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Treatment Options

User
Posted 04 Nov 2026 at 17:18

I was diagnosed with prostate cancer a couple of weeks ago and today I got the news that my bone and CT scans don't show evidence of spread and the cancer is cinfined to my prostate, so my treatment options are surgery to remove the prostate or hormone and radiotherapy. 

For those of you that have made the choice between the two options what helped you choose and what was your experience of the treatment and the side effects? Is it a straight choice or do you have hormone and/or radiotherapy alongside surgery?

I have a follow up discussion with the specialist nurse next week and I'm trying to gather info before that chat. Any advice or experience you are willing to share will be gratefully received. 

Edited by member 05 Nov 2026 at 10:42  | Reason: Not specified

User
Posted 04 Nov 2026 at 17:40

Hello mate. 

I'm sorry that you've joined our club but welcome to the forum.

It would help us, help you, if you could give full details of your diagnosis including PSA levels, Gleason score and cancer staging.

It's great news that the problem appears to be prostate confined  so I assume you are T2 staging.

Here's an excellent video on various treatment options and their possible side effects.

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

Good luck, pal. 👍

 

User
Posted 04 Nov 2026 at 19:17

Thanks Adrian56. I'll have a look at the video.

My PSA is 4.86, and a Gleason 7 (4+3). And yes a T2. It's a whole new language, isn't it?

User
Posted 04 Nov 2026 at 19:50

Originally Posted by: Online Community Member
It's a whole new language, isn't it?

It certainly is, mate. Based on numbers and letters, and I was rubbish at algebra at school. 🙂

Your 'figures' are pretty good, leaving most options open. 👍

Edited by member 04 Nov 2026 at 20:02  | Reason: Not specified

User
Posted 05 Nov 2026 at 21:32
DM, the point of having a diagnosis but needing to decide on treatment is probably the most stressful stage in the whole process.

The fact that you have two options means that from the published clinical data there is no difference in outcome between the two, usually measured in the rate of relapse (based on PSA). But remember that by definition data on 10-year outcomes is based on treatment over 10 years ago, and the technology has improved since then.

I chose surgery; I was 63 at the time and the usual advice is that surgery is better for younger patients (in PC terms!) and radiotherapy for older. That is because surgery involves some pretty traumatic damage to your body internally, and the younger you are the better you are likely to recover. Everyone is going to have issues for quite a few weeks, if nothing else you will be needing a catheter until the urethra heals. Once the catheter is out you may have incontinence issues (needing pads to absorb leaks) which can recover quickly or slowly or not at all. And everyone has erectile function issues for months and for many this is ongoing. The good thing is that if you have a relapse after surgery radiotherapy is still available as a second hit, that isn't often possible the other way round.

Radiotherapy is usually given in combination with hormone therapy (androgen deprivation therapy) which has its own issues. But radiotherapy alone has less severe effects in the short term than surgery; there will probably be slower and longer term issues with continence and erectile function. The big worry is spillover of radiation triggering cancer developing in nearby tissues (bladder or rectum) but that takes around 20 years so is less of an issue in patients when they reach 70 or so. However the hormone therapy has its own problems, while it contributes to fighting the cancer and is crucial if it has spread beyond the prostate (not your case it seems) it is imperfectly reversible with a risk of long term drop in libido.

Having said all that, the new generation of radiotherapy machines allow better targetting than the ones of 10+ years ago, which means they should achieve the same curative benefit with fewer side effects. And for some patients using hormone therapy is no longer necessary, it would be worth asking what they recommend in your specific case before coming to a decision. Surgery is also likely better now in that the "robotic" methods were relatively new 10 years ago and not universally available and there are now many more machines and surgeons experienced in using them.

Tough decision, there isn't really a "right" answer it just has to feel right for you. Make yourself fully informed before deciding. Good luck.

User
Posted 05 Nov 2026 at 22:04

As an older gentleman,  77, I was advised not to have surgery due to possible risk of long term incontinence. My cancer had not spread beyond the prostate but I was Gleason 9 high risk. I was put on hormone therapy, Relugolix, for 2 years and had 20 sessions of radiotherapy which were not a problem to complete. My issue is the side effects,  the radiotherapy reduced the length of my erect todger by 50%. The Relugolix totally wipes out your libido and significantly reduces ability to get an erection. I have been taking the pesky Relugolix for 17 months and have discussed coming off it but due to Gleason 9 I was strongly advised to tough it out for another 7 months. I am currently experimenting with the delights of Sildenafil, self stimulation and a pump to try and keep good penile health and maintain some sexual function untill I am off the tablets. I am finding things rather worse than I was originally told but I am determined to persevier.

Good luck with whatever you choose.

 
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