Do you regret having had a prostatectomy vs. radiation, or vice-versa?

@edtrucks
When I was diagnosed with prostate cancer if 2023 my R/Os recommended radiation.

Mayo Jacksonville only has photon (building new cancer center which will have Proton). I went through consultation and was to get SBRT. It is a good treatment program.

My PCP wanted me to get second opinion on proton radiation offered at UFHPTI. I did and found I wanted proton based on consultations. My PCP agreed was best for me.

Both radiation treatments successful outcomes are the same. The main difference is that Phtoton enters body at full strength radiaes all tissues and organs in the beam path and exits the body at full strength. Been around very long time and excellent outcomes.

Proton enters the body a low dose, when programmed location is met then realeases the full dose it is programmed for and done not exit the body it stops at where it is programmed to stop (sometimes margins past prostate are programmed in).

So the rationale is that proton radiation will not cause a much secondary damage to other tissues and organs than photon. Proton is used with children as have long life span and the secondary cancers would be lessoned. Proton is also used on eye, brain, etc. because of the ability to tighly control the radiatin beam entering, treating, and does not exit body affecting other organs and tissues like photon does.

What is the difference in succsss rates between them, none. So the rationale of using photon is to lesson the chances of secondary cancers caused by photon hitting other organs and tissues and or radiation damage done to other healthy tissues and organ.

The side affects are similiar because you are talking about radiation of the prostate so both side affects are similiar. If you are interested in learning more about proton radiation I recommended contacting UFHPTI and asking for their handout package. It is free and now obligation to be treated there. In addition to their programs there they include tons of research on proton radiation, and include two books (Walsh book is on of them) on prostate cance.

The long range studies are ongoing about the difference in treatments and short and long term side affects diffference in both types of radiation and different treatments. UFHPTI was give an 25 million dollar federal grant to do long term study on this subect. I am a participant in that study.

Generally prostate cancer cells have testosterone receptors and are activated by testosterone. The inhibitors block these receptors and are often successful at stopping, or at least slowing growth of cancer cells. However, if the cells have multiplied many times they become less like normal prostate cells and can lose their testosterone receptors. then this approach stops working and PSA goes up. This may take many years. Personally I would prefer radiation therapy in this situation.

I also had a robotic prostatectomy in December 2010 at age 60 and had all the usual side effects which I have described elsewhere in this thread. Fortunately my PSA is still zero.

My father had a high PSA at age 84 and was treated with hormone suppression with a GnRH inhibitor, and it seemed to work well for about 9 years. Then his PSA jumped and he had extensive metastatic disease and died at the ripe old age of 94. He said he regretted not having been offered radiation therapy or surgery.

I did not have Cribiform, I did have a bulge and lost some of my nerves, but was also 3 + 4 mostly with some 3 + 3.

In 2006 robotic surgery wasn't what it is today either!!! Robotic surgery has made leaps and bounds in perfecting procedures with much less side effects to surrounding tissue!