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Deciding between radiation and prostatectomy
Prostate Cancer | Last Active: Mar 19 10:36am | Replies (74)Comment receiving replies
3+4 grade 2, Decipher .46, psa 2.93, bilateral PC.
SBRT, prostectomy using hood technique, nerve sparing. I am 74.
Struggling with SBRT vs Prostectomy using hood technique.
Thank you for any input.
Replies to "3+4 grade 2, Decipher .46, psa 2.93, bilateral PC. SBRT, prostectomy using hood technique, nerve sparing...."
@ray092271
SBRT Sure looks like it would be a good choice for you. 3+4 With radiation you have a very good chance of long-term remission.
Of course, if they can spare the nerves with surgery, it would be better than SBRT, which will definitely radiate the nerves resulting in ED problems down the line in a year or two.
Then again, you never know what’s gonna happen with surgery. They do have solutions to the ED problems that might happen with either treatment.
Were any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive. I’m just wondering why you got a .46 on the decipher, was something found that you didn’t mention.
@ray092271 Hey Ray, it’s really a coin toss, sorry to say; but I will tell you this.
When I was diagnosed at age 64 with Gleason 4+3 in most of my prostate, I consulted two different RO’s who said they could treat me successfully.
I then went to a very well known NYC prostate surgeon.
After looking at my biopsy report (which wasn’t good) he sat back and said, “You know, if you were 10 years older, even I would recommend radiation; but you’re too young and there’s a good chance this could come back.”
I had surgery but my point is that even this surgeon - who had something like 4000 RARP procedures on his resume (also worked with pioneers of DaVinci system) - was recommending radiation IF I were 74 - your exact age.
Take that for what it’s worth but my diagnosis was far worse than yours and even the famous surgeon was advocating radiation for men in your age range. Best,
Phil
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@ray092271 There are a lot of harsh, immediate side effects from an RP that may only improve to certain degrees or not at all. The side effects from an SBRT treatment are most often non-existent or very mild. You can most likely obtain a durable remission (closest thing to a cure) with either treatment (RP or RT) given your mild pathology. Keep reading lots of accounts on this forum from RP and RT guys to get a feel for what generally happens from each treatment. I chose radiation and am really happy I did. See my bio for more details.