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Radical Prostatectomy vs. Radiation therapy?
Prostate Cancer | Last Active: Apr 21 7:39pm | Replies (52)Comment receiving replies
@readandlearn After you have read hundreds of case histories across multiple forums, patterns, trends, and percentages start to burn in to your memory. The 90% number of incontinence and ED complaints coming from RP patients versus RT patients is one such number. If I were to tally the actual count, I think it would be likely higher than 90%. Anyone can just do their own small sample tests on case history posts and see what I mean.
Concerning urologists often being surgeons, that too is a trend I picked up from reading so many case histories. So, of course, not every urologist is a surgeon and not every surgeon will recommend an RP for every case. There are certain circumstances where an RP or radiation is clearly the better treatment. However, a trend that I saw repeatedly was a patient being "railroaded" down a certain path, and most often down the RP path. Patients would often admit that this happened to them without them realizing what was being done. The advice from many such patients was to do your research, talk with as many patients and doctors as possible, and get as many perspectives as possible. As I began to do this myself, I came to the opinion that radiation would have been better for many cases that been steered into an RP. Of course, each case is unique and often either approach would often work well so it is not a cut and dried decision.
In my research, many patients complained that RP side effects are underreported in official statistics and that when you talk amongst many RP patients you get to see what the real statistics are on incontinence and ED. Reading accounts on the forums are a great way to do that.
Even today, the current statistics given by google on how long a man will typically live once diagnosed with metastatic cancer are completely wrong. Google will say something like 5 years to live is typical and yet virtually every metastatic guy on this forum will tout all the new drugs like Nubeqa that has let them live far longer than that. Not to discount the current studies, videos, and books, but the best information comes from real patients talking right now on forums.
Replies to "@readandlearn After you have read hundreds of case histories across multiple forums, patterns, trends, and percentages..."
Hi all, time for a gentle reminder about the Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/. Please review.
As someone who manages this patient forum, I completely agree that great information comes from patients/caregivers supporting patients/caregivers as they journey with prostate cancer and navigate their health and care.
However, forums can give an unintended bias. People who do not experience side effects are less likely to post on a forum or once resolved may discontinue participation. We're lucky here in the Prostate Cancer forum that many members stick around to share their tips and recovery stories.
Drawing conclusions and statistics from online forums does not represent a patient population objectively. Forums can however reveal themes that can be used as a starting point to discover research questions that can and should be explored in objective, randomized controlled studies.
All information shared by members on the Mayo Clinic Connect is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community.
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@wwsmith The old adage “When all you have is a hammer, everything looks like a nail” can be applied to almost every area of medical expertise.
Unfortunately, many, many specialists feel that THEIR chosen field holds all the answers - which is what attracted them in the first place. RO’s are gonna push radiation, Urologists - surgery…it’s only natural.
Since most men are usually seen first by a urologist, poked by the Uro, sent for scans by the Uro and biopsied by the Uro, they tend to bond with the Uro favor what he/she tells them and that is surgery.
Of course, there are Urologists who work closely with ROs in centers of excellence or big teaching hospitals and they may refer - and DEFER - to the RO, but I don’t think that’s common.
Without any evidence to back it up, I’ll go out on a limb and speculate that the more educated patient, or the more financially successful one will seek out second and third opinions after his urologist’s.
The less informed or those relying heavily - or totally - on medical insurance or Medicaid don’t have the time or luxury to educate themselves on all the options open to them. They trust and blindly follow, thinking that ‘Doc’ has their best interests at heart…ergo, probably more surgeries done by a lot of mediocre Urologists who do a few (?) per month leaving incontinence in their paths…JMO
Phil