Surgery OR Hormone + Radiotherapy

Tony

UPDATE 3 months after RARP. Seven weeks after surgery I had been told by the surgeon that the cancer had been contained within the prostate and not near the edges, which was good news. Also, the post-op diagnosis was now increased from 7 (3+4) to 7 (4+3), which, in the words of the surgeon, confirmed that surgery was a good decision. Today, my first 3 month PSA test is 0.03 as I read it, however the surgeon tells me that it is in fact “less than 0.03 and as good as it gets”. I think that this shows, in my case anyway, that the MRI and biopsies were accurate in indicating that the cancer cells were contained and not near the edges, which might be useful information for anyone at that stage of diagnosis.

Hello good people I need you advice and help concerning my father's treatment. He is 69 years old but he is an active person. He was diagnosed with prostate prostate cancer about two months ago. His PSA level is 7.46 and according to the hospital's report he is stage 2a. We made a biopsy and we have two different Gleason. The first one is 4+4 in 12 of 20 point and the second one is 3+4 in 9 of 20. Yesterday he made a PET Scan and we are waiting for the result. He doesn't have any problems. We were offered  to choose between robotic surgery and radiation therapy together with hormonal therapy. The doctors don't want to tell us which option is better for him. They only tell us the advantages and the disadvantages for the both of them and that according to them he will be cured with both. I will be grateful if you can help me and share your opinion and personal experience. Thank you in advance!!!

Hi Gergana, it was me who started this thread earlier in the year. I was aged 71, fit and active. My diagnosis was similar to your father’s: PSA 10.83, after MRI scan and biopsies: Gleason 7 (3+4), T2c  (c meaning the cancer cells were in both sides of the prostate). I was given the same 2 options as your father. I chose surgery, robotically assisted, as the indications were that the cancer was contained within the prostate and not near the edge, so I thought let’s hopefully get it all out while it’s contained. Also hormone & radiotherapy was going to take 5 or 6 months and surgery would not be possible afterwards if needed. I was in hospital for 1 night only after surgery which went well and was nerve sparing. After histology my post-surgery diagnosis was increased to 4+3, the surgeon confirmed that there were no cancer cells near the edge and that surgery had been a good choice. My 3 month PSA test result was under 0.03 which means undetectable, so it appears that all the cancer has gone, another test in 3 months time. Apart from the inconvenience of a catheter for a week after surgery, I was lucky that I had no side effects and was fully continent. If I had to do it again I would choose surgery, but of course everyone and there diagnosis is different. Best wishes for your father’s treatment, whichever it is,
Tony

That looks not too bad a result. Localised with no spread. Curative pathway I would think.

Where there is no perceived advantage of offering one treatment over the other, doctors will usually leave it to the patient to decide because a case can be made for and against surgery and radiation. (Apparently, this has been explained to Dad and he will decide). In the UK, a majority of younger men tend to have surgery and older men RT. Unfortunately, the extent and severity of after effects of a treatment cannot be known until after the treatment and some men need salvage treatment with either option. Any treatment experiences posted here may not necessarily be the same for your Dad.

Hope whatever Dad decides works well for him.

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