choice of surgery or Radiotherapy

Your diagnosis is remarkably similar to mine.  I had surgery and then salvage RT and HT.  I was 46 at the time.

I have no regrets with the decisions I made.  

You must be guided by your own doctors though.

One piece of advice.  Don't rush into salvage radiotherapy treatment too soon after surgery and try to get a PSMA scan before any salvage radiotherapy treatment begins.

You have every reason to hope.  My PSA is now <0.006.

Edited by member 27 Jun 2022 at 09:10  | Reason: Not specified

I know how you feel.  I'd never been in hospital and radiotherapy seemed fairly clean although I wasn't keen on 6 months of hormone treatment and was suspicious of the after effects of radiotherapy.   On the other hand for the op you always think it might be you where something goes wrong.  You need a certain fitness to have the op as they slant the table head down.

To cut a long story short I decided on surgery for reasons many don't agree with.  That is, a feeling of doing something fast. Although I was told it was close to leaving the prostate.  I convinced myself I was going to sleep for a couple of hours and then it would be gone.  It was like that and I felt really good about it.   Although there is a couple of months of healing which if I hadn't been retired might have been more complicated.  I'm also pretty laid back about the after effects.  I'm 99.9% continent, although have quite a bit of ED.

For someone your age I've read that surgery is a good option as you can later have radiotherapy.  Whereas surgery after radiotherapy is usually said to be difficult.  I was sort of impressed by your doctor offering that though.

I've also read that for a T3 radiotherapy is able to reach those areas outside the prostate that might be effected unseen.

It's not an easy choice and it can depend on both your own preferences and clinical diagnosis.  I think knowing what I know now with a T3 I'd be leaning to RT although there could be other factors.  Lastly and perhaps I shouldn't say this but fear is illogical as Spock would say.  Some 10,000 have the op every year in the UK alone.  If that helps.

All the best, Peter

Edited by member 27 Jun 2022 at 14:44  | Reason: Not specified

Hi 

I can't give you advice as that must be your personal choice but this is the Brachytherpy version i took.

I had no symptoms but microscopic blood in my urine at a private medical for the renewal of my 7.5 ton driving license so was sent for PSA that came out at 2.19 and after further treatment they found 5 cores out of 20 positive with Gleason 3+4=7.

I had the choice of robotic removal but took the brachytherpy option.The hospital side was easy in on a Sunday night operation next day and released home the following, very easy no fear no great pain just a couple of pills.

I think i had a good run no great pain no incontanence just getting up three times a night but no leaks or accidents. I am coming up to six years with PSA 0.05 and was signed of in 2020.If you click on my Avatar you can see my journey so far.

Regards John.

I am 72 and had been on active surveillance for 9 years, my PSA had been below 10 for most of that period, but went up to 13 last November. I underwent Stereotactic Ablative Radiotherapy 3 months ago and my PSA is already down to below 3. Stereotactic does not involve months of hormone therapy, simply 5 minutes treatment for 5 days. 

I felt lethargic for 3-4 days after and experienced bowel and urine issues for a couple of weeks, but now fine. This treatment tends o be for focused, localised issues, but worth discussing with your Oncologist. You may not have centre near you that offers it, mine was The Freeman, Newcastle. I would have travelled anywhere for the ease of the procedure.

Otherwise OH is happy with his decision, ED is currently WIP