Just wondered...

"Get rid of it, no prostate = no prostate cancer......"

Not necessarily the case unfortunately.  Sometimes when surgery is done cancer is revealed beyond where surgery can go.  There is also the possibility that some micro cancer cells may have escaped the Prostate.  RT can be directed at a wider area but no guarantee there either.  If required RT can usually be given after surgery but is much more difficult after RT and few surgeons will do it. (The operation is an intricate one and operating on a Prostate damaged by radiation makes it even more difficult).  Side effects have to be considered too and having both of these forms of treatment can increase the degree and extent of combining these two forms of treatment.   Younger men tend to have surgery whereas order men more often have RT.  There are several reasons for this but perhaps the main one is that many years on there is a small risk that RT can initiate a further cancer and a younger person would normally have more years for this to be a risk.

You could ask whether if you have surgery you will also be given RT or whether this is a strong possibility in your case.

HT is usually started prior to RT and may continue for anything up to 3 years thereafter.  You should also consider the possible side effects of HT which could affect your treatment decision.  (Potential side effects are detailed in the Tool Kit).

There's a research paper I read (but don't seem to have saved) that looks at success of prostatectomies (in terms of length of time before biochemical recurrence) verses diagnosis before treatment. They used the three high risk ratings as the markers to check against, i.e.

Presenting PSA >= 20;

Gleason >= 8;

T3 or above.

Basically, your chance of biochemical recurrence is quite low if you are not high risk in any of these 3 catagories, but increases if 1 or 2 of these apply, and if I recall correctly is around 50% if all 3 apply.

Of course, these are general stats, and there may be reasons why they don't apply to you. It's good to put the assumptions you are making to your consultants, so they can tell you if any are invalid, of if there's something about your case which means you should be considering other factors.

Of course, what risk you chose to accept is up to you, but I would suggest that most people would probably not go through a prostatectomy if they thought it had only a 50% chance of success, and failure meant having to do RT and HT too. The probability of things like ED and urinary incontinence if you have both radical procedures is very significantly higher than with just either one alone.

Edited by member 21 Dec 2019 at 14:12  | Reason: Not specified