Can't understand why anyone would choose surgery over Brachytherapy? I must be missing something?

16 months on from open RP - Still here, has it gone - more than likely, will it ever come back – who knows !

PSA at 3 months 0.014

PSA at 6 months 0.012

PSA at 12 months 0.013

So within the realms of testing tolerance still all ok – a ‘less than’ symbol in front would be even better but I’m kind of ok with it.

Waterworks wise I was continent almost the day after the catheter came out – the odd dribble here and there after I’ve been for a wee which can be annoying but not the end of the the world, but on a normal day to day basis I have full control.

Erection wise still nothing of any consequence to speak of – using the vacuum device 2/3 times a week and on 5mg of tadalafil daily – these tablets make a small improvement and when coupled with the infamous durex ring I can muster a rather un-impressive semi - but the tablets make my legs ache really badly so I do have breaks from them and when I don’t take them there’s nothing there at all.

Tried a full dose of tadalafil - no further improvement and a full dose of sidenafil made my head feel like it was going to explode so haven’t bothered again.

I frequently question my decision to go for the RP – as physiologically the loss of erections is massive for me at the moment – Its having a much bigger impact on me mentally than I ever thought it would - but at the time of having to make the choice I didn’t ever think it would be an issue for me as I was only 51, had never suffered with ED before at all plus the surgeons didn’t really see it as being that much of a problem - the emphasis was much more on the possible incontinence side effects.

Would Brachytherapy have been any different - I don’t know, and never will? Erection wise things would probably be better now but who knows what it would be like in the future? Plus could I cope with the knowledge that ‘it’ was still inside me – when the engineer in me knows the best thing to do with a bit that’s gone wrong is get rid of it as soon as possible. Again I don’t know.

So if your reading this thread looking for some guidance/advice, I think the only thing that I can say for sure is whichever way you go it’s going to be a lot tougher than you imagine and things are unlikely to ever be the same ever again.

As a side note – I’m kind of wishing the surgeons had been a little more realistic with me up front – not sure it would have changed my decision but it might have levelled my expectations of my ED recovery - if it’s really going to take 2 years plus to see any improvements , then just says so. All this 3 months then you should start to see something is in my mind (and lots of other people I have spoken to and read posts from) not really being honest – yes some lucky guys may see improvements early on but in my research the vast majority don’t.

Phil

Give them a chance first - if Caverject or Invicorp injections work for you, they are amazing! The pump is important to maintaining penile health in the short & medium term as the wait for a penile implant could be years. 

I love your posts Dave, they combine information with experience and humour but delivered with great humility. 

It's interesting because now that I have commenced hormone treatment, I thought why didn't I just cut it out. It has dawned on me that despite the commonly held view that "you don't die from you die with prostate cancer", many die with. I have faced up to my situation, which is that I am buying time, not a get out of jail card. Hopefully radiotherapy and HT will buy me a decade but having looked at the tumours size and anterior lesions of 1.8cm, although it is supposedly N0M0, I have no doubt that time shall prove otherwise.

Gabriel