What are the best treatment alternatives to prostatectomy for aggressive prostat...

Finding the right treatment path can feel overwhelming, especially when facing decisions about aggressive prostate cancer. Many patients in similar situations explore various evidence-based options including radiation therapy, hormone therapy, or combination treatments, which other community members here have discussed extensively. Consider bringing a list of questions about different treatment approaches to your next appointment with your oncology team, as they can help weigh the benefits and risks based on your specific situation and help you make the most informed decision for your care.

Hi Alfie, My case is just like yours. Cancer confined to prostate with no extension to surrounding anything. I chose not to have prostatectomy. So first they started me on hormone deprivation therapy. Pills to reduce testosterone in your body because it is fertilizer to the cancer. You will be on that for up to two years. Some side effects from that but all tolerated especially if you compare it to dying of cancer. Next about a month into things you get brachy therapy. They insert radioactive either “seeds” or very thin hairs into your prostate. Don’t freak you are asleep anesthetized for this. Almost no post procedure effects. Just a little tenderness for a couple days. Then I did five weeks of five days a week of external beam radiation. The actual radiation thing takes about ten minutes. In and out. I experienced no side effects from that. Biggest deal is arriving with a full bladder and empty bowel. By the end of the first week I had it pretty well down as far as achieving that. According to both my prospective surgeon and radiation oncologist the outcome of radiation vs surgery are the same success rate. However, many patients who go for surgery end up needing external beam radiation anyway. Plus no surgery and radiation do not cause the urinary incontinance that surgery does.

@karl knobelauch thank you I just got a shot of lupron yesterday I didnt know anything about pills to take and yes ill be doing radiation also

I believe a biopsy of your prostate will help you immensely with deciding which path of treatment you will ultimately pursue. I recommend a MRI guided biopsy, where you will undergo general anesthesia, put to sleep so you experience no discomfort or while undergoing the procedure. I had zero after effects, no pain, no bleeding, nothing. But my biopsy did indicate Gleason 9 prostate cancer. And the rest is history. Full surgical removal and follow up radiation and currently taking drugs to lower testosterone to zero. This is all working well, with PSA <.01, so presently cancer non detectable.

@kevin hill i did a biopsy thats how he determined the gleason score and risk factor