Choice advice

If you have not yet done so, I suggest you have a meeting with a Urologist and an Oncologist. These will know from your scans and histology the type, location and extent of your cancer. Ask the Urologist whether the cancer is believed to be well contained and is confident that s/he can preserve one or both nerve bundles If the cancer is well contained you may take the view that you would opt for a Prostatectomy. (Should this not be successful it is likely that you could have RT as a salvage treatment but then be subject to the side effects of both forms of treatment). Also, you could ask the Oncologist what type of RT would be most suitable in your case. (I understand Focal Treatment has been ruled out). Ultimately, you may have to decide which option to choose. There are pros and cons for each treatment. It may help you if you read the 'Tool Kit' as here. https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

Edited by member 02 Apr 2025 at 01:57  | Reason: to highlight link

I appreciate that much research suggests the aggressiveness of tumours rarely change although a few may do so. However some men for instance on biopsy are said to be Gleason 3:4 yet following surgery are told their Gleason score is 4:4. What happened in these circs.?This however does not help in making a decision on whether surgery or radiotherapy and hormone treatment may be the best form of treatment. In terms of offering a cure the success rates are similar. The only way to choose is to look at potential side effects of each type of treatment. Therein lies the problem because side effects are not uniformly experienced by all men. Some men prefer to know the tumour has been completely removed but for others it is not an issue. For others the risk of ED may make them decide not to choose surgery particularly if nerve sparring is not an option. Another person may think the long term risks of radiotherapy or side effects of hormone therapy make surgery preferable.  I think perhaps writing a pro and con list for both treatments and from that determine which form of treatment is best for you may be an option to consider. At the end of the day it is a personal choice, when the choice is available, as it is an individual’s  perspective of what potential side effects they feel most able to tolerate. No lay person should direct you one way or another. What may be worth exploring to inform your decision is whether surgery is likely to be nerve saving, is the tumour contained in the prostate, what radiotherapy regime would be offered to you and how long would you be on hormone treatment

Wishing you the very best of luck regardless of your final decision.