Would you recommend proton therapy vs surgical removal of prostate?

Posted by seekingclarity @seekingclarity, Dec 2, 2025

Looking for positive feedback. I am 59yr AA male, diagnosed with prostate cancer. My PSA has been 4.86 to 5.46 over the last 6 mths. My Gleason score was 3+3=6, 3+3=6 group 1, with one score reading of 3+4=7. I recently spoke with my urologist and we meet on 22 Dec 2025. I have been working with 2 separate Urologist to confirm diagnosis. Now that I have the confirmation I need I am really not in favor of the invasive robotic removal. I have done my research into other less invasive treatments of which were not initially brought up by the doctors. One is Cybernife radiation treatment and the most recent is Proton therapy treatment. I would like to if anyone has heard of any good results for men just under 60 to have proton therapy or cyberknife and what type of feedback was recieved. What were some side effects if any at all? Why aren't the doctors recommending these options outside of the cost. I have been told by some doctors if you do radiation first that they will not do a removal if the cancer returns. Why is that. My final thought is if PSA is not the sole determining factor for someone to have cancer why is it looked at that way. Finally what is the possibility that cancer has been present for ones entire life and has only become a discussion due to a biopsy.. Why cant it continue under surveillance? Help me unravel my thoughts. However I am leaning more towards trying the the Proton therapy. Please share feedback thank you for listening and I apologize for any confusion.

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@wwsmith "I am a big advocate of radiation treatment (RT) over radical prostatectomy (RP)."

Weill, I am the opposite. I chose RALP 5 years ago to avoid peripheral damage. I chose non-nerve-sparing because the cancer had already reached the surface of the prostate, so the nerves were probably already compromised. Surgery always removes the seminal vesicles, & cancer that escapes to the lymph glands is out the range of radiation, unless you radiate the entire pelvic region (with associated damage). In my case, there was no incontinence, then or now. I still have all the unused diapers.

I can always do radiation later (so far unneeded), but not the other way around. Plus, I kinda liked the idea of one visit (plus one post-op) rather than 38.

My friends who have had surgery are cancer-free after 15 years without any issues. Those that have had radiation, had have significant bladder issues.

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@readandlearn Modern radiation techniques cause very few incidents of incontinence or bladder issues. Just by perusing this forum it is easy to see how many more RP men than RT men have complaints of severe side effects and cancer recurrences.

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