Hello northshorepaul,
You are correct in your statement and or clarification to my previous comments regarding the option for salvage surgery following radiation and the return of Prostate Cancer to a patient. To further clarify……..Salvage Surgery is not a very high percentage option and the majority of surgeons do not do it based on the past experiences and outcomes of patients who
have utilized it. Again, surgery or radiation as your initial treatment is and remains a very personal choice. The surgery first option creates most of the incontinence and ED issues experienced by most patients immediately following the procedure. These symptoms come more slowly but do manifest for patients who choose the radiation option first as well. However, they generally manifest and progress more slowly over time. Obviously, any final decision is determined on a case by case basis. As I stated previously, there is NO best option for any Prostate Cancer patient. There is only the BEST option for them based upon their evaluations in the decision process.
The statistics I’ve read, researched and studied point out the fact that salvage surgery comes with certain risks based upon all of the dead tissue caused by previous radiation. Surgeons in general don’t like to perform salvage surgery on the dead tissue caused by the previous radiation and the further complications that the surgery can cause in the post surgical recovery stage. Again, this is a choice and option that the patient and their surgeon make together. I would never tell or recommend to any patient that they shouldn’t consider it or choose it. However, I would advise them to do sufficient enough research to evaluate the risks and outcomes associated with it.
Obviously, like all the choices and considerations made by any Prostate Cancer Patient whichever initial treatment you choose affects whatever your available secondary options may be if you need to make one if your cancer returns. In addition, there is always the personal option not to do anything at all.
All medically related decisions are made as a matter of personal choice along with the recommendations made by their surgeon or radiologist.
It’s been my experience that either surgery or radiation emerges as the best choice for a patient after considering all of the facts in their case and the degree and seriousness of their cancer when it’s first diagnosed. Some patients don’t have as many options if their stage of cancer is more serious and has spread outside of their Prostate into their nodes and other surrounding tissue. From a personal perspective, I made the surgical option primarily because all of my cancer was still limited to my Prostate. I also preferred to have all of my detectable cancer removed if possible which thankfully, it was.
It also provides me the secondary option of radiation if my cancer returns. Again, I made my personal choice based upon the facts involved in my specific case in addition to my own personal risk assessments.
At best, all of us can hope that our cancer remains in remission so we don’t have to make any kind of secondary options.
I send my best wishes to you in your journey and to all of our fellow Prostate Cancer Patients for the best outcome possible, (living the rest of your life with your cancer in remission).
GODSPEED