial radiation” philosophy change an initial radiation treatment decision.
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@brianjarvis
I am glad you posted this.
I have read post where if you have radiation you cannot have surgery. That is not correct.
What the issue is that radiation causes a lot of damage to prostate and margins. It does not make a good surgical organ to remove after radiation damage to it and the margins. What I was told a Mayo and my own research is the bottom line not many urologists out there experienced and expert enough to do the surgery and thus most do not want to do them.
However there are (per Mayo) urologists that do do surgical removal of prostate and other tissues after a patient has had radiation treatments. They are just hard to find as requires some really expert ability.
Again I am glad you posted your post as it echos what I have been told by my medical care team.