Why did you choose surgery instead of radiation or vise versa?

Posted by ozelli @ozelli, Oct 13, 2023

I think this may be a topic that the newly diagnosed may find useful.

The differences are often subtle which makes the decision even more difficult but better to be information-overloaded rather than information-deprived.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@kjacko

Glad to hear you’re doing well. I’m prepared to wear pads. And also the catheter for a week.My doctor puts a lot of emphasis on Kegel exercises. I do them religiously throughout the day, everyday. Hoping it makes a difference. Thanks for the response!

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Oh yeah! Do those Kegel exercises. I didn't realize how important they were until I stopped doing them for about 3 days straight after the catheter was removed. I still do them daily now.

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@vanman59

I'm 59, and just had Radical Prostatectomy surgery 4 months ago. The cancer was removed and everything is clean after my 3 month check up as well. I too had 3+4=7 on 1 core out of 14. Wishing you the best! I'm sure you've been told this, but be prepared to wear pads for sometime afterwards. I am down to 1 daily now. But glad that I had the surgery.

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Van I to am 59 had 3+4=7 and surgery June 12 this year. 0 PSA so far with another check next week, same results I hope. I use 1 to two lightest pads a day. 97% of leaks is after peeing just hard to stop drip drip drip. If you would not mind sharing I am curious where you are as far as ED. I use pills and pump and 95% of time successfully inter course is achieved. Have had 4 successful inter course without pump. Starting Trimix this week, just arrived today. Had good result in doctors office. Thank you and wishing all happy healthy days. Jason

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Even though I am in my 50s, my onco team recommended radiation. My prostate cancer had already metastasised when it was discovered, and I'd reacted badly to major surgery on my spine to debulk the lesion (extended ileus — digestive-system shutdown — for nearly 2 weeks, along with a whole string of other complications like steroid- and IV-feeding-induced diabetes, pneumonia, etc etc) for 2 months, plus paraplegia from the spinal-cord compression. If all of that hadn't happened, I think I would have opted for surgery was well, but since the horse had already bolted (so to speak), there was little use going to all that extra trouble to shut the barn door just a tiny bit tighter.

I have a friend who watched his dad die of prostate cancer about 25 years ago. As soon as they detected an elevated PSA in him in his 50s, he insisted that they take it out right away instead of waiting and monitoring. He didn't want to relive his dad's experience. I know some celebrities like Stephen Fry have gone public about making the same choice.

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@vanman59

I'm 59, and just had Radical Prostatectomy surgery 4 months ago. The cancer was removed and everything is clean after my 3 month check up as well. I too had 3+4=7 on 1 core out of 14. Wishing you the best! I'm sure you've been told this, but be prepared to wear pads for sometime afterwards. I am down to 1 daily now. But glad that I had the surgery.

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Radiation can also cause you to need pads for a while if it damages the bottom of your bladder. That can happen even with modern techniques like SBRT.

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@northoftheborder

Radiation can also cause you to need pads for a while if it damages the bottom of your bladder. That can happen even with modern techniques like SBRT.

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I had a radical prostatectomy in 2006 via robotic. I had to have 2 large pads every day for leakage.

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The biggest problem with pads (IMO) is the emotional impact. Once one gets over ones own ableism (the inner voice telling you that you're a failure or an object of shame/pity), wearing a pad is not a huge deal. After childbirth, many women have to wear pads for the rest of their lives because of occasional leakage.

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Surgery allows for a complete pathology to be performed, definition of margins, and removal of known cancer cells. With other treatments, you must rely on imperfect medical tools/procedures (MRI, biopsy, etc.) and hope for the same. For myself (56 when RP was performed), I wanted to fully understand the situation ensure all known cancer was removed from my body. Obviously, cancer is cancer and you can't say PC will never return. However, having a RP removes the currently defined cancer in your body, and in my opinion, gives a man the best chance to live a PC-free life going forward. Also, if PC comes back, this path allows for more treatment options (difficult to have a RP post radiation).

Just my opinions based on my experiences/research. Everyone is unique and must make a personal decision based on their circumstances.

Good luck to everyone!!!

Jim

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@hammer101

Surgery allows for a complete pathology to be performed, definition of margins, and removal of known cancer cells. With other treatments, you must rely on imperfect medical tools/procedures (MRI, biopsy, etc.) and hope for the same. For myself (56 when RP was performed), I wanted to fully understand the situation ensure all known cancer was removed from my body. Obviously, cancer is cancer and you can't say PC will never return. However, having a RP removes the currently defined cancer in your body, and in my opinion, gives a man the best chance to live a PC-free life going forward. Also, if PC comes back, this path allows for more treatment options (difficult to have a RP post radiation).

Just my opinions based on my experiences/research. Everyone is unique and must make a personal decision based on their circumstances.

Good luck to everyone!!!

Jim

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You have pretty much described the outcomes that my urologist discussed with me when deciding which treatment options to consider. With that in mind, I have my surgery in two weeks. Hoping for the best! 🙏🤞

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@tomf

Similar story with me. Last November I was 69 and had one (of 14) biopsy core diagnosed with 4+3 =7 and all imaging made it seem completely contained within the prostate. I got three unanimous opinions and the one that convinced me was the radiation specialist. She said if her husband had my results, she would tell him to have his prostate removed. My situation allowed for great confidence in removing all the cancer once and for all. Yes, there would be side effects, but those could be dealt with. So, three months later (on my 70th birthday) I underwent RALP and my PSA's have been negligible and steady ever since. For that I am happy with my choice. However, I was deluded by all the YouTube videos by men who went through this. They had me convinced that in just a few weeks all the side effects would be gone. They were wrong. It has been 8 months and the incontinence has reduced a lot, but it is by no means gone. I am undergoing Pelvic Floor PT now, and getting many exercises that should help me get drier. If you choose surgery, pay great attention to getting your Pelvic Floor in the best shape possible.

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This is "off topic".
Tom, I'm 70 years old and I have never been any sort of mechanic. When my washing machine developed problems 5 years ago I thought that I could fix it by relying on You Tube videos. Big mistake! I ended up ruining both the washer and the dryer.
Now I spend 2 hours a week at the laundromat. It's OK, I do like to read!

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@kjacko

You have pretty much described the outcomes that my urologist discussed with me when deciding which treatment options to consider. With that in mind, I have my surgery in two weeks. Hoping for the best! 🙏🤞

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kjacko - Best of luck with your surgery and I pray all goes well. I assume you have chosen a center of excellence for your surgery. I did a lo of research and chose Mayo - Rochester and Dr. Igor Frank. Amazing hospital, surgeon, and staff. The quality of life for the rest of your life will depend on the competence of the surgeon and his staff.

I will be praying that all goes well and you come out with negative margins and full control of your equipment.

Jim

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