Deciding: Surgery or Proton Radiation + ADT

@gently Thank you!

Hi Dave, If you have a low Decipher Score - or similar test for aggressiveness - my personal feeling is to opt for radiation at age 74.
Please do your homework, but I am fairly sure that the 15 yr outcomes for both surgery and radiation are the same; side effects vary on an individual basis when it comes to radiation so be aware of this.
But if either treatment can get you to age 90 (in the optimal scenario) I think radiation is less invasive and much less life altering than surgery.
When I was diagnosed at age 64 with extensive Gleason 4+3, even the surgeon I consulted told me that if I were 10 yrs older he would definitely recommend radiation; and this was a guy who helped pioneer the DaVinci robot…Best
Phil

I went through the same process as you, yet with a Gleason 9 and no metastasizing. When presented with the options by my Urologist, I decided on radiation (photon) with ADT. The main reason being that I didn’t like the possibility of me having to wear diapers as a result of incontinence. This seems to happen more with elderly people who have surgery. Anyway, so far, so good after close to two years. Best to you on your decision..,

I had three choices in 2018: surgery, radiation, or HIFU. I chose HIFU due to it being the least invasive and the shortest recovery time. Not everyone is a candidate for it, but if the cancer is localized to the prostate, you're in luck. No problems after the procedure.

A blanket thanks to all! This info is very helpful and, if there are more responses, I welcome them as well. Will be meeting at Mayo with the radiation oncology this week and hope to learn more then about proton versus photon versus surgery.

@sicerno - hi - your situation similar to mine - gleason 8 - radiation n adt orgovux - 1st blood test - psa < .01. I been on adt for 6months now - dr. wants me to do 3yrs adt - just wondering how long you have been on adt n what duration they want you to do . I'm just having personal issue with length of adt n why? Any info you can offer . I finished radiation mid August - ty Gary

Hi Gary, thanks for the response.
I finished radiation in March and have been on Lupron and Zytiga plus prednisone for 20 mos. My treatment plan is for 24 months. During that time my PSA has consistently been at 0.00. Of course I have had to deal with loss of body hair and hot flashes.
I accept them as part of the plan and hope there is no “remnant” creeping around which might show up later. All in all, I am satisfied with the treatment, tho’ it has side effects.