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Surgery AFTER radiation

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Prostate Cancer
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Posted 9/4/2010 12:07 AM (GMT 0)
I have heard and read conflicting reports about the possibility of prostatectomy surgery AFTER radiation. A surgeon, who does DaVinci type surgery, told me (in answer to my question), "Yes, I have done a number of "clean-up" surgeries after radiation failed." He did say it was more difficult after radiation.  One who asked the same question of other surgeons and urologists told me , "they described a post-radiated prostate as having indistinct margins from the surrounding tissue. In other words, it's not really a self-contained organ anymore.   And, radiation failed, which usually indicates the cancer cells have escaped the prostate.   So, you have a radiated prostate feeding cancerous cells into the surrounding area and the prostate itself is now difficult (some say impossible) to remove.  " I would be interested to know if anyone has had direct experience with surgery after radiation.   Many thanks in advance   skyforb  
Posted 9/4/2010 1:22 AM (GMT 0)
sky,

welcome here for starters.

my surgeon has almost 30 years experience as a uro/surgeon, and he said he had participated in to post radiation prostate removal surgery while he was a resident. he said they were very brutal surgeries, and he has never done once since, and would never do one again, period. for starters, the patient is almost guaranteed 100% total incontinence for life, and as you described above, the prostate and prostate bed are just one big mess of merged and melted margins. There are surgeons that will do it, but far and few between. As far as there being any curative hope on a salvage surgery, the chances would be slim to none from what i have been told.

david in sc
Posted 9/4/2010 2:49 AM (GMT 0)
There are a few specialized surgeons that perform this. It is not recommended. The primary treatment for failed radiation is cryosurgery, HIFU, or HDR Brachytherapy. In order for the treatment to be successful the cancer has to be confirmed to be contained. There is no local treatment that will cure PC if it is not local.
JT
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