Prostatectomy Question? Side effects outweigh benefits?

Perhaps people are too polite to say it, but any MD who says "we don't do prostatectomies anymore" is either misinformed, lying, or marketing (and perhaps more than one of those three?!) The MDs I'm looking for are able to talk about nuance, ambiguity, and relative values. They can discuss situations where certain treatment plans are preferable and situations where they are less desirable. They have experience as well as familiarity with research following clients who have had different presenting profiles and treatment plans over extended periods of time, including those for whom initial treatments proved inadequate and/or undesirable. They know not only their own opinions but those of their colleagues in the field, whom they respect. They have had patients die and grieved the loss. They have personally wrestled with tradeoffs between quality of life and length of life for people they care about, if not themselves. Those are the MDs I'm looking for, and they will generally be happy to provide the treatments they are best qualified to provide and familiar with colleagues who can provide the treatments they are not best qualified to provide. Any urologist of excellence, given the shortage in the field, has plenty of work and should not need to push people toward their own specialties. And an MD who is ethical in the consultation room is more likely to be ethical in the operating room, the radiology lab, and the chemo protocols, not to mention the billing protocols.

@spino

I agree 100%. I was shocked to read it since RP was and still is a "gold standard" for PC . That doctor is blatantly lying to his patient - unbelievable ...

As somebody already mentioned before, no scan in the world can see what can be seen during surgery and also after gland is out and examined in detail under the microscope.

If my husband chose radiation he would have been treated for 4+3 PC while in reality he had 4+5 gleason that was discovered after RP. Also, if patient has cribriform glands or IDC pathology , those features sometimes evade radiation treatment. After radiation it is very, VERY hard to remove a gland and very few surgeons know or want to do it, and one can not irradiate the same spot twice !
My husband wanted to have option of RT if he ever has BCR and we are very happy that he chose RP as a first line of defense.

BTW - both RO and surgeon suggested RP as a best approach for my husband's case.

My advice - if you have prostate cancer...find the highest quality, most skilled and well-reviewed urologist to do a single-incision DaVinci Robotic Radical Prostatectomy. Like my doctor told me when I asked about "active surveillance": you"have" prostate cancer and it is not going away...there is no need to watch and wait for two years, it is only going to get worse, so...I am taking your prostate...now." That said...while every surgery has its recovery issues, I still do wonder if I should have waited: my father lived to 99 years 10 months "with" prostate cancer and no treatment. But, he suffered greatly with horrible UTI's and sepsis his last five years. His doctor said he was now too old for the surgery, with which I agreed. My maternal grandfather lived to 96 "with" prostate cancer. It was diagnosed in the late 1970's and he lived until 1992 - roughly 15 years without many issues. He dies of Alzheimer's. He went for a monthly injection right into the prostate (ouch). My maternal uncle lived to within weeks of his 87th birthday and died of a massive cerebral aneurysm/stroke. He had his prostate removed about 10-12 years prior. They each had their issues, but none of them had my issues.
I just had my 6-month check up - PSA still < 0.1 ng/ml. But with "surgical margins" and cancerous tissue left in me, plus my diagnostic category/grade as a pT3b, my cancer has a very high probability of returning within five years. Had I left it intact and just done other treatments, I would at least be 100% continent and able to perform sexually. While I have regained 98% urinary continence, I have not had one erection in 6 months which is extremely depressing. You haven't shared your Gleason Score, your Decipher Test score, or the descriptives in your biopsy report, but I can tell you this: the Gleason Score doesn't tell you anything until your prostate is removed and the surgical pathology report is given to you. THAT is the tell-all report. My overly confident "we caught it early" urologist (Gleason 3 + 4 = 7 with only 6-10% of cells at "4" - so very close to still being a Gleason 6), was dumbfounded when my surgical pathology report came back with lots of other issues that threw me into the pT3b category. Yes...the post-surgical complications are unpleasant, but I read here that a lot of men do not suffer them at all, or for less time (we're ALL different). I still say get the radical prostatectomy...then you know the cancer is gone ("if" there are no "surgical margins" in the pathology report, which means your urologist left cancerous tissue inside of you, like mine did, which only happens 10-20% of the time). Good luck.