Prostate removal vs radiation treatments

Hi Steve366 and welcome to the forum. It will help us to help you if you fill in your profile with your diagnosis stats (Gleason, staging and PSA).

I was 71 when diagnosed in 2018 with Gleason 4+5=9, T3A N0 M0 and a PSA of 15 and I was offered a choice either surgery or Hormone Treatment + Radiotherapy. It was the hardest decision I have ever had to make but opted for HT/RT as I was told that surgery could lead to the possibility of stress incontinence when taking part in energetic sports. I had three years of HT and 20 sessions of RT in Feb/Mar 2019. My PSA dropped to 0.4 by the time RT started, was down again to 0.1 at the end of the 20 sessions and was undetectable a few months later. I finished HT in June 2021 and my PSA remained undetectable until my last PSA test in June this year when it had risen to 0.2, so currently in remission. My next test will be in December this year and as long as it remains below 2 the Oncology department will do nothing. I will continue with 6 monthly PSA tests for another three years and, if all is well move to annual tests for life.

I hope that helps.

Like you puzzled why a radiologist would say to go for surgery in case the cancer returns.

There's alway a chance the cancer can return with either treatment.

As Seamus suggests a few more details would be helpful

Steve 

From my own personal experience I was told if I had radiotherapy treatment then the option of later attempting to remove the prostrate would be highly unlikely as radiotherapy is like costing the prostate with superglue making any operation difficult and in many cases not possible. So I can certainly understand why the radiologist said have the operation, if any radiotherapy is required after the operation that can still happen, 

Yes you're right on that RT after surgery is definitely an option but very difficult the other way round.

Think if u have RT first , and plenty have incl me,  and cancer returns then you go down another route, IE new treatments or possibly Chemo 

Good luck 

Steve 

Thanks for the info.  I unfortunately don’t have all my stats memorized in my head at the moment and I’m traveling and won’t be back home until tomorrow. I will post back with the stats.  I am curious why my urologist and oncologist have yet to mention hormone therapy. Until I reached out to the forum, I didn’t know this as another option.  You mentioned they are injections and are combined with radiation?  I will research more on this. Thanks for the insight.

Hormone therapy is not normally given on its own.

Normally given in tandem with RT, can be some bad side effects though, obviously not always.

HT can also be given if all other treatments have failed and can keep the cancer at bay for many years, HT on its own can't cure PC 

Steve 

I had something similar. Brachytherapy consultant thought surgery was best option for me. I was given the impression that due to my relatively young age of 51 at the time that they weren't sure about secondary cancer caused by radiation which Im not too sure if there is much data on this. I also think that my nhs biopsy showed cancer all over prostate so not sure they felt the ldr seed Brachytherapy was the right option. Since then I've had. mpMRI and fusion biopsy that didn't really agree with the nhs biopsy, so going to have a session of HiFU in next few weeks.

At all times the Brachytherapy consultant said it was my choice but as I wasn't opposed to surgery then that might be the better route.