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Best treatment for positive surgical margins after prostatectomy

Posted by @ginnys in Cancer, Aug 13, 2012

My 59 year husband recently underwent robotic prostatectomy for a moderately aggressive prostate cancer (Geason score 7) and we need advice about best option for follow-up treatment. He refuses hormone therapy. Is adjuvant radiation treatment better than salvage. Are there any other possible alternative treatments we don't know about? Thanks for your comments!

Tags: Cancer, Prostate Cancer, radiation therapy, radiation, Robotic Surgery, prostatectomy


Posted by @pvgreg, Dec 8, 2012

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


Posted by @ginnys, Dec 10, 2012

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!

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