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RT or RP

User
Posted 06 Dec 2022 at 23:04

Hi 


Considering the negative sides of hormone treatment. Is RP not a swifter, less complicated process? Or are they both efficacious treatments with different adverse side effects?


Gabriel 


 


 


 


 

User
Posted 07 Dec 2022 at 02:01

Depends what you mean by less complicated. Ask the surgeon and the anaesthetist and they will probably say RP is very complicated, but you get to sleep through that bit.


And if the surgery has complications then a lifetime of complications for you is certainly not less complicated. Of course RT is not risk free either, it too can have complications.


Quite honestly we'd all be better off not having cancer, but it's inevitable for a male, and now you have to make life changing decisions on incomplete information.

Dave

User
Posted 07 Dec 2022 at 09:29
Bear in mind too that around 30% of men who have an RP go on to require salvage RT, so they finish up with both sets of side-effects.

Best wishes,

Chris
User
Posted 07 Dec 2022 at 10:05

Bloody hell. The Autumn double, like picking the winner of the Cambridgeshire and the Ceasrewitch!


 


Gabriel 

User
Posted 07 Dec 2022 at 20:07

I hope you solve this Gabriel


Then you can advise me as I am sure I will face the same dilemma 😀

User
Posted 07 Dec 2022 at 21:45
I am one who has now experienced both treatments, just as Cheshire Chtis says.

I can tell you that recovery from RP is not at all an easy and pleasant process, men differ but you are likely to suffer significant incontinence for weeks to months, and ED for quite a lot longer. By comparison RT is a doddle, OK you are rather tied down while having daily sessions but the immediate side effects aren't nearly as bad or long lasting (though it had a temporary effect on rectal as well as bladder function). However the accompanying HT definitely affects quality of life, as well as inevitable ED I found I had less energy and put on a bit of flab round my middle, but that should be reversible.

Other things being equal (which they may not be in your case, follow your consultants' advice) the clinical success has been reported as very similar for both. However as I have pointed out in previous threads, that data showing 5- of 10-year cancer-free survival is based on the techniques that were used at least that long ago; things have moved on and my impression is that RT technology is changing faster than RP. On the opposite side is the fact that once your prostate is removed PSA tests are exquisitely sensitive to small bits of residual dividing cancer cells which helps you get salvage treatment quickly, plus the fact that salvage RT following RP is routine where the converse is mostly not possible.

So there isn't a "right" answer, which is why so many of us agonise. I seem to think you said in another thread that your particular pathology seemed to favour RT according to your consultants - in which case I would take their advice.
User
Posted 08 Dec 2022 at 00:44

Such a difficult decision to make. My husband always knew he wanted RP and we had to try harder to find someone who would do it. We’re very thankful that he was one of the lucky ones in terms of op and recovery. He didn’t find the catheter too challenging, just the odd panic (mainly me) when it got a bit blocked with small clots. Continence was really good from day 1, he used pads for a few months but mainly dry apart from when having too much alcohol, and some leakage in the early days. ED hasn’t recovered as quickly (50% nerve sparing) can see improvements and apart from the odd time using the pump he hasn’t had any other medication to help with ED, so still hopeful. He was really not interested in me at all when he had 6 months of HT, so although our sex life is very different to before the op, it was nice to get his testosterone back and to feel closer again after HT. We know he may need RT in the future because he had lymph node spread but will just have to deal with that if and when it happens.


As most will say it’s only you, along with any guidance from your medical team that can make the decision. Everyone reacts differently to all treatments so we can only tell you of the experience that we have had.


Wishing you the best of luck on deciding your treatment. 

 
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