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54M, “favorable” prostate cancer diagnosis — surgery vs. radiation
Prostate Cancer | Last Active: 8 hours ago | Replies (35)Comment receiving replies
I was diagnosed as a 3+4, Only one core, But the doctor felt it to be treated, and I had the choice of radiation or surgery. I was 62 at the time. I chose surgery because my father had radiation and died of prostate cancer and I figured that would give me a better chance. That was 16 years ago. I’ve had four reoccurrences. I’ve had 40 sessions of radiation 12 years ago and had no side effects at all other than incontinent starting six years after the radiation. Of course, I had a prostatectomy before that so who knows what caused the incontinence?.
After surgery, I found out I was a 4+3. This is not uncommon about 1/3 of cases end up with a change to the Gleason score After surgery. That was 16 years ago, Four years ago I found out I have the genetic problem of BRCA2, which is why it keeps coming back.
At 54 you should definitely get genetic testing, That is way too young to be having prostate cancer. Do you have cancer in your family? Breast cancer prostate cancer, ovarian cancer, and a few more can be caused by genetic problems.
If you have surgery, you should have Retzius sparing surgery and also spare your nerves.
If you pick radiation you should also ask for a spacer like SpaceOAR, Barrigel, or BioProtect. Yes, it is possible to have long term issues as a result of radiation but they normally do not happen, Usually the urinary issues and diarrhea problems cease in a short time following radiation.
The chance of follow on cancers due to radiation is very low. Here’s some Information from a Stanford study.
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
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@jeffmarc Fabulous summary! And to my knowledge, about as accurate as one can get. I too had genetic testing done when first diagnosed 8-years ago. It took almost 6-months to get the results, but I was told by that specialty group, that I too, lacked the two BRCA-1 and -2 mutations of genetically induced prostate cancer, and that my specific case, was strictly a "lifestyle disease" (i.e., I did not "inherit" the disease, nor could I pass it on to male children). My radiation oncologist later concurred with that genetic assessment, and notably, my own father died at age 80 of bladder cancer (never having had prostate issues).
As for the incidence of secondary cancers occurring to non-target tissues from radiation treatments later in life, again, my oncologist fully agreed with what's been said here. He stated that the reported incidence of such "secondary" cancers, was well below 3%, and that the vast majority of that 3% did not occur for 10 or more years. For what its worth, he had also stated at one point, that the radiation level of IMRT (external beam radiation), was roughly twice the strength of an average x-ray.