Long-term prognosis of RT with 76cc BHP?

Hi team:

Some of the Protect data (less BCR for PSA>10 pts) and my worries over ED have me looking at RT. I had always ruled it out because of BPH and the risk of obstruction but the RO I saw was v bullish on basis that "you are not straining". I have a median lobe and despite that (because some of the research is pretty encouraging) am looking at prophylactic PAE. I cannot expect that to last a lifetime, even assuming it works initially.

Now surgery for BPH symptoms after RT carries high risk of UI. BPH is a progressive disease so what does the team think of the risks of long-term issues of a BPH/PCa patient after RT? I spoke to a urologist who painted a really grim future or permanent catheterization etc. Am I just being scare-tacticed? What do people think?

Good luck finding any studies on the course of BPH after RT for PCa (please let us know if you do). This appears to be a big black hole.

I finally had a TURP when my BPH won over the finasteride and tamulosin (Flomax) that I had been taking for years with good results. A few years later I was diagnosed with PCa and had successful surgery. If I knew at the time of the TURP that I would encounter PCa, I would have paid extra to have the RP then. I suggest that anyone with BPH carefully investigate the RT options that are proposed. IMO BPH is a big factor in favor of surgery.

Djin