Diagnosed today w/ PCa. Seeking feedback w/ treatment I think I want

@johnt15

PCRI.ORG is where we begin to learn so much!

Glad you posted it Not a shill either!

Ray

@jeffmarc

Thank you sooo much Jeff. Appreciate all you do.

Ray

@ray092271

My prostate was small, 48.9 cc.

Hi,

With both surgery or radiation side effects(ED & leakage) are very possible. Surgery you get it right after, with radiation you get in months or years later. The newer one port prostate removal has very less ED and leakage problems. ADT is not very fun either but some of the newer drugs(Orgovyx) show less side effects. Talk to your medical team more in depth about treatment options.

Dave 3+4

@thig350
The catheter's only for a week and then it's over. And it's not that bad.

Hi, There is a one incision surgery technique that usually has less nerve damage which means less ED and less urine leakage, talk to your doctor team about it. Usually it is harder to surgically remove a prostate after it has been radiated but it can be done by an experienced surgeon.
Dave 3+4

@jeffmarc Hi Jeff, thanks for the reply.

I have not yet been treated but Ancan (Rick and Stuart) have helped me immensely. Both gentle pushes, understanding and help with connections and decision support . I have made a friend also who recently was treated and also lives in SEA and California (I used to live in California) so it has kind of become part of my life.

Can only speak from my own experience. I am T3a, chose robot assisted laparoscopic radical prostatectomy non nerve sparing. Most important to me was to remove the bulk of the cancer and get a good look at the cancer and where it might have spread because if needed this gives medical and radiation oncologist a better chance of fighting the cancer if need be in the future. Weigh the cost and benefits of all treatments do your own research and seek guidance from God.

On a statistical basis both a prostatectomy and radiation with ADT offer equivalent outcomes worth respect to disease-free survival and over all mortality. In the case of recurrence after surgery, salvage radiation and ADT are available treatment options. With radiation and ADT, if there is a local recurrence, surgical options are limited , but there are circumstances where surgery can be done and other options exist. Sadly neither approach is free from potential side effects and complications. As far as bladder and colon damage from radiation are concerned, preliminary testing can assess your risk of late complications. A hydrogel rectal space is commonly used to reduce bowel exposure. If you have only talked with your surgeon, and not consulted directly with a radiation oncologist, you should do that before finalizing your decision. Your age (57), too, should be weighed in to the final decision. I was 73 when I and had SBRT in 9/2025 and am 6 months into a 12 mos course of ADT. It’s no picnic, but I’m back to all my normal activities and exercise with so far an excellent treatment response.

@thig350
In reply to treatment choice.
I will be honest with you, won't pull any punches, I was advised to go with radiotherapy mainly due to also waiting to have my spine operated on due to having Stenosis spinel channel nerve damage in neck. I haven't been properly well since last April / May after the treatment concluded. 6 weeks ago they found blood in my poo, setting alarm bells ringing, quickly arranged a colonoscopy, thank evens they didn't find any bowel cancer, this is the worrying bit, they found damage caused by the radiotherapy treatment and polyps and also diagnosed severe bowl Diverticulosis disease wide spread. I have got to have the procedure repeated on 24th April to investigate further, won't pretend I'm not concerned.
Good luck with what ever treatment path you take