Choose between robotic surgery and proton therapy.

I understand that both treatments are about equally effective, however, the surgery preserves the radiation treatment for later, if needed, but not radiation first. I had robotic surgery ( which was not bad ) then 13 months of ADT and Erleada for aggressive, locally advanced cancer. The meds were noticeable but not terrible, no bathroom issues but ED , but with the ADT ED was not an important issue. Considering my type of cancer I think that I selected the proper treatment at an excellent facility.

Popcovas, read, research, ask questions of anyone who has experience. Then, consider the particulars of your relative's specific situation - age, activity, health outside of the PCa, expected life expectancy. He should, of course, also consider the thoughts of a spouse or significant other because it affects not just us. The answer to the question you pose will be different for all who are faced with similar options.

My own situation is a diagnosis at age 65. I'm otherwise healthy, active, and expect at least a couple of decades more. All indications for me pointed to PCa being contained to my prostate. I chose to get it out. My surgeon has performed about 1,000 of these surgeries and followed all the items on my checklist (robotic assist, nerve sparing, and laparoscopic).

The post-op pathology report showed all sampled lymph nodes and seminal vesicles were clean and the margins were clear. All indications are that my 3+4 was contained within my prostate when it was removed 3 weeks ago. I feel good about my decision. I was really worried about incontinence and ED. My surgeon tried to reassure me but I was still concerned. The nerve sparing seems to have, thankfully, worked on both issues.

One book that helped me make my decision was Dr. Patrick Walsh's Guide to Surviving Prostate Cancer. Another book that help me prepare for continence was Vanita Gaglani's Life After Prostatectomy.

Regardless of what he decides, as my friend Michael on this site encouraged me, know he's done the work to make a choice and he's considered all the things he can. Now, stop worrying and be positive about the future. He'll have made the right choice for him.

Godspeed!

Thank you so much for such a good answer. Trying to find people who has undergone proton therapy to compare their experience also.
He has two friends after robotic surgery and their experience was good also

My situation is very similar to yours. After consulting with two different urologists, I will be having the surgery next month. They both agreed that this was the best option. To avoid repeating, the responses you have above pretty much summarize mine as well. One of my relatives had his removed 15 years ago and has had no problems at all. When I talked to him he recommended I get it removed. He said the possibility of wearing a diaper for years if that happens is better than dying. Hard to argue that point. My doctor said I’ll be good as new in 6-8 weeks. 🤞🙏The most important thing is to have a really good feeling about the doctor you choose. Best of luck.

Wearing a Depend and a pad is much better and sounds much better than wearing a "diaper"

Had RARP last January 31st. Gleason 8 before surgery, re-scored to 7 afterwards. All contained in prostate with no lymph node involvement.

Down to 1 Depends a day. 3 words - Kegel Kegel and more Kegel. It works!

Hello!
How was continence and erection after the surgery and now?

No good !!!

I had proton beam 3 years ago at Mayo in Arizona. As of today October 203 no signs of recurrence. The cancer was mostly grade 3 with one biopsy grade 4 all on the right side of the prostrate. I found it a very positive experience with mostly no side effects and no recovery time as with surgery. The most difficult side effects occurred the first few weeks when i had a very hard time urinating due to swollen prostrate.

Continence is slowly getting better but still no life on the other side of things.....