Decision

Thx Gup it’s all so confusing 

I personally just want to try and have as good a quality of life as is possible after either treatment 

Tony 

I've been on this site for about 4 years and I do read about more issues with surgery than RT particularly ED 

Now I'm not saying that everyone who has surgery has major issues like ED but once u lose it can be difficult to get it back.

Do your research, take it easy.

Steve

They wouldn’t be talking about surgery if your prognosis wasn’t pretty good , so don’t be too downbeat . I’m 69 and had surgery last week . I’m totally continent at night and dry most of the day already . If I could stop myself taking a pint in the evening when my pelvic floor is exhausted , things would be even better . I know I’ve been very lucky so far.

yes , it’s major surgery and you need a skilled surgeon. But it doesn’t carry many of the risks that bowel , lung ,and braincancer operations do . The operative mortality is difficult to track down , but with laparoscopic surgery ( robot aided or not ) is probably not much higher than the risk of your prostatic biopsy . I have had no more than mild discomfort. My preexistíng symptoms of bph ( enlarged prostate ) have been improved by the cancer surgery .

Surgeons like to operate ( I was an anaesthetist ). But at least some of that is that they see the outcomes of their work , and they genuinely believe in what they do.

So far , I have been astonished by how it’s been . I was anxious and confused before , and nearly pulled out of surgery  . But we’re all different, and will have different outcomes from the same procedure . Best wishes , Bill

A surgeon will always make surgery the most appealing and a radiologist will always make RT seem favourite.  Only you can decide so read the pamphlets from MacMillan and Prostate Cacner UK re side effects carefully.  Make a list of the Pro's and Cons of both treatments and then decide which ones would be easiest to cope with for you, and your family situation etc..

You should be able to get a referral to see a radiologist anyway.  I told my urologist I wanted to consult with both to get both views and I did that on the NHS.  Though these days this might be more difficult to arrange due to Covid and associated backlog so a private consultation may happen quicker - and you will get a good long chat of half an hour instead of a hurried consultation.  I was lucky in that I eventually found my rad.onc in the University Hospital who was a Professor and at the forefront of both radiology, oncology and surgery.  I did pay for a consultation with him in the first instance because getting to see him here in Wales on the NHS would have been more difficult because of our devolved NHS and different rules about how we can access treatment outside our local health area.  Because I knew the tumour was pressing on my rectum and I already had bowel and bladder problems I wanted to make sure that  because my only choice now was HT and RT that I had the best I could get and needed something to ensure that there was little collateral damage from the radiation to my rectum and bowel and chose this consultant as he used fiducial markers (3 gold seeds implanted into the prostate to better target the RT and avoid the worst of side effects.  Worked really well for me too.   Because a surgeon really only knows surgery that is what he will favour and because a radiology oncologist knows most about RT they will favour that.  It is probably an unconscious bias but understandable  because they are specialist in just their area.  GP's have very little specialist knowledge.  Consultant's know a lot about one thing whereas a GP knows a little (sometimes very little) about millions of things.  If you want to contact anyone to discuss this then contact the Prostate Cancer UK Specialist nurses on 0800 074 8383.  Their helpline is open Mon, Tue, Thur, Fri from 9am - 6pm and on Wednesdays 10am - 8pm.  Although they can't make the decision for you they may be able to help you see things more clearly.  We have found them to be so knowledgeable and helpful - even calling back to see how appointments have gone afterwards.  I asked my urologist before my MRI when I was left with only the choice of HT and RT which he would recommend for his Father and he did then grudgingly say HT and RT so I was leaning that way even before the MRI - which I had after the biopsy which left me with just the choice of finding a good Rad.onc.  So I then researched all different types of RT and how they were performed - even going to Prague to see if I could pay for Proton Beam and also to Royal Marsden for Cyber Knife.  I couldn't have proton beam treatment as I had a prosthetic hip and the consultant at the Royal Marsden said it would be far better for me to have  RT and HT as the shorter treatment and higher daily dosage of cyber knife may mean I had worse side effects than I was likely to get from RT - nice to hear a consultant pass up the chance of private work.

If they give you the choice then they believe both options will bring about the best outcome.  We are all different, have different pre- existing conditions or as they cheerfully call them co-morbidities and some on other medications so everything will be different for everyone.  As I have said before you may get some or all side effects to a greater or lesser degree.  Some people sail through whatever treatment they have but that may not be because they don't have or don't notice the side effects but because they carry on, as much as possible with a normal life with a positive outlook.