Weighing up longer term risks of surgery vs Radiotherapy

I have recently been diagnosed with 2TCN0M0 prostate cancer, I met the surgeon yesterday who outlined three of the choices that I am sure many in a similar situation to me have faced, active surveillance, radiotherapy or surgery. I will meet the oncologist in a months time where we will discuss radiotherapy further. My Gleason score is 7 (3+4) The surgeon indicated to me that my Gleason was 7 in the left part of the prostate but only 6 in the right hand side. Whilst I understand that 15 year survivability is broadly the same with the three options that were shared with me, I am interested in better understanding the longer term side effect risks of surgery vs radiotherapy, having heard that about 5% of men having had surgery will still be incontinent after a year and that there is a risk in the long term of bladder cancer or bowel cancer with radiotherapy. If anyone has any information about these longer term risks that can help me make an informed decision, I would be grateful to hear from them.

Hi Pilgrim 

The way I looked at this was to concentrate on , in theory, the  easiest  option.  I Def didn't want major surgery so had 4 years on  AS which u have also been offered.

Then 20 sessions of radiotherapy, a few side effects during treatment but they soon finished and everything ok now.

Having surgery can certainly produce issues like ED and urinary problems. Obviously not everyone has them it has to be said.

Only downside to Radiotherapy is no surgery if cancer returns whereas radiotherapy after surgery ok.

So do think it through, time on your side and see what others say

Best wishes 

Steve 

Whilst looking for something else I came across this information. In particular section 1.3.7 gives some indication of short and long term effects of active surveillance, Prostatectomy and Radiotherapy.

https://www.nice.org.uk/guidance/ng131/chapter/Recommendations#localised-and-locally-advanced-prostate-cancer

This information does have limitations in that techniques have improved since this information was produced and it doesn't include things like Brachytherapy or the focal therapies. With radiotherapy modern machines provide a more targeted dose so that there is less collateral damage to adjacent structures.