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Deciding between radiation and prostatectomy

Posted by cjp63 @cjp63, Jun 17, 2024

After my MRI biopsy with a gleason score of 3+4, I was strongly advised by my urologist to go for treatment. Which procedure is best? Side effects?

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Profile picture for ray092271
ray092271 | @ray092271 | Mar 18 6:52pm

Phil thank you for the detailed information. I appreciate it.
Especially like no wrong choice!
I tend to think and rethink.
So appreciate your input!

Ray

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Moderator
Colleen Young, Connect Director | @colleenyoung | Mar 18 7:44pm
In reply to @thebeej "So glad I have found this group of sharing souls. I really need the support and..." + (show)
Profile picture for thebeej @thebeej

So glad I have found this group of sharing souls.
I really need the support and encouragement, and dare I say, optimism?
I am Gleason 7, 3+4 with favorable for spreading. My radical prostatectamy is the Monday after Easter and I am trying to stay optimistic.
My father survived prostate cancer and had his removed 25 years ago, so I was on the high-watch list since then. My PSA has fluctuated around 4 since then every six months, so there was no alarm. Just regular monitoring. In summer of 2024 the PSA was 3.1. Last summer it was 5 and my new doctor --suggested an MRI, then biopsy. Last April, I ran a half-marathon. This April I am having prostate cancer surgery.
My urologist/oncologist is optimistic, as I guess he should be.
But I'm praying this robotic surgery can get it all? And fearing spreading.
And ready to take on any challenge it is has gotten out.
Thanks friends, for reading

Jump to this post

@thebeej, you have many reasons to be optimistic. Your doctor gives you a favorable forecast. Your father fared well. There are many men here in the group who have run races post surgery too, like @jerryegge @web265 @ava11 @trusam1 @thehowlingdog.

Being fit will serve you well. This year's half-marathon will be surgery and recovery. And next year's goal?

It's natural to worry about spread and question whether surgery will be successful. I wonder if the tips shared in this discussion will help focus on the things you can do:
- Prostate cancer surgery: What can I expect & prepare for?https://connect.mayoclinic.org/discussion/48-about-to-have-prostate-removal-surgery/

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Profile picture for lyricw
lyricw | @lyricw | Mar 19 8:50am

I was 3+4-7 & had choice SBRT or RARP. Radiation concern was proctitis, cystitis, delayed ED & incontinence. RARP concern was ED & incontinence. Radiation includes several mm around prostate for any seeding of prostate bed. I had RARP a week ago & post-op path shows 2 0.5mm PSM. One advantage of RARP is salvage radiation in case BCR. Radiation BCR consider spot ablation procedure or spot radiation but generally not surgery.

I chose RARP because age 69 & opportunity to remove cancer yet backup radiation if required. Radiation would have gotten. One around prostate. I would lean more radiation if mid 70s or older.

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thehowlingdog | @thehowlingdog | Mar 19 10:36am
In reply to @thebeej "So glad I have found this group of sharing souls. I really need the support and..." + (show)
Profile picture for thebeej @thebeej

So glad I have found this group of sharing souls.
I really need the support and encouragement, and dare I say, optimism?
I am Gleason 7, 3+4 with favorable for spreading. My radical prostatectamy is the Monday after Easter and I am trying to stay optimistic.
My father survived prostate cancer and had his removed 25 years ago, so I was on the high-watch list since then. My PSA has fluctuated around 4 since then every six months, so there was no alarm. Just regular monitoring. In summer of 2024 the PSA was 3.1. Last summer it was 5 and my new doctor --suggested an MRI, then biopsy. Last April, I ran a half-marathon. This April I am having prostate cancer surgery.
My urologist/oncologist is optimistic, as I guess he should be.
But I'm praying this robotic surgery can get it all? And fearing spreading.
And ready to take on any challenge it is has gotten out.
Thanks friends, for reading

Jump to this post

@thebeej To jump on Colleen's post: my Gleason also was 3+4, PSA jumped from 4 to 14 in one year. At 71 ran half marathon on Oct 16, radical prostatectomy on Oct 31. Back running again end of Dec, marathon end of April. 4 years later I log at least one half and one full marahon every year since along with numerous 5K, 10K and 10 milers. You'll be golden. ONE word of advice: do those f'ing kegels, they work!

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