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Diagnosed today w/ PCa. Seeking feedback w/ treatment I think I want
Prostate Cancer | Last Active: Apr 24 1:15pm | Replies (60)Comment receiving replies
@survivor5280 Thank you for sharing your experience. I've learned alot since my initial post on this thread.... Because of my age of 57 I can see leaning towards removal because I am concerned that radiation could cause me problems down the line.... I really don't want to be in my late 60's or early 70's and need to deal with the radiation side effects plus whatever else life is throwing at me at that time. That said, radiation is very effective and from what I have learned, there is a little bit of "overspray" of radiation that hits the area around the prostate which would in theory zap any miniscule cancer cells that if I had opted for surgery may be missed until later on when I would then need salvage radiation, which I may have avoided if I just went with radiation in the first place... I don't want to have surgery to avoid radiation only to then have radiation anyway! Oh my, I'm really thinking this whole thing into a pretzel 🤣
Replies to "@survivor5280 Thank you for sharing your experience. I've learned alot since my initial post on this..."
@thig350 You are not going to avoid salvage radiation by having radiation as your primary treatment; you simply WON’T be able to have it if your primary treatment fails.
And radiation (all types) fails just as much as surgery so do not view it as superior as far as outcomes are concerned.
SBRT would be an option if your cancer recurs, but you’d probably need ADT as well.
My decision to have surgery was, in fact, because I COULD have SRT if needed…and I did.
Phil
@thig350 You are thinking correctly now since any treatment is a choice between bad and worse. As far as radiation definitely get a Prostox test if considering this option. If it shows high risk you have a 70%+ chance of late toxicity; at low risk it drops to less than 10%. As Jeff mentioned the overall population risk of developing another cancer is 1 in 40. This becomes 1 in 33 with radiation. Treatment area has gotten very precise, so no overspray. At Grade 3 there is intentional treatment of the prostate bed, local lymph nodes, etc. since there is a good likelihood of small amounts of cancer being present. These are treated at a lower dose (Gys). It is done by using a wider field on some of the fractions.
As heavyphil mentioned most under 60 opt for surgery so they have the option of salvage radiation later. Being younger there is also better recovery. Your concern is valid since undetectable cancer outside the prostate (or poor margins where a little detectable is left) are the main causes of recurrence after surgery and the percent is significant. If you opt for surgery, the most important decision to minimize side effects is the selection of the surgeon. Read all of wheel1s posts. You want the latest surgical technique with nerve sparing to minimize side effects which are usually permanent ED and incontinence. I would be seriously tempted to spend the $35K (including travel) to have it done at the German clinic he used. If you look you should be able to find the same technique in the USA. The decision on a surgeon is going to impact the rest of your life so spend the time to verify and make the right one.
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@thig350
Here’s what Stanford found when it comes to secondary cancers from radiation.
It may not be as bad as you think.
In a study of about 145,000 men with prostate cancer, the team found that the rate of developing a later cancer is 0.5% higher for those who received radiation treatment than for those who did not. Among men who received radiation, 3% developed another cancer, while among those who were treated without radiation, 2.5% developed another cancer.
https://med.stanford.edu/news/all-news/2022/070/prostate-radiation-slightly-increases-the-risk-of-developing-ano.html