Unilateral nerve sparing surgery and ED

HH 

Just my opinion but if it's near the edge possibly consider Radiotherapy.

Problems with ED are very real and  especially if the surgery doesn't clear out all the cancer and u need salvage Radiotherapy.

I had a slow growing tumour near the border and went for RT.

Obviously the surgeon won't be particularly happy with this move.

Best wishes

Steve

I'd definitely consider radiotherapy. What have they offered you?

The multi disciplinary meeting agreed the recommended course of action in my case was surgery. Whilst I won’t rule out radiotherapy, it wasn’t suggested as the best option.

I agree, from your brief description radiotherapy certainly looks like an option to seriously consider. 

Thanks Steve.

Confusion is really starting to set in now because everything I have read and been told has suggested very strongly that having RT first makes any subsequent surgery very problematic. You’ll see in my reply below that the multidisciplinary group have recommended surgery in my case.

I want to take the option which gives me the best chance of being cancer free long term given the fact I am relatively young in prostate cancer terms, and surgery seems to be that option, regardless of the consequences.

Can I ask how old you were when you were diagnosed, along with Gleason etc, so I can compare our circumstances please?

Many thanks.

HH

HH

Diagnosed 2013 aged 60 , went on AS for 4 yrs, had Radiotherapy March 2017. no real problems since then.

Gleeson 6, PSA at treatment about 12,  2 tumours largest 13mm close to border.

I understand what u r saying, surgery can be difficult after RT but not the other way round.

Only thing is the more treatments u have the more potential issue with side effects ie ED etc.

It's a bit of a gamble really, if ED would be a big issue for u then surgery or surgery followed by salvage RT could be problematic. I assume that your PSA is lowish.

Do as much research on line to help make your decision but looking at your other 2 replies both saying RT, yes I know that we r not experts but have been thru it all.

Good luck

Steve

In answer to that one, they don't always get it right. If you get the chance tell them about your concerns with the ED issue and ask them why not RT, is it just because of the difficulty of surgery after? why is surgery the best option?

Thanks again Steve.

Yes, my PSA is low at 4.1.

You hit the nail squarely on the head when you use the word gamble, as it’s very clear any treatment has its own drawbacks, and in many respects I am uncomfortable being the one who has to make such a huge decision. A surgeon will recommend surgery, a RT specialist will suggest that treatment, with them all saying they will be happy to do what I want! I wish someone entirely independent would make the decision for me - the multidisciplinary meeting is as close as it gets to that, I suppose.

The reason I asked about your age when your treatment started is primarily because my age seems to be a driving factor in what I have so far been told. The clear gist is that, because I am only 54 and otherwise reasonably fit and healthy, then a prostatectomy is the preferred course of treatment. If I was ten or fifteen years older then the recommendation would perhaps be different. I thought that advice seemed perverse at the time, with surgery elsewhere generally being seen as a last resort, but I now understand the thinking.

I suppose if there is a plus to prostate cancer it is that most of us have the luxury of time to allow us to make a choice. It’s just a pity that choice is less than a simple one!

My thanks again.

HH

I agree , your age makes it a lot more difficult but as a kind of spring chicken ED is a big issue for u.

Take your time and take it easy, hopefully other will post, come back anytime.

S

That’s the irony! If I was twenty years older ED would be fairly low on my priorities.

Thanks for taking the time to share your experience - really grateful.

HH