Prostatectomy Question? Side effects outweigh benefits?

Posted by fuzzy123 @fuzzy123, Jul 30, 2023

My doctors told me they no longer due Prostatectomies as the side effects far outweigh the benefits !! But I see many of you are ??? And some are still getting them done at the Mayo Clinic and other Medical Centers !!!
So who is right and who is wrong here ???
I had 44 external beam radiation treatments!!

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@glennh23

Hi there if you go down the surgery way I would recommend that you get your PSA tested every six month. I wasn't told that if my PSA level went up above 0.01 action needed to be taken but they didn't take any and it was too late for me I am now stage four and it has spread to my lymph nodes. So I hope you take my message on board thank you very much

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Very sorry to hear this. How are you treating it now? Also, how does PSA go up if the prostate is removed? I always thought the prostate produced PSA. Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly found in semen, but a small amount is also found in blood. I am curious how it increases after the prostate is removed?

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@ddun1953

I had mine removed 11 days ago. Gleason 8, On the Margin too, PSA was 6.9
I did not want cancer sitting in my body so the CAT said no spread as well as the Bone Scan. The Surgeon feels he got it all. Had 1 Lupron Shot 3 mo. and will do that for 12-18 months and have some radiation as well as the Lupron starves any cancer running around and the radiation poisons the rest. i meet with the Surgeon on the 24th to review latest blood PSA and also the Lab on the Margin part of the prostate and also the two lymph nodes that they took. This chit wants to kill like a Great White Shark so be aggressive at your data you shared. You only have 1 life.

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First off, I wish you all the best for good health cancer free. It’s interesting talking with others here how treatment varies with each doctor. I was told they would not use radiation after surgery which concerned me as I feel if it has spread to the lymph nodes it could be caught and killed before it spreads.

I was told they don’t “overtreat” if they do not see it on any other tests, and use a watch and wait approach. How long after you had surgery will it take before you do radiation treatment?

What did you mean by the lab on the margin part of the prostate? I wasn’t aware they did any testing for that.

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@jm23

First off, I wish you all the best for good health cancer free. It’s interesting talking with others here how treatment varies with each doctor. I was told they would not use radiation after surgery which concerned me as I feel if it has spread to the lymph nodes it could be caught and killed before it spreads.

I was told they don’t “overtreat” if they do not see it on any other tests, and use a watch and wait approach. How long after you had surgery will it take before you do radiation treatment?

What did you mean by the lab on the margin part of the prostate? I wasn’t aware they did any testing for that.

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On the margin is on the outside like a sticky substance on a basketball. I guess they lab it some how along with the two lymph nodes located next to the prostate. This is me talking and info from Dr. Scholz on Utube along with other of my friends who have had the surgery lately and Dave McCoy went in the total all out attack on it as he had it removed, then on Lupron and had 4 months of radiation 5 days a week so he took the max radiation for a life time to just not wait but kill the little bastar-s. He has been cancer free for over 3 years now. Wait for what, a recurrence as any recurrence comes back very angry and tougher to kill after that. I am going in for the win baby. Say, after surgery, as most all have a 0 or -.1 PSA. Well, they wait and watch and it bounces up to say 1, it is now angry and comes back with a vengence. With me it all depends on the 24th of Aug appt. with the Urologist/Surgeon. The initial CT and Bone S said no spread, he said twice after the surgery, no spread so we will see soon. I have one friend who has been on Lupron or equal for 18 years now.

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@jm23

Hello all, I was doing research to seek information on what others have done to evaluate this important decision. I was just recently diagnosed with a very rare type of aggressive prostate cancer with mostly gleason 8’s & 9’s and a PSA of 3.5 which baffled the doctors. I’ve been doing regular blood tests and at no point had it gone up or increased.

Bone scan and PETscan came back clean with no signs of spreading. Trying to evaluate my path and like others here have stated, due to the option to have radiation after surgery I am leaning towards surgery. It’s tough to decide what option is best weighing the side effects, but having radiation as a backup seems like a good move as the Surgeon said they will not remove the prostate if we choose the radiation path.

My concern is, if the cancer has spread and so far is undetected why don’t the surgeons offer radiation in addition to surgery for the surrounding tissue now instead of waiting to see where it shows up? Also, since my PSA levels and never been an indicator I may need to do a PETscan or Bone Scan to detect it in the future.

Also, with so much cancer in the prostate can any of the cells escape into the body and land elsewhere?

Thanks in advance. I appreciate reading everyone’s experience here.

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So, what my docs told me is that you really can't determine if the cancer has spread until you are in there. All the scans and blood tests in the world won't give them as clear a picture as literally going inside and taking a look. I had robotic surgery so it wasn't quite as invasive as the original method.

And Yes, when in there they found that it had spread. They had to send it all off to a lab to before they made any treatment recommendation. They didn't schedule any treatments until after the results came back. Unfortunately, my cancer was so aggressive that after the results came back I underwent, hormone, chemo, and radiation therapy.

So, if you asked me... let 'em do the surgery (since they recommended it) and be prepared for more news and treatments in the future.

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@lcashell

So, what my docs told me is that you really can't determine if the cancer has spread until you are in there. All the scans and blood tests in the world won't give them as clear a picture as literally going inside and taking a look. I had robotic surgery so it wasn't quite as invasive as the original method.

And Yes, when in there they found that it had spread. They had to send it all off to a lab to before they made any treatment recommendation. They didn't schedule any treatments until after the results came back. Unfortunately, my cancer was so aggressive that after the results came back I underwent, hormone, chemo, and radiation therapy.

So, if you asked me... let 'em do the surgery (since they recommended it) and be prepared for more news and treatments in the future.

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Thanks for the information and I truly hope you are doing better after all of those treatments. That’s quite a lot to handle both physically and emotionally for you and your family.

We have a second opinion next week with a surgeon who is top notch in my area. I have been reading up and becoming more familiar with treatment options and standards as many doctors do not give you the full picture with important details from my experience.

I picked up Dr. Patrick Walsh’s book Surviving Prostate Cancer (1st Edition) which is a bit outdated but useful. I found out there was a 4th edition released in 2018 and there will be a 5th edition coming early October.

I wish these doctors would explain things better so those who are diagnosed with PC can understand it better. There’s so much to learn it seems, and even more importantly the options were not explained in detail for example if you choose radiation therapy you cannot remove the prostate if your PC returns but there are other options like Cryotherapy and Hormone Therapy. Still not ideal, which is why I am choosing an RP personally.

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@undetectable

Good info. What were the issues with proton therapy?

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I had pain when urinating, constipation, hemorrhoids and fatigue during treatment. All resolved within a couple of weeks after treatment.

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@lcashell

So, what my docs told me is that you really can't determine if the cancer has spread until you are in there. All the scans and blood tests in the world won't give them as clear a picture as literally going inside and taking a look. I had robotic surgery so it wasn't quite as invasive as the original method.

And Yes, when in there they found that it had spread. They had to send it all off to a lab to before they made any treatment recommendation. They didn't schedule any treatments until after the results came back. Unfortunately, my cancer was so aggressive that after the results came back I underwent, hormone, chemo, and radiation therapy.

So, if you asked me... let 'em do the surgery (since they recommended it) and be prepared for more news and treatments in the future.

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Sending lots of healing wishes. Did you have a PSMA PET?

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About two years ago, my prostate was removed due cancer, now the las PSA test was .31, I took a pet scan and it showed an anormalidad brote lite in the área, due to my concern, what is your advice to take care of the problem?

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In reference to my prostate sings afore mentioned what is you professional opinion for treatment?

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@undetectable

Sending lots of healing wishes. Did you have a PSMA PET?

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Yeah, like a lot. I think I have had three or four. The cancer was in remission for 5 years. Zero (or undetectable) PSA. But.... it came back. Now that it is back the doc wants a blood test once a month. Had a scan, they found the spot. They zapped it again (radiation). That spot went away. But now there is a new one. Sooooo, more scans. I'm a regular.

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