Best treatment for positive surgical margins after prostatectomy

So the surgery did not get everything? Is that why you are asking about radiation? My husband, 64, just diagnosed this week with prostate cancer (Gleason score 7) so weighing surgical options. Dr in Prescott wants to do open surgery, as doesn't feel there's been enough da Vinci procedures to validate outcomes any better. We 1.5 hrs away from Mayo clinic in Scottsdale & awaiting for appt. How long ago did your husband have this surgery? Any incontinence or loss of sexual desire? Thx

Hi: My husband had robotic surgery this past July (2012) and two margins were positive (meaning there was cancer past the area that was cut out) and it was very likely the cancer would spread. His side effects were very minimal (only incontinent for three days, but he did 200 kegel exercises every night before the surgery). He works out in the gym 1-2 hours every day so I think that's why he had so little problems. Mayo Clinic is the best and, I believe, that an open procedure is better than DaVinci - as I think they can see better during an open procedure and avoid positive surgical margins. So, if we could turn the clock back, I think that what we should have done.

So, after surgery, we were aggressive and asked for adjuvant radiation treatment, which started 3 1/2 months after surgery as that is the best chance to avoid metastatic spread. He completed the radiation just last week and, again, the only side effect, he said, was the inconvenience of going in for treatment every day for 7 weeks.

Sexual desire has waned a bit (to be expected), and there are problems in that area, but I understand that it can take up to 2 years to regain all that......just have to be patient and creative!

Best of luck to you!

@pvgreg ...husband had open prostatectomy 14 years ago....Gleason score of 7. We checked options ....at medical centers we could drive to....decided not to go 5 hours away for closed method....nor 2 hours ...opted for head of urology ...oncologic urologist....who specialized in open surgery using nerve sparing ,less blood approach. He told us that he felt his ability to palpate lymph nodes inside was an advantage. Yes recovery takes longer with open vs.the other ways.......
But his PSA levels have been negligible for 14 years.
A funny...maybe helpful book that I read a few years ago is
"The Prostate Monologues...what every man can learn from my humbling confusing and sometimes Comical Battle with Prostate Cance" by jack McCallum. Tdrell