Robotic prostatectomy or Radiation Trearment?

Hi DL,

You ask " It is LD Brachytherapy that I have been 'battling' to explore. Not sure anyone knows the % chances of any particular individual having a recurrence of the cancer but whether you have radiation treatment (inc. Brachytherapy) or a radical prostatectomy there is a risk that the cancer can return, usually I told this is 10 - 15 years after treatment."

My understanding from reading is ;

The chances of needing further treatment after surgery are around 30%.

After R/T around 40%

Surgery recurrence is usually seen quite quickly after as the psa is an excellent marker in that if it goes above about 0.1 and continues to rise, then further treatment is required. Usually R/T if thought local.

With R/T recurrence it is usually around a three to eight year period with psa again being the marker. Local salvage treatment may be offered but more often it is just HT. If you get to ten to fifteen years out then the chances of recurrence would be much smaller by then. Same with surgery.

With Brachy, there are a couple of weak points & maybe why some consultants have strict cut-off for suitability.

One is the aggressiveness of the tumour. ( Gleason & psa figures ) in that each seed is strong enough ( enough radioactivity ) to actually destroy every bad cell.

Another is volume ( size ) of the prostate. The danger is that a gap occurs between the seeds allowing cells to escape. Sometimes more seeds are used but it is a risk. Each seed only covers a certain area or distance.

Obviously, if  on the margin then again the seeds may miss cells.

This is not to put you off your chosen treatment by any means  but just to make you aware of some points.

Devon lad my husband and as well as member Kennt and others have had low dose seed Brachytherapy.

Kennt's and our profiles are pretty up to date.

For information only of course since the decision is entirely yours.

Of course there is the possibility of recurrence, the same as with any of the treatments, as well as the possibility of bowel cancer further down the line.

It seemed to us that there were not real guarantees with any of them and the possible side effects from some of the others cancelled them out as treatment as far as my husband was concerned.

We were assured before we went ahead that survival rates for Brachytherapy equalled that of surgery.

It's horses for courses and what suits your particular form of the cancer, your lifestyle and your mental ability to cope with having the prostate still inside you.

John's prostate was small apparently and only required 58 seeds (which I must admit I personally find a little disconcerting as I expected them to zap it with a lot more)

Mine isn't a "young man" being 74 (although for some reason he's taken to doing squat thrusts as exercise - I think he's trying to kill himself some other way!!). He's (we) are still hoping for a long and relatively healthy rest of our old age.

Sandra

Opting for the best treatment according to the known biology at diagnosis ( no-one can do more ).Providing the diagnosis is thorough enough.

Accepting the decision made was right at the time. For you.

Having consultants who are well-skilled in administering the treatment.

Not being swayed into picking the treatment just for the least likely side effects; trying to negotiate with cancer may not be wise.

Accepting that one or two stray bad cells can cause problems later on & always being watchful ( thank you psa testing ).

Always being realistic.

And luck. Definitely luck. Perhaps most of all.

Hi Rob

I am lucky that because my cancer is localised and only Gleason 3+4 (and yes I do know that it could be worse as a biopsy is only a sample) that I have had a little time to consider my options and overcome my initial fear. Think I have said before but will mention again that having cancer seems to me to be a little like the autistic scale ……. you could have cancer but be anywhere on that scale and your individual prognosis is almost unique to you.

Gleason, PSA, Staging etc are all attempts (and good attempts at that ……. thank God for them) at defining your cancer and the risks associated with it – but at the end of the day like most things in life it, and you (meaning ‘one’) is unique. Luck, well having cancer is not lucky but I agree that the advice you are given and the choices you make re. treatment have an element of ‘luck’ to them as no-one knows exactly how the cancer is going behave in the short term and after treatment.

I have studied the options inside out, and spoken to many folk and several consultants and I am convinced this is the treatment I want, if I prove to be suitable and ATM I have not been told that I am not suitable …. only that it is a viable option that in most cases would be as successful as radical prostatectomy.

Finally let’s remember that most men with prostate cancer die with it rather than of it.

Thanks for your comments, really appreciate and the help that I have had from this site.

dl

Thanks for all replys devonlad Gooodluck . And a great thankyou to these kind of sites ......and esp christies goodluck guys  As good as clear after 10 months .Dont leave things to late in life Ron

Congrats devonlad ...was in and out in 5 hrs all together .http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-cool.gif  Have a great newyear