Newly Diagnosed

I had HIFU seven years ago. No problems prior to the proceedure and none after. Check it out. It's the least invasive way to kill the cancer.

My husband had his PSMA Pet Scan and the cancer is localized. We have met with the Radiation Oncologist and next will be meeting on Nov. 19th with the Surgeon to get back sides. I think my husband is really interested in the surgery but based on what I have read the radiation provides a better longterm outcome. Please advise if someone can give me some insight.

@tbyota
Did your R/O mentioned the Decipher test? It is a test genetically on the biopsies taken for a more accurate risk level of his PC.

Your husband is still young these days so that is an equation a lot of us on MCC did not have.
Why is he leaning toward surgery? What are his R/Os and urologist recommending. Was ADT mentioned?

I chose proton radiation 30 rounds low dose and was not required to take hormone treatements as my Decipher test came back low risk not the initial intermediate risk per my Gleason Score. That is why I promote the Decipher test as was so influential in my treatment plan.

I am sure on MCC you will see surgery and radiation all have their pros and cons. I am not sure your source of radiation is better than surgery. I would think the experience of the surgeon doing a surgery and the comprehensive prior test would be the key to long term success. The major factor on success is that the cancer has not spread outside the prostate.

Most, not all, PC are slow growing and if caught early and still inside prostate has an very high cure rate. A lot of poster want to get rid of prostate with cancer inside versus damaging the cancer via raidation and having it die.

So really comes down to a individual choice made by the individual of what is best for him. I do though like many other posters suggest doing a Decipher test to verify the risk level of his cancer. The results of PSMA test was extremely good.

There are many forms now of radiation therapy with high dose short term and low dose long term. I had low dose of proton radiation and 30 rounds. Yes some minor side affects but not at all life changing.
Good luck on you and your husband decision.

Thank you for the information. No I dont remember the Decipher being mentioned but I will discuss with the R/O. I think he is leaning towards surgery because it is one and done so to speak. However, he is reading more about both and seeing Radiation although daily for a while is a option. Also, I think because if you have radiation you cant go back later with surgery.

You're approaching this in the right way: get as much info as possible from multiple experts (urologist, RO, others who have made this journey). There are many many factors which can influence your decision--some you've mentioned: age, Gleason, etc. Some not mentioned--size of prostate, BPH?, family history, genetics, etc. Because most PC is slow, you don't need to rush to decide. But a thoughtful, careful decision will be a relief in itself.

@tbyota
I agree with others that suggested Decipher test. Also, he can ask for Prostox test that will determine his reaction to radiation. Some people are genetically more sensitive to radiation toxicity and can have higher incidence of long term side effects.
Regarding having surgery after radiation, it is actually other way around. Radiation damages prostate to the extent that it is almost impossible to remove it after radiation. Only a few surgeons have expertise to do it or are willing to do it. Many people choose RP because after surgery they can have salvage radiation if cancer ever returns.
Both RP and RT have the same success rates except in rare cases when pathology shows IDC or cribriform gland present. In that case RP has some advantages according to some scientific papers.
Regarding weight problem - I would advise that he tries to loose weight because weight loss is very important for long term cancer control since obesity is proven risk factor for prostate cancer. If he is not willing to reduce caloric intake and to start exercising program, maybe he can try Wegovy . I think that it is approved for weight loss now and especially if person has any cardiac problems.
Whatever you decide, I am wishing your husband super successful treatment and complete eradication of cancer < 3

Thank you. He has started back exercising and reduincy intake. I will be asking about the test.

He is exercising and reducing his intake

Im just curious. My husband has stage 3. If you have radiation but not the surgery and it returns what are your options?

@tbyota
First steps would be to get a PSMA PET scan to see if there’s metastasis that can be zapped with SBRT radiation.

The next step would be to go on ADT and an ARSI (Zytiga or a lutamide) To suppress whatever there is and stop it from growing.

If many metastasis are found Then chemo or Pluvicto Could be used.

You should definitely have genetic testing to see if you’ve got a genetic problem. You can get it done for free here.

Prostatecancerpromise.org

Don’t say you want your doctor involved when filling out the form online or they won’t send you the kit until they speak to your doctor. If certain genetic issues are found there are drugs for them specifically.

Did your husband get a decipher test? It will show the likelihood of the cancer coming back. Definitely speak to your doctor about that.

All of the steps mentioned will be done in coordination with a doctor or even more than one doctor.