prostate or radiotherapy
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Archives1
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Depends on you are I understand. If you are younger have it removed, because radiation will probably cause you trouble 10 years down the road. At leastbthats what my surgeon braid. I'm 1 year out from removal no side effects remain. Early on incontinence was a problem and so was erections. But I've been dry since week 12 and erections with help from a pill.
Archives1
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Hello grseme. I’m seven and one half months post opp. There hasn’t been any improvement in the incontinence and the equipment down there doesn’t work at all, even with pills. It didn’t turn out so well for me. To answer your question, would I choose different if I could do it over? I’m not sure, Maybe. I’m still hoping things get better.
Archives1
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Remember, just because one procedure didn't work doesnt mean the other would. In fact it might have been worse. Its also on a case by case basis and what the doc is trained and comfortable with. If the doc is afraid maybe he sends you to radiation. If greedy, he does the surgery. I know of 11 guys and they wound up having 6 different procedures. Then again, not all had the same degree. A person cant look back and change anything in life, and believe me Ive tried.
8 months post prostatectomy and still need 2 pads per day. 72 years old and fair erection with no meds tho with viagra i had one at 3 weeks, probably some kind of world record.
8 months post prostatectomy and still need 2 pads per day. 72 years old and fair erection with no meds tho with viagra i had one at 3 weeks, probably some kind of world record.
Archives1
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Do research on Prostatectemy surgeons in your area and insurance network.
Surgeon Scorecard
We calculated complication rates for surgeons performing one of eight elective procedures under Medicare, carefully adjusting for differences in patient health, age and hospital quality. Use this database to know more about a surgeon before your operation.
projects.propublica.org
Archives1
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@grseme There are many things to consider.
What is your PSA?
I would assume you had a Biopsy -
What is your Gleason Score? (My Gleason Score was 7 (3+4))
How many cores in the Biopsy and how many had cancer? (I had a standard 12 core biopsy with 2 cores with cancer and another core uncertain)
What is your age?
How is your health? Your Heart?
I am almost 5 weeks post Radical Prostatectomy (Robotic assisted Laparoscopic Radical Prostatectomy). The incontinence has been tough on me because I had no clue what to expect. I went from using 20 pads a day, then switching to pullups. Week 2 - 12 pullups a day; Week 3 - 9 pullups a day; Week 4 - 5 pullups a day. My urologist advised me to "Measure things week to week", not day to day.
This group has been very helpful.
I know things will improve and in 6 months that I will be glad and relieved to have had the Prostatectomy over radiation. Radiation MIGHT have all the same problems as a prostatectomy. I was able to talk with someone that did the prostatectomy and someone that did the radiation.
I choose the prostatectomy over radiation because radiation is typically 5 days a week for 8 to 12 weeks. I did not want that much exposure due to COVID-19. I also wanted the cancer removed.
Terry
What is your PSA?
I would assume you had a Biopsy -
What is your Gleason Score? (My Gleason Score was 7 (3+4))
How many cores in the Biopsy and how many had cancer? (I had a standard 12 core biopsy with 2 cores with cancer and another core uncertain)
What is your age?
How is your health? Your Heart?
I am almost 5 weeks post Radical Prostatectomy (Robotic assisted Laparoscopic Radical Prostatectomy). The incontinence has been tough on me because I had no clue what to expect. I went from using 20 pads a day, then switching to pullups. Week 2 - 12 pullups a day; Week 3 - 9 pullups a day; Week 4 - 5 pullups a day. My urologist advised me to "Measure things week to week", not day to day.
This group has been very helpful.
I know things will improve and in 6 months that I will be glad and relieved to have had the Prostatectomy over radiation. Radiation MIGHT have all the same problems as a prostatectomy. I was able to talk with someone that did the prostatectomy and someone that did the radiation.
I choose the prostatectomy over radiation because radiation is typically 5 days a week for 8 to 12 weeks. I did not want that much exposure due to COVID-19. I also wanted the cancer removed.
Terry
Archives1
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Grseme,
I am a bit younger than most so my decision was weighed more based on that, I just turned 50. I had mine done in Cleveland by the surgeon who pioneered the micro-robotic procedure so he was obviously very skilled. I was told by him that 1 in 10 will have recurrence of cancer regardless of seeds or removal. If I went with Cryo and it failed there would be so much scar tissue surgery could be done but 100% were incontinent. If I went with seeds and cancer came back he could do surgery but it would be much more difficult and 50/50 I would be incontinent. Also if PSA begins to elevate and they just did the seeds would mean more biopsy and MRI to determine the cause.If PSA Elevates now it will be 6 radiation treatments or hormone shots. If I went removal at my age only 4% chance of incontinence at 1 year and with nerve sparing, and my age 80% likely to get sexual function back as well. I obviously went for removal. I am 11 weeks out and using only 1 pad a day more for security and the occasional dribble. Thankfully sexual function was back by 2 weeks. I could get along without meds for that but so much easier with it.The best piece of advice my surgeon gave my wife and I is make a chart of pro and con for each procedure, think about it for only 2 weeks and then make up your mind and never look back. Just my 2 cents.
I am a bit younger than most so my decision was weighed more based on that, I just turned 50. I had mine done in Cleveland by the surgeon who pioneered the micro-robotic procedure so he was obviously very skilled. I was told by him that 1 in 10 will have recurrence of cancer regardless of seeds or removal. If I went with Cryo and it failed there would be so much scar tissue surgery could be done but 100% were incontinent. If I went with seeds and cancer came back he could do surgery but it would be much more difficult and 50/50 I would be incontinent. Also if PSA begins to elevate and they just did the seeds would mean more biopsy and MRI to determine the cause.If PSA Elevates now it will be 6 radiation treatments or hormone shots. If I went removal at my age only 4% chance of incontinence at 1 year and with nerve sparing, and my age 80% likely to get sexual function back as well. I obviously went for removal. I am 11 weeks out and using only 1 pad a day more for security and the occasional dribble. Thankfully sexual function was back by 2 weeks. I could get along without meds for that but so much easier with it.The best piece of advice my surgeon gave my wife and I is make a chart of pro and con for each procedure, think about it for only 2 weeks and then make up your mind and never look back. Just my 2 cents.
Archives1
Staff member
Hi thanks for all your replays my Gleason score is 3+4 and I am 68 years of age I am fairly active, walking at least 3 1/2 miles a day up to 9 miles on some days, my surgeon says 80% do not have a problem 10% only use 1pad a day 5% use more than 1 and 5% have long term incontinence, but looking on the internet I am not sure about the stastistc if he is right, he also says i am the ideal candidate which i find rather suspious, the oncologist says do not have surgery only because you will be able to have radiotherapy if it returns. I had 28 biopsies 18 were clear 10 were not and with my Gleason score of 3+4 presume that at least 6 were a 3 to be the predominant one. they say I do not have to hurry and take my time, but keep changing my mind, would I be able to do everything that I am doing now if I have my prostate out even if my incontinence is heavy? Really appreciate all your thoughts and it is a fantastic forum
Archives1
Staff member
@grseme Your surgeon minimized the incontinence in my opinion. He is giving stats on final results. Dont be shocked, but after a week with a catheter, you have a much higher % of temporary incontinence. My surgeon minimized it and I was originally devastated, through walking and Kagels I overcame t in about 12 weeks. Some fellas on here never do.
Archives1
Staff member
@grseme I agree with @Gkimp. The surgeon is talking at the 12 month mark.
It is your decision and only you can decide what is best for you.
My thoughts are
1) Ask your surgeon what would happen if you did nothing.
2) You had 28 cores / samples in your biopsy which means your prostate is enlarged. The pathology report or MRI should state how large your prostate is.
3) 10 of 28 cores had cancer - 10 divided by 28 is 35.7% of your prostate has cancer.
4) How long and how well do you expect to live. From what I am reading, you seem to be in great shape (not just good). I am 55 and before my prostatectomy, I walked 2 miles in 35 minutes and that was the maximum I could go. I would think you will live much longer than 10 years and have an active life.
It is your decision and only you can decide what is best for you.
My thoughts are
1) Ask your surgeon what would happen if you did nothing.
2) You had 28 cores / samples in your biopsy which means your prostate is enlarged. The pathology report or MRI should state how large your prostate is.
3) 10 of 28 cores had cancer - 10 divided by 28 is 35.7% of your prostate has cancer.
4) How long and how well do you expect to live. From what I am reading, you seem to be in great shape (not just good). I am 55 and before my prostatectomy, I walked 2 miles in 35 minutes and that was the maximum I could go. I would think you will live much longer than 10 years and have an active life.
Archives1
Staff member
I chose high-dose rate brachytherapy because I'd had a TURP about 10 years prior to my cancer diagnosis. My urologist said I would almost assuredly have some incontinence with a prostatectomy. I was happy with my decision. No incontinence and minimal erection problems.
About 7 years post-treatment I developed calcium stones in my prostate. I had a second TURP, which was a very bad mistake. Some tissue was removed in my bladder neck, and I now have a permanent case of incontinence. It's mild & manageable, but I should have been told that going in to operate on previously radiated tissue was going to cause incontinence problems. Live & learn!!
About 7 years post-treatment I developed calcium stones in my prostate. I had a second TURP, which was a very bad mistake. Some tissue was removed in my bladder neck, and I now have a permanent case of incontinence. It's mild & manageable, but I should have been told that going in to operate on previously radiated tissue was going to cause incontinence problems. Live & learn!!
Archives1
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I've had cancer throughout my reproductive organs, and melanoma cancer on my arm. In both cases, I opted for major surgeries - and they worked. It took five surgeries in each region (10 surgeries total) to get rid of all of it, over the course of one year, but ultimately, it worked. I have a major 8" jagged scar on my arm that crosses over and around my elbow, but it was completely worth it to be cancer free. I'm almost three years cancer-free in both regions.
That same year, I also had a 3/4" breast tumor which turned out to be benign, but I had it removed, lest it become cancerous. I have three small scars from that.
After the hysterectomy, my sexual chemistry changed dramatically and now I feel like a eunuch. But having zero sex drive is actually a huge relief and makes life more simple.
I don't regret any of the surgeries I had. The surgeries meant I could avoid chemo and radiation, and keep my hair. I'm so grateful I had good health insurance that was actually willing to pay for surgery. Chemo/radiation cost less money and that's why they're often pushed first by health care systems.
So I recommend surgery over radiation. Radiation can rot your bones and teeth and cause so many problems down the line, so I would avoid it at all cost.
That same year, I also had a 3/4" breast tumor which turned out to be benign, but I had it removed, lest it become cancerous. I have three small scars from that.
After the hysterectomy, my sexual chemistry changed dramatically and now I feel like a eunuch. But having zero sex drive is actually a huge relief and makes life more simple.
I don't regret any of the surgeries I had. The surgeries meant I could avoid chemo and radiation, and keep my hair. I'm so grateful I had good health insurance that was actually willing to pay for surgery. Chemo/radiation cost less money and that's why they're often pushed first by health care systems.
So I recommend surgery over radiation. Radiation can rot your bones and teeth and cause so many problems down the line, so I would avoid it at all cost.
Archives1
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ericy said:
Exactly that from my Urologist. I’m 3 months out and age 72. I plan on being alive in 10 years, so I didn’t want to fight other kinds of cancer later. Plus I like the idea of radiation as back up.
But understand that my urologist is the most recommended surgeon for robotic prostatectomy in several states. He has done thousands of them, so he leans towards surgery.
I’m getting a bit better with the incontinence every week.
I’ll start working on the erections when I dry out.
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