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Posted 9/18/2022 9:10 PM (GMT 0)
The decision to treat is based on a very small sampling and is often upgraded at final pathology. Since I’ve been made aware of the PC world 10 years ago I’ve come to believe that with surgery you have a higher risk of BCR and permanent side effects like ED and incontinence.
The documentation of secondary cancers 20 years out are probably based on old studies and not the current technology.
I was told by a surgery consult they would need to cut wide and follow up with radiation, that made my choice much easier.
In the end keep doing your research before committing as there is no going back. Any treatment is better than the alternative.
If you haven’t already check out yananow.org. Read the contributor stories to see how patients fared with different treatments over the years.

Post Edited (Fauntleroy) : 9/19/2022 1:26:22 PM (GMT-7)

Posted 9/20/2022 5:16 AM (GMT 0)
Well, I did not get a lot of clear answers. One big advantage of surgery that I hadn't thought about is that my urinary issues will be cured (weak stream and a little leakage after, if I'm not careful). On the other hand, the Rad Oncologist said that radiation could make those symptoms worse, and that's his biggest concern with radiation for me. I have such a small volume of Gleason 7 that that he even suggested I could look into a more targeted treatment (which UTSW does not do). However, I've already have gleason 6 and 7 cancers. I can't see just treating that one area of the prostate and taking the chance that I won't get another prostate cancer in the rest of it over the next 30 years. And I've already gotten sepsis once from a biopsy, don't want to have any more of those. Anyway, having a tough time making a decision. Eeny, meeny, miny, moe....
Posted 9/20/2022 6:27 AM (GMT 0)
Have not been here for quite a while but see that the same old question is still popular. RT VS Surgery? Here is what I learned from this forum 8 years ago. Surgeons are not RT experts! I would suggest you talk with an RT expert. I had Gleason 3+4 much like you and that's why I am chiming in. I am so glad I chose Brachy Therapy because of the quick recovery and very few but manageable Side Effects. Had some blood in urine, and a bit of crotch ache for a few hours post op. Next day I was back to walking a mile and eventually 3 miles. I was able to walk, walk, walk, off a few minor aches and pains for the next month. Only side effect was a reduction in sauce production with no reduction in orgasmic feelings. Find and talk to people who have had RT and Surgery, do lots of research, and study this forum's results and side effects following RT and Surgery. Hope your journey is a cancer free event with minimal side effects.
Posted 9/20/2022 11:45 AM (GMT 0)

JRK said...
Well, I did not get a lot of clear answers. One big advantage of surgery that I hadn't thought about is that my urinary issues will be cured (weak stream and a little leakage after, if I'm not careful). On the other hand, the Rad Oncologist said that radiation could make those symptoms worse, and that's his biggest concern with radiation for me. ...

An honest RO! That's the flip side of my honest uro/surgeon, whose first words to me after telling me I had a Gleason 10 biopsy were that surgery and RT were equally good treatment options for my cancer.

I had a (very successful) TURP for BPH. At my post-op visit, my uro/surgeon showed me post-op photos and said he was surprised I had been still able to pee: my urethra had been almost totally occluded by the BPH and I was surely headed toward acute urinary retention.

Several years later I got my diagnosis of high-grade PCa, which was successfully treated by the same surgeon. If I had had my PCa diagnosis years earlier, I could have treated both conditions with the RP!

Djin
Posted 9/20/2022 10:19 PM (GMT 0)
JRK...I get you. I agonized over my decision. There is something to be said about curing your urinary issues--I suppose the importance in your decision making is how much of an issue it is for you. As someone that had radiation with no previous urinary issues, I feel like I pee about 80% as well as I used to. In my case, that's handled with a Rapaflo that I take about every 5 days. (The prescription is for once a day, but I basically wait until the difference has become noticeable.)

I've always found that most guys here just get to a certain comfort level with a treatment. I hope you gravitate to one!
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