Considering Alternatives to Prostate Surgery: Seeking Advice

Hey Steve, I was given both options with the same survival % with both. The only difference was the recovery time (more with surgery) and sideffects for both - some were similar but not all. For example, surgery was 6-8 weeks recovery with no to slight physical activity. Also, more urinary sideffects with surgery and ED issues. Radiation sideffects were less in the urinary and ED end. Fatigue but not terrible (at least for me) and the waiting game of PSA lowering over 18-24 months. Surgery PSA should be zero since the prostate is gone. I opted for radiation because of my active lifestyle but it's a preference for individuals. Best wishes moving forward.

Thanks Gary. Lots to think about. Good luck👊

Also did EBRT no regrets PSA hopefully still going down almost a year after treatment its at 1.82 down from 4.3 Gleason was a 3+4 7 Decipher was 0.14 I hope this is in the rear view mirror. I’m a young 67 otherwise in top shape age group swimmer former middle weight boxer

Steve, educate yourself. Look heavily into options. I had little options because they believe it's gone outside to a lymph. On Orgovyx & Zytiga. Scheduled for 28 VMAT radiation fractions mid July. Been a crazy journey which I call my nightmare maze. Started w PSA 11. Urinary issues & little sexual activity. PSA initially went to 38 but quickly down to 1.5 after couple months on ADT. Prostate & lymph shrunk 65-70% & urination pretty normal, like it was 15 years ago. Radically changed diet! Exercise as best I can (evidence strongly indicates resistance training helps significantly). Depending most heavily on God (much more to say on that if interested). Last PSA 0 17 😆. I'm 1000% confident I'm getting through this healed!

Steve, if you have it available, you might consider SBRT. It is progressing at warp speed. Check out episode on Dr. Geo Prostate Podcast!

I know a guy who went through SBRT & ADT combo. He's doing well so far! After tremendous investigation, that'd be my choice if I could have had that option with what I've learned. It's intensive work to look into but it is worth the effort if you have the options w insurance, etc.

After a PSA rise to 7.1 and a 4+3 GleesenI chose 23 IMRT radiation treatments plus a one time high dose brachytherapy procedure “boost” with six months of Orgovyx. My PSA two months post radiation is .0.04 and my only side effect has been urinary frequency that improves with every day. I agree with others who suggest you compare your options carefully. Consider the short and long term side effects and comparative effectiveness different treatment options

Thanks for all the info guys. I’m waiting on a call back from my surgeon. Probably going to postpone my surgery and consider other options. Good luck to all👊

I actually don’t see a lot of cases where the surgery and prostate removal was the “one and done” solution rather it leads to other post operative issues which are typically very difficult to manage and life changing. Another point is unless the PC is very advanced not many men die from it the treatments are now numerous and advanced designed for each case. Thanks

Just do it I was in the same situation and in one year my Gleson change to 7 and six months after stage 3 after surgery pathology test found tumor growing don't wait

Wow. Now I really confused. Just Do it. Sounds like a Nike commercial 🤔

I’m was feeling like I have time to figure it out. With a Decipher score of .59, maybe not?

So Ruben, did you elect surgery?

C A, Can I ask how they selected 23 treatments? I'm scheduled for radiation next week for 28 & a little apprehensive about so many. I would love a reason to ask for a decrease of #.

I had 28 and it’s not that big a deal you will get through it fine.

My RO reduced my sessions from 25 to 23 but I never got a reason other than he felt 23 was sufficient. Note my 23 IMRT sessions were followed by a high dose brachytherapy “boost” procedure and I am just now finishing six months of ADT

Steve, I wish you best of luck with your decision. I had a similar situation although no two patients are the same - Gleason 6 with a decipher of .63. My doctor recommended surveillance but my wife and I agreed we didn’t want to wait to see it get worse and or spread. Had the surgery and am making good progress with incontinence and ED rehab. But to me, while daunting early on, seemed like lesser issues to work on with choices for improvement. Turned out post procedure pathology showed a Gleason 7, and post op PSA’s have shown non-detectable. While this is no guarantee I feel we made the right voice for ourselves. I’ve been back exercising and pretty much functional aside from rehab issues since 2 months after the procedure. Rehab hasn’t been an issue and I’m getting through it - seeing progress helps a lot. The whole thing is teaching me patience, something I’ve not had much of until this journey. I hope this gives you some context for your decision. Best wishes

Hey Steve S. Thanks for the positive feedback on surgery. My family is thinking the same. Why wait for it to get worse. Get it done and move on. Glad you’re happy with your decision 👊

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Yes I did elect surgery is the best option for me and hopefully for you to I'm recovering well and getting strong good diet and exercise find balance in your life body soul and spirit pray and establish a strong relation with God

Stage 1 but aggressive on hormones over a month. Seriously interested in the ablation techniques. Very difficult to navigate. Each doctor seems to push their services and network. Get as many opinions as possible. Good luck!

I know what you’re saying. It’s like buying a car. The Ford dealership touts their brand, Chevy touts theirs.

Also Jonathan. Ablation techniques seem to be getting more popular, but for the most part, they are not covered by insurance. Yet…

Absolutely, one must be careful. I would love to travel to Connecticut for the ablation. I have good insurance but fear it will still cost too much. Especially out of state. This medication is fogging my brain but I believe Medicare covers it in some states. Not all forms, some are still experimental. Still have a consultation with another specialist. I’m sure this one time treatment is less expensive and therefore less profitable.

Hey Steve, my score is 7. I'm coping with side effects from 2 hormone pills, soon will start 28 radiation treatments. I'm assuming they want me to continue the pills after? I don't believe the quality of life is great! It could be worse i guess.... I'm going through this one time!! I'm 70 and hoping to be done with it in a year or so? I'm also living with type 2 diabetes, insulin everyday, fatigue. I'm very happy with my first 70 years! Now I'm not sure i want to fight off medical conditions for 10 years? Don't mean to be so gloomy, just thinking out loud. I wish you luck, and a smooth ride!