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I wouldn't expect anything else from a surgeon. He is well respected in his field, but surgery would have been my last choice. I know some guys have had great outcomes with surgery, but the odds are not as good when it comes to side effects with surgery compared to Tulsa. I'm super happy that I chose Tulsa, and if I need a salvage treatment I'm ok with that as long as it's not surgery. As I hoped and expected, I have had zero side effects, but "possible" recurrence.
When it comes to recurrence, these are the stats I found.
Surgery - 80 to 90% cancer free 10 years
Radiation - 70 -90%
Tulsa - 70 - 85% (5 year, still new)
But look up odds of side effects and you'll see why I chose Tulsa. Erectile problem up to 50% with both radiation and surgery. Up to 20% Tulsa. Urinary tract complications are less likely with Tulsa too. Everyone has to decide what is most important to them. Quality of life was my main driver.
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@paulcalif You seem to be totally in the know about your focal therapy and the possibility of a negative outcome. You chose it for quality of life issues and I can’t blame you - surgery sucks.
But if your cancer is truly back and you really want to kill it once and for all, ADT will probably be suggested as part of your treatment and QoL issues will once again, have to be addressed.
Please keep an open mind before you say NO! To ADT. If your cancer came back, even if it wasn’t considered high grade or aggressive before, it could be now.
Radiation alone may not be sufficient to put it down and ADT can certainly help achieve that. You will hear and read that ADT will give you an extra 3-5% chance to avoid yet another recurrence, but don’t hold hard and fast to that. This is a MoFo of a disease and it never shows its true colors. A wise Urologist once said to me “Six months of Orgovyx isn’t gonna kill you” - and he was right…Best,
Phil
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@paulcalif
I’m with you Paul! I did my Tulsa in July of 2024. PSA has remained stable at 0.8. And 3 clear MRIs. I am perfectly OK with the fact that I may have just kicked radiation or something else down the road a bit. I was continent the day the catheter was removed and back to sex the same week.