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Radiation or surgery?

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User
Posted 14 Jun 2026 at 02:13

My partner was diagnosed with prostate cancer about 18 months ago, most recently his MRI and subsequent biopsy has revealed that is Gleason score has increased to 7 and also his PSA has increased to 10.8 (was eight only six months ago). We are awaiting a bone scan to ascertain whether it’s  metastased to his bones, but in the meantime they have suggested either going for radiation with hormone treatment or a prostatectomy. Can anyone advise or share their experience if they have decided to go down the radiation route or the more radical way and go for Surgery in the first instance. We don’t know whether to try our radiation first or then Surgery if that’s possible or whether the success rate is worse with radiation. Any help or feedback would be greatly appreciated     Thank you 

User
Posted 14 Jun 2026 at 14:16

Hi, Georgia

I'm sorry that your partner is having prostate problems. However, it is great to see, in order to support him, that you've joined us. Welcome to the forum.

Surgery or radiation is one of the most often questions on here, and unfortunately there is no definite answer as to which is best.

Here's a video which may help you decide.

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

Good luck. 👍

User
Posted 14 Jun 2026 at 15:06
If it's caught early surgery is still the gold standard especially if young too. It has the benefit that if you get it all it is never coming back. I will caveat that with you will probably never know for certain they have it all eg for myself I still have detectable PSA 11 years after surgery.

The cut off / decision point for staging is usually around T3A so if it's T3B radiation is normally recommended.

User
Posted 14 Jun 2026 at 17:03
Hi,

I have had both prostate and skin cancer in recent years. In both cases, I found myself mentally wanting it to be taken away. I had surgery in both cases and am glad the tumours are gone. I found a lot of relief from having them surgically removed. A prostatectomy is a long journey with ups and downs, but in my mind, two years on, I am glad I went through it. If you read various threads on here you will find alternative views and I think both routes are good choices.

I think the main thing is to be guided by what makes you feel the most at peace. After whatever treatment, you both want to be able to enjoy life to the very fullest and that started with a peaceful state of mind for me.

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User
Posted 14 Jun 2026 at 14:16

Hi, Georgia

I'm sorry that your partner is having prostate problems. However, it is great to see, in order to support him, that you've joined us. Welcome to the forum.

Surgery or radiation is one of the most often questions on here, and unfortunately there is no definite answer as to which is best.

Here's a video which may help you decide.

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

Good luck. 👍

User
Posted 14 Jun 2026 at 15:06
If it's caught early surgery is still the gold standard especially if young too. It has the benefit that if you get it all it is never coming back. I will caveat that with you will probably never know for certain they have it all eg for myself I still have detectable PSA 11 years after surgery.

The cut off / decision point for staging is usually around T3A so if it's T3B radiation is normally recommended.

User
Posted 14 Jun 2026 at 17:03
Hi,

I have had both prostate and skin cancer in recent years. In both cases, I found myself mentally wanting it to be taken away. I had surgery in both cases and am glad the tumours are gone. I found a lot of relief from having them surgically removed. A prostatectomy is a long journey with ups and downs, but in my mind, two years on, I am glad I went through it. If you read various threads on here you will find alternative views and I think both routes are good choices.

I think the main thing is to be guided by what makes you feel the most at peace. After whatever treatment, you both want to be able to enjoy life to the very fullest and that started with a peaceful state of mind for me.

User
Posted 14 Jun 2026 at 18:50

Thank you for your responses. He is T3A. He is otherwise fit and healthy. Doesn’t smoke and is an average weekend or social drinker. He’s not overweight and exercises regularly. We are undecided as I guess just waiting for the bone scan before moving forward. We see the consultant in a couple of weeks with the results and our decision 

User
Posted 14 Jun 2026 at 18:51

Thank you for the video x 

User
Posted 14 Jun 2026 at 20:26
Hi

I was initially diagnosed T3a and had surgery in Jan 2025.

I believe that the likely outcomes from either surgery or radiotherapy are very similar.My only advice would be to understand the potential side effects .I made my choice knowing the side effects of surgery , therefore , nothing has been an unexpected surprise.In the case of surgery talking to the surgeon about how nerve sparing the procedure may be is important.Good Luck with whichever route your partner chooses.

Swannie

User
Posted 15 Jun 2026 at 10:04

Hello and sorry to hear your partner has joined the club.

Have a read of my bio, but in summary I would recommend discussing both options with both a surgeon and oncologist. My aim was to have all the facts and then to make an informed decision from there. It is very much a personal choice with that guidance. Like myself the goods news is both are viable options and both are on the table.

For me this was the most difficult period so far in the journey. But things do improve.

User
Posted 16 Jun 2026 at 06:28

Go for surgery, if it comes back in the bed for example you can have radiation afterwards. I had radiation first which didn’t work and now I’m faced with an operation that carries a very high risk of life changing complications.

User
Posted 16 Jun 2026 at 22:19

I was a T3a, Gleason 4+3 =7. 
I originally wanted prostatectomy but bone scan showed possible metastasis. A PSMA PET scan subsequently showed that there was no metastasis, it was probably some arthritis in my spine. By this time I’d already gone down the hormone therapy and radiotherapy route. A 6 month course of relugolix pills and 20 sessions of radiotherapy all finished in early Feb this year. A few side effects, but no pain of surgery, no incontinence, and now feeling great with all treatment finished.

The downside - I still have a prostate, and will have 6 monthly PSA blood tests for the next 10 years. I have everything crossed that my PSA doesn’t start going up over the coming years.

User
Posted 16 Jun 2026 at 23:28

Hi Georgia

I am not sure if our experience will help but here it is:

My cancer was well contained with clear negative margin all round. I had nerve sparing prostatectomy, performed by a very experienced surgeon, over 15 years ago, and have suffered from both erectile dysfunction and arousal climacturia (leaking urine when sexually excited and ejaculate urine at orgasm). At the time we were devastated; you would think we would regret our choice of treatment, but we don't. I am cancer free and have managed to re-establish our sex life with unexpected benefits. 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

 
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