Radiation VS. Prostatectomy? Looking for advise on which best for me.

Posted by grywolf @grywolf, Jun 16, 2023

I'm looking for my best option. What others have had and effects of it. I realize everyone is different. Recently diagnosed current PSA 13.1 65yr old relative good health. From readin on here seems like mostly everyone did Radiation instead of Prostatectomy wonder why? Was told thats what I should have. But getting PET scan and if spread then no surgery. My Gleason is 7 (3+4) I had 8 out of 12 positive biopsy samples. As you can tell I'm abit overwhelmed. Thank you in advance.

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I had no choice since the cancer had metastasized locally to lymph nodes. Hence doctor put me on Radiation. A close friend of mine whose cancer was contained within the prostate underwent radical prostatectomy 4 years ago and is happy today, no ADT to bug him.


I was diagnosed with PCa in 8/2022 at age 70 when PSA doubled to 6.97 in 6 months. Biopsy showed Gleason 7(4+3), with 30% of samples showing aggressive cancer cells. MRI with contrast showed cancer was confined to the prostate.

I spent the next couple of months consulting with surgeons and a radiation oncologist, reading the Patrick Walsh book and reading everything else I could find on PCa.

RALP was performed in 1/2023 and my recovery has gone extremely well. Six weeks after the catheter was removed, I was able to resume pelvic floor exercises and bicycling. Five months post-surgery, continence has largely returned and two PSA test results of < 0.01 have convinced me that I made the right decision.

Erections are still not possible, although nerve sensations are returning and I’m optimistic that will improve also with time.

Good luck with whatever course of action you choose.


I believe that surgery is the best route if it available to you. If you have radiation and the cancer returns, ( which is very common) then the surgery route is either not available or much less effective. The surgery and post surgery is not bad and most guys remain continent. Post surgery, radiation is still available but erections for me are history. I have Gleason 9, CR and I had surgery and 13 months of ADT and Erleada and I think that I did the right thing but my Gleason score and CR are difficult issues. Good luck to you


First, get the book I have pictured here. My Gleason was 8, 4+4, 25% involved. Bone scan and CT Scan showed no metastasis. 62 years old.

Doc advised surgery because of aggressive cancer. So I did my reading and it backed up my doctor.

This is a proven work of information. Statistics bear out the options so you are a little more objective with your decision.

There is the shock factor, but once you get past the initial wave, I pray for you to have peace with your decision.

Jump to this post

Agree completely. Read this book, Dr. Walsh's "Surviving Prostate Cancer". It is very comforting for yourself and family. Initial shock of diagnosis can be overwhelming. After doing the research and readi8ng this book your internal alarm and panic systems will move away from Code Red. Then you can make a choice that best fits your needs.

Good luck and best wishes.


I am definitely in the camp of RP. If you have a known cancer in your body and you are healthy in all other aspects, I could not imagine taking the chance of radiation therapy that could leave an unknown cancer cell in your body. I am 57 years old, was diagnosed with PC in the Fall, 2022 and had a RP in November, 2022. My Gleason Score was 7 (4/3). Surgery and recovery went well and I cannot say enough positive things about the Mayo-Rochester team. If you go with a RP or Radiation, it is crucial that you get a center of excellence. The rest of your life will depend on the experience and expertise of the doctor and his/her team.

Good luck!!


Don't feel bad I think all of us get overwhelmed. The prostrate cancer therapy treatment options are very confusing. But you are in individual so has to be based on your specific case and you as an individual.

I see you asking about who radiation versus surgery. Remember that a lot of urologist/oncologist/radiologist don't recommend surgery in later years of life. Others like me have heart failure or other medical issues that reduce options. It is why you need to know what is best for you.

I do recommend a test called Decipher. It is another test beyond biopsy. It will give a more specific and accurate level of your cancer. If it is low equals treatment options, intermediate other, high other. Prostrate cancer is unique but like all cancer caught early is the best for diagnosis. Hopefully you will have a urologist and oncologist that will be willing to give you all options. I would still recommend getting a second opinion as you will see there are different views by different medical doctors.

Go Luck but stay positive it helps deal with this.

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