Not sure of operation or radio therapy

Hi Danny,

Welcome to this forum but sorry it is due to a PCa diagnosis that brings you here.

At the end of the day it is going to be you who will have to decide which of the options open to you that you plump for, so to help you make this decision you need to research each of these treatments and PCa from reliable sources. A good place to start is the 'Toolkit' , available from the main part of this site.

There are potential side effects with all treatments and it is not really possible to predict how severely these will affect an individual. Therefore, care must be taken not to be swayed by how a relatively small number of men may report how they were affected. They may not be representative in terms of side effects or outcomes. It also has to be remembered that there are different types of PCa, some of which are more radio resistant for example. It is also difficult to know precisely by how much the cancer has spread until the removed prostate is examined in the lab and not always then, assuming surgery was the treatment. With a T3A staging there is a strong possibility that surgery may need to be augmented with RT if RT is not the primary treatment. (It is very difficult to have surgery after RT and most surgeons will not do it.)

As a generalization, surgery has the worst immediate side effects in terms of incontinence and ED quickly improving for some whilst for others taking longer or in some cases never. With RT, after a relatively short term mostly incontinence passes but in the long term ED in particular becomes more likely and there is a small risk of another cancer being initiated years later. RT is also often accompanied by Hormone Therapy which also has varying side effects, loss of libido, premature fatigue, hot flushes sore nipples and growing breasts and weight gain are some of the possible side effects. HT can also affect men emotionally and in their behavior to some extent.

So before making your treatment decision I suggest you also ascertain whether with RT you would also have HT. Also, would the RT be Brachytherapy or External Beam or a combination of both? What type of surgery is on offer, Open, Robotic or Laparoscopic? Is your preferred choice to have surgery and possibly RT/HT thereafter or avoid surgery?

I wish you well in making your decision, I found it lifted a weight off my mind when I made mine.

Edited by member 16 Apr 2016 at 16:33  | Reason: Not specified

Just worried about op and ED

HT worries me also wish there was a magic wand

What I am confused about is that 3 years ago I was diagnosed with enlarged prostrate but not given any treatment

Doctor did nothing

I feel if he had I would not be in this position now 😞

Edited by member 16 Apr 2016 at 08:03  | Reason: Not specified

Hi Danny, like Arthur I was not given a choice as my prostate is too clos to my rectum wall for surgery so had HT and RT and it has not been too unpleasant although have had all the side effects listed by the others, for some it is worse.

If you need somebody to actually talk to there is the specialist nurse on this site who you can telephone and I am sure that they will explain in simpler terms than doctors and give you practical information so that you can make a decision, unfortunately it is one that only you can make.

Regards Chris/Woody

Life seems different upside down, take another viewpoint

Danny, for some men the diagnosis is clear and there is no advantage to one treatment over another so they are given the choice and must decide themselves. In your case it seems there is a slightly different situation - your multidisciplinary team has looked at all your results and scans and advised that surgery would be better IN YOUR CASE. We are not medics and haven't seen your scans so we cannot know better than your team.

One of the important things about radiotherapy is minimising the collateral damage that the radiation does on its way through your flesh and organs to get to the prostate. Perhaps your tumour is very close to the bowel, or the bladder, or right in the apex and they are concerned that the radiation would leave you with too much damage to those organs.

The other possibility is that you have only seen a surgeon. Generally speaking, surgeons will recommend the op over radiotherapy (RT) while oncologists will advise RT over the op. It's natural to advise their own specialism over others if they think you are suitable. So you could phone your nurse specialist (were you given a phone number for one?) and ask him/her whether your results have been to a multi-disciplinary meeting or have they only been reviewed by the urologist? If only the uro, you can ask for a referral to an oncologist before you make a decision.