Why did you choose surgery instead of radiation or vise versa?

I have 3+4 6 less in 5 % in one core my urologist wants to operate my radiologist said I could watch it or he could do 5 radiation treatments I went to a 3rd doc he wanted to put me on casodex. I am 72 I’ve been watching it for a year I got a appointment at Mayo from a srcond opinion it makes it hard to decide what to do when every doc you see tells you something different

Age 70, 3+4, contained, no stream problems, healthy and at weight. As everyone says, your specific condition may be the deciding factor. For me, I wanted to avoid the initial downtime of surgery (even robotic) and the greater risks (ED, incontinence). I went with HDR brachy (no seeds), which is still the second most invasive with two out-patient procedures, to minimize radiation exposure to healthy tissue and still get the job done. I spoke to two Mayo Rochester doctors (surgery and radiation). Both said I was good for either choice. THE MORE IMPORTANT DECISION IS TO PICK THE BEST HOSPTIAL/DOCTOR. Travel if you must.

Similar story with me. Last November I was 69 and had one (of 14) biopsy core diagnosed with 4+3 =7 and all imaging made it seem completely contained within the prostate. I got three unanimous opinions and the one that convinced me was the radiation specialist. She said if her husband had my results, she would tell him to have his prostate removed. My situation allowed for great confidence in removing all the cancer once and for all. Yes, there would be side effects, but those could be dealt with. So, three months later (on my 70th birthday) I underwent RALP and my PSA's have been negligible and steady ever since. For that I am happy with my choice. However, I was deluded by all the YouTube videos by men who went through this. They had me convinced that in just a few weeks all the side effects would be gone. They were wrong. It has been 8 months and the incontinence has reduced a lot, but it is by no means gone. I am undergoing Pelvic Floor PT now, and getting many exercises that should help me get drier. If you choose surgery, pay great attention to getting your Pelvic Floor in the best shape possible.

Great comments above. I am a big advocate for removing the prostate when cancer is detected. There are obvious exceptions --> Those with other serious health conditions, advanced age, metastasized PC, etc... After my research, I went with a radical prostatectomy at Mayo-Rochester last year and I am very happy with my decision (most men will say this with whatever treatment they chose 🙂 ). I looked at other treatments, but could not justify the potential of leaving unknown cancer cells in my body - With my robotic RP, the prostate and seminal vesicles were removed (plus 9 lymph nodes for me) and a full pathology was performed to determine margins. With alternate treatments, they believe the cancer has been treated, but there is no physical evidence. For me, this was very important, I wanted to know if the cancer had been addressed to the best of my ability - Fortunately, pathology showed the cancer was contained to my prostate and outlook is good. Unfortunately, cancer is cancer, and reoccurrence can always occur.

Personally, I struggle with the statement "don't worry, prostate cancer is slow growing, you will probably die from something else". Obviously, there are exceptions when you have other serious medical conditions and you know your lifespan is limited. However, if you are in your 70's and the doctor tells you something else will kill you, he is probably basing this on the average life expectancy (77 for us in USA). This age includes all of those that have abused their bodies with drugs, heavy alcohol use, no exercise, over-eating, getting your food from the center of the grocery store (processed food), difficult jobs, etc... For myself, I work to stay in shape and I pray for a much longer life (it is my hope, only God knows) - To not do everything possible to fight the cancer is like giving up.

My opinions are simply opinions. Everyone has to do their own research and base their decision on their individual circumstances. If someone (doctors included) tells you that there is only one treatment possible for your situation, you should probably get a 2nd/3rd opinion. The only rule set in stone, you MUST utilize a center of excellence (like Mayo-Rochester) to address your prostate cancer. To utilize a local doctor because of a relationships or travel inconvenience is not a wise move.

Good luck to everyone in making your decision and ultimate treatment!!

Jim

Similar story with me. Last November I was 69 and had one (of 14) biopsy core diagnosed with 4+3 =7 and all imaging made it seem completely contained within the prostate. I got three unanimous opinions and the one that convinced me was the radiation specialist. She said if her husband had my results, she would tell him to have his prostate removed. My situation allowed for great confidence in removing all the cancer once and for all. Yes, there would be side effects, but those could be dealt with. So, three months later (on my 70th birthday) I underwent RALP and my PSA's have been negligible and steady ever since. For that I am happy with my choice. However, I was deluded by all the YouTube videos by men who went through this. They had me convinced that in just a few weeks all the side effects would be gone. They were wrong. It has been 8 months and the incontinence has reduced a lot, but it is by no means gone. I am undergoing Pelvic Floor PT now, and getting many exercises that should help me get drier. If you choose surgery, pay great attention to getting your Pelvic Floor in the best shape possible.

I’m 3+4. My doctor feels anything over 1(I’m 3) should be surgery.

tomf, I had proton radiation but side affects was leaking after urninating and not being able to hold urine when really needing to go.

Can I asked what the PT was that they gave you to do? I see others also mention these exercises and how it helped them.

@jc76 I am still in the initial phase, but it boils down to strengthening my core and doing kegels in that physical position that I leak the most in. The focus is on inhaling by lowering my diaphragm and exhaling by bringing it back in. Then I breathe properly while doing kegels while standing. This is because I only leak when I'm standing, never sitting or lying down. Then I breathe properly while doing bridge and side bridge exercises (you can Google them) with a kickball squeezed between my legs. They tell me I will be learning more exercises but would like me to have sessions with them two to three times a week for 12 weeks. My original Pelvic floor specialist only gave me one kegel exercise to do while sitting down. That didn't do the job.