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Surgery or Radiation + Hormone Therapy
To all. I’m a 72 yr old male recently diagnosed with prostate cancer. My stats are 6.9 PSA up from 3.5 a year ago. Biopsy showed one cell with Gleason 8 and several 7’s which puts me in the low end of the aggressive scale. Pet scan shows cancer is localized to the prostate.
Scared to death of each strategy’s side effects. As I understand it Surgery may not get all of the cancer cells. It will leave me with urinary issues and ED.
Radiation will attack a broader area and likely will kill more cancerous cells that may be outside the Prostate. Hormone therapy will lead to 4 yrs of ED as well as a host of ongoing issues ( depression, bone loss, diabetes , etc.).
Would love to hear from people who have gone thru this process. Thank you!
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This choice seems more and more confusing for me. My urologist told me the following: Gleason 8 or less, surgery is probably better. Gleason 9 or 10, radiation is better, because surgery might accidentally spread the cancer.
I was Gleason 9, and got radiation. Was it the right choice? Ask me in a decade or two.
"Gleason 9 or 10, radiation is better, because surgery might accidentally spread the cancer."
First time I've heard it said that way, but, makes some sense I guess.
Looking forward to hearing your "All Clear" in 20 years!
Suggestion:
Book Surviving Prostate Cancer by Patrick Walsh, MD
Download or hard copy (both free) Patient Guide from Prostate Cancer Foundation pcf.org
Best wishes.
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3 ReactionsDeciding on treatment for prostate cancer (PCa) is complicated. And it's not a trivial decision... your choices can have life-long effects.
The good news is, PCa can be successfully treated with surgery and/or radiation -- with excellent long-term survival rates -- especially if you're treated by experienced doctors at a Center of Excellence.
Best advice I got from my Urologist was to do extensive research. That is, with PCa there are no short-cuts to making a WELL-INFORMED decision. You've got to educate yourself.
As already mentioned, Walsh's book "Surviving Prostate Cancer" is excellent. Get the 5th edition, it's the latest.
And there are many many educational videos from reputable sources. Like this:
https://www.youtube.com/watch?v=ryR6ieRoVFg
Best wishes.
Diagnosed at 72, Gleasons of 3+4’s and 4+3’s, I read Dr Walsh’s book and researched lots at sites like Mayo Clinic, Cleveland Clinic, Johns Hopkins and more. I chose RALP as radiation after surgery is a viable option where the opposite is NOT the case. After I explained all my thoughts to my Urologist, he told me that he would have made the same decision.
I did Kegel PT with a DPT before and after the surgery, I was 100% continent after the surgery. The post-surgical pathology report showed a type of cancer that would have survived radiation.
Best of luck and come back with any questions.
I looked at all options, including removal and multiple types of radiation machines. I understood the risks of all of them. I chose a narrow margin, special type of radiation machine that limited the exposure of healthy tissue to radiation. I did not want to take the risks associated with surgery. NCCN.org is a source used and followed by many physicians, which is also open to patients , and is very helpful describing possible treatments for a different levels of cancer, including prostate.
I would suggest getting the decipher test which does, or can, change the treatment that the doctor chooses. The purpose of the test is to give you an idea of how aggressive the cancer is and it is easy to read. It uses the biopsy material which I have heard is good for up to a year.