Radiation vs Surgery Gleason 3+4=7, Long Term Side Effects (Cyclist)

@acn25
Exercise resolves the problem of fatigue for many people on ADT. If you got on the bike and road you would find out you would be less tired after a little while of doing it. It sounds counterproductive, but it really does work.

I had severe hot flashes on Lupron. My oncologist prescribed a depo-provera Shot every three months and it stopped the hot flashes almost completely, Until I went on Zytiga. I had a fascist at night that resulted in the sheet under me being wet. About five years ago, I got an Embrlabs wave device. It stopped the hot flashes at night completely. During the day it helped too.

One of the Mayo doctors did a talk on side effects and had this slide about drug drugs to help with hot flashes.

I had 45 days of low-level radiation done 7 years ago, but the prostrate cancer came back 2 years ago. I saw my urologist in Rockford who sent me on a wild goose chase in Chicago to have cryotherapy done. I would never use this urologist ever again. There are other things about this Rockford urologist that are very disconcerting which do not need time wasted on.

I did not want to forgo the sex with my loving wife.
So, 22 months ago I went back to the UW Cancer center in Rockford Il. I had to decide to do either a week of heavy-duty radiation, at the UW cancer center in Rockford or go to Madison UW and have the Brachytherapy done.
Since the original radiation did not do what I had expected I elected for the Brachytherapy.
The Brachytherapy was done in May 2025
My PSA is undetectable.
I take Sildenafil 100mg (Viagra) an hour before intercourse. My orgasms are dry but intense.
I am 77 years old
My new urologist is in Madison Wi well worth the drive for me!
My wife and I are happy!!
Hope This Helps with your decision!

At age 65, Gleason was 4+3. Underwent RARP, and cancer was found in seminal vesicles and lymph nodes in pelvis. Pylarify showed no further metastases, but to eliminate any microscopic disease, I did two years of ADT (lupron, abiraterone, and prednisone) and 47 days of EBRT. Had diarrhea in the last couple of weeks of radiation, but that went away quickly post-treatment. In spite of being quite physically active, developed extreme fatigue in second year of treatment as well as bilateral neuropathy and radiation colitis. I did pelvic floor PT, which helped some with incontinence, but still had difficulty holding it in, especially at night. Post-treatment, my testosterone returned quickly to normal, and everything has gotten much better. A lifelong cyclist, I’m back to cycling several times a week. Urinary continence is barely an issue, and although I worry about the cycling affecting the colitis adversely, so far so good. Even thinking about upgrading my bike so that I can do more.

My Gleason score was 5+5 a 10 found 2 years ago, had issues urinating so they got me on Lupron getting shot every 3 months did a TURP to fix the urinating problem then 45 days radiation have now they added Erleada pill daily. Last summer after the radiation had some pain during urinating and needed to wear pads for a couple months now off them. My side effects is hot flashes still very active but get tired had to learn to pace myself.

I initially wanted radiation but my Prostox test put me in the high risk category for future urinary complications so I somewhat reluctantly chose RALP. It was done in January this year on my 67th birthday! Maybe that was good luck because at six months post prostatectomy, my PSA is undetectable, I'm fully continent, my erections are recovering (approximately 50%), orgasms are there, and my urologist has given me the go ahead to cycle again with no restrictions.
So, for now, I consider myself one of the lucky ones. Fingers crossed on a recurrence.
Good luck to you!

By the way, I forgot to mention that I was also 3+4+7, no spread beyond the prostate, and a high decipher score (.85).

@kjacko thanks for your reply. Who was your surgeon and where did you have your surgery done?

@tactive My surgeon was Alex Zacharias. My procedure was done at Aurora Hospital in Grafton, WI. Everything I was told about him was absolutely true. I highly recommend him.

@quaddick thank you and keep on grinding those pedals!

@kjacko thank you!