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Prostatectomy or Radiation? Lot of stress over which to choose
Prostate Cancer | Last Active: 3 days ago | Replies (116)Comment receiving replies
@paulsheldonfoote While I do agree that a significant percentage of surgeries ‘fail’, some pathologies such as cribriform or IDC are not completely eradicated by radiation. Nor are those cells which give a high Decipher score.
If you are in the lucky category of complete glandular containment and have none of the contributing aggressive pathologies, SBRT is definitely the way to go.
But some of us view surgery as merely the first stop on a long train ride with no idea how many stations we’ll have to pass!
Phil
Replies to "@paulsheldonfoote While I do agree that a significant percentage of surgeries ‘fail’, some pathologies such as..."
@heavyphil
He really hit the nail on the head with the fact that radiation doesn’t always get IDC and cribriform.
Those are cases where HDR brachytherapy could finish those things off. Problem is, that’s not done very often.
At recent ancan.org Advanced prostate cancer meetings Rick has been talking about this and the fact that IDC is really aggressive and has to be treated aggressively. He tells people they should get surgery, followed by radiation If appropriate. It’s been brought up in multiple meetings since IDC seems to be pretty common with advanced cases.
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@heavyphil
I had asked one radiation oncologist for SBRT. She refused. She said that at my age and physical condition that SBRT would result in a very long recovery time. Today is my last day of 28 days of EBRT. I understand now what she meant. My sleep will be interrupted for a long time because of running to the bathroom.
I agree about the long train ride. Every 3 months, I shall be going for PSA blood tests. If the result is bad, then I shall need to do another PSMA PET-CT. As you noted, PSMA PET does not identify some IDC-P cases. If I need another stop, the next stop might be a brachytherapy boost. I have not heard any oncologist mention that more than 30,000 men die annually from prostate cancer (not with prostate cancer) because they do not respond to any of the treatments.
For men who live near proton beam facilities, I urge them to read:
You Can Beat Prostate Cancer And You Don’t Need Surgery To Do It by Robert Marckini.
Paul