Should I choose surgery or radiation for early stage prostate cancer?

This is such a significant decision, and it's completely understandable to feel uncertain about which treatment path to choose. Many people in this community have faced this same choice between surgery and radiation, and you'll likely hear various perspectives based on different experiences and individual circumstances. Consider discussing factors like your age, overall health, lifestyle preferences, and potential side effects with your medical team, as these can all play important roles in determining what might work best for your specific situation.

I'm facing this exact same decision right now and it's honestly overwhelming - you're definitely not alone in wrestling with this choice. It really helps to know others are going through the same thought process about surgery vs radiation.

Thank you @alfie by when do you hope to make your decision? It would be great to keep talking with you if its possible?

Unfortunately my PETSCAN got rescheduled do to a insurance technicality...I switch my insurance from HMO to PPO and although I have the same company and it was approved under HMO they made me get another authorization under PPO now my scan is scheduled for February 20th I will continue to use my soursop tea and other herbs until then

That was the toughest decision I had to make. I chose surgery over radiation simply because I was told by my oncologist that if radiation didn’t completely work the surgery would be much more difficult after radiation. Surgery then if needed radiation is easier (so he says). I am 9 months out of surgery with PSA of 0.07. PSA test next week. Jim

I would radiate first than see whats going on before removing it

I am under active surveillance now for 2 years. I am 70 and my PSA test has been in the low .6 range every 3 months for those 2 years. Three MRIs also showing no lesions also. May I ask how old you are?

I just struggled with the same decision recently; it’s certainly a hard decision and I met with everyone including the surgeon; and at this stage 2 diagnosis of a 3-4 Gleason; I really can only make the wrong choice by denying it. Otherwise radiation therapy or surgery is fairly equally a good option for a successful outcome. I have chosen the slow ride on targeted radiation treatment without hormones. It takes longer, but in my opinion, minimizes risk of radiation exposure on healthy areas. I will follow up with my results in a few months.

Even guys that had it removed usually still get it in the bone or lymph node I wasn't going to remove mine cause I didn't want to go a Year pissing on myself and wearing a pee bag

I had surgery Dec 2024 and I was lucky that I never had incontinence...I did have ed ..but its alot better...my gleason before surgery was 3+4 and my psa was 4.6....it is now 0.04 and I am doing great....that last comment that guys who get it removed usually get it in their bones or lymph nodes is not true....both radiation and surgery can cause different results but it all depends on how bad your cancer was before treatment

At this early stage it depends on how aggressive the cancer is. Anything less than an 8 Gleason score is likely curable with radiation alone. Higher Gleason scores will likely require hormonal therapy as well.

@darren I really appreciate your feedback. I decided yesterday to go with radiation. 🙏🏾🤞🏾🤞🏾🙏🏾

Good luck Roger!!! Thoughts and prayers for you and your family!! Jim C.

My Gleason score was 3+4 also. This was 15 years ago. Not as many choices then as now. My PSA was only 3.8. I chose surgery, and they found that the cancer had already escaped the prostate. NED after surgery. A year later it was back. Radiation. NED after this for 3 years. It came back again. Now I’m Stage 4 Metastatic (the cancer migrated to my bladder). Quarterly hormone shots and meds have kept it at bay so far. Science has outpaced the progress of my cancer to date. If it makes you feel better, get a second opinion. Is your current doctor a urologist or an oncologist (medical or radiation)??

Dear Roger F — Two years ago I went through the same decision process as yours and I also went with radiation. Two years later, I can say I made the right choice for me, and I hope down the road you’ll feel likewise. As to ADT (not that you asked), I cut it off after 4 months because I read medical journal articles that said my Stage 1, Gleason 4+4 in only one core wouldn’t likely gain significantly with further ADT. So far, I’m right, as PSA remains <0.01. As you now know in spades, we have too many complex and difficult choices to make! Which is not to say that our choices should be same as yours. Instead, we can be a literal guide: We’re farther down the long and winding road you’re on now, so let us let you know what’s down that road. THEN … make the decision(s) best for YOU. And afterwards, let others know what happens, as they, in turn, make their choices. That’s how we slowly but inexorably gain in longevity and quality-of-life. — Dave Stauffer, Denver