• Surgery or radiation

    Asked by mustarrosa on Thursday, August 16, 2018

    Surgery or radiation

    Curious. I have been offered either surgery or radiation and my doctors are leaving it up to me.

    16 Answers from the Community

    16 answers
    • JaneA's Avatar
      JaneA

      Isn't it ironic that we have to make such a BIG decision when we don't know enough to make that decision?

      I don't have any experience with prostate cancer. I would recommend that you download the Patient Guidelines for prostate from from the NCCN. Here's the link - it's about 112 pages of information about prostate cancer and includes recommendation for each stage. This should provide enough information for you to make an informed decision.
      https://www.nccn.org/patients/guidelines/prostate/index.html

      about 1 month ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      Did they at least tell you what the pluses and minuses of the two treatments are?

      I hope some fellows who have been there done that with prostate cancer will chime in with their experiences. I like having choices, but I sure do hope you were given a lot of information to use in making those choices.

      Best of luck.

      about 1 month ago
    • geekling's Avatar
      geekling

      You need to ask questions.

      1. What are the probable side effects with each treatment?
      2. Which treatment has a greater chance of success?
      3. Please define success?
      4. If it were you or your brother, which would you do?

      And more.

      Good luck.

      about 1 month ago
    • po18guy's Avatar
      po18guy

      There is a veritable mountain of decision-making resources available here: https://www.cancerforums.net/forums/14-Prostate-Cancer-Forum

      about 1 month ago
    • ericeinh's Avatar
      ericeinh

      I was faced with your same dilemma 6 months ago. My Urologist offered both, but recommended radiation, mainly because of the advancements they've made over the years. I was relatively young at 52, and my own personal research basically said people my age should have surgery. I went ahead and with the radiation, despite thinking I was taking the easy way out. Also, as you are probably aware, you can have radiation after surgery if it is necessary, but not surgery after radiation. I completed my 42 treatments 3 months ago. Other than a more active bladder, and a little bit of fatigue, both of which are back to 90% of where they were before treatment, I have none of those potentially embarrassing side affects (so far). While I still have a long way to go, my first follow up appointment said my PSA was tracking just as expected. So without knowing any of your details, I would definitely recommend radiation, especially if your Dr says your a candidate for either.

      about 1 month ago
    • mustarrosa's Avatar
      mustarrosa

      I have read the NCCN statements and talked to radiologist and another surgeon and initially decided on radiation but now I'm back to thinking of surgery. There is erectile dysfunction related to both and I guess you could have a graded ED response to both.. I'm thinking about the time commitment to radiation and just want to get it taken care of more quick;y with the operation.

      about 1 month ago
    • mustarrosa's Avatar
      mustarrosa

      I have read the NCCN statements and talked to radiologist and another surgeon and initially decided on radiation but now I'm back to thinking of surgery. There is erectile dysfunction related to both and I guess you could have a graded ED response to both.. I'm thinking about the time commitment to radiation and just want to get it taken care of more quick;y with the operation.

      about 1 month ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      @mustarrosa, that seems like a good solution, especially since, as @ericeinh said, you can still have radiation later if you need it (but couldn't have surgery later if you have radiation first).

      If it was me and side effects are generally the same, I think I would go with "let's get this stuff out of me ... now" ... but it is hard to know if you haven't been actually faced with the decision.

      about 1 month ago
    • Ross' Avatar
      Ross

      My experience - Some 9 yrs ago I was diagnosed with stage II PC. At that time my urologist recommended surgery. I did not seek a 2nd opinion but proceeded with surgery. As it turned out the biopsy after surgery indicated stage III cancer and 3 months after surgery I had some 50 radiation treatments plus 4+ yrs of hormone therapy. ED was a fact of life as were hot flashes. As I understand surgery is not recommended after radiation. Now in my late 70's, feeling good with no active cancer. Best wishes to you going forward on this journey and in making a decision.
      A survivor, Ross

      about 1 month ago
    • meyati's Avatar
      meyati

      What type of radiation? There are several different types of radiation therapy, which includes radiation implants--like breast cancer it all depends on what type and what stage.

      I was hanging out at the radiation center when I had head radiation--I met several gents that had prostrate cancer. Some had surgery and radiation--Several of the gents said that they wished they had radiation from the get go. I asked my radiology oncologist about it, and he preferred radiation.

      One reason that I'd tend to agree with my RO, is that he pointed out the bad points of radiation therapy-and the pros and cons of both treatments. Surgery can cause erectile dysfunction-it leaves scars that interfere in future scans, causes pain in the crotch. Surgery has to try to leave a wide margin of non-cancerous tissue around what the surgeon removes. The best surgery is laser surgery.

      Radiation is less invasive because nothing is cut out, but radiation can cause future cancers, Next radiation burns muscle and small blood veins, which makes any surgery difficult to do and to heal from. My experience is that radiation really hurts the surgery scar tissue

      about 1 month ago
    • ericeinh's Avatar
      ericeinh

      To follow up on my previous response regarding why I chose radiation. My wife is an O.R. nurse, and she favored it because she is the first one to say no surgery is without risks, above and beyond just the ones associated with the specific procedure, such as infections. While the daily treatments seemed to go on for ever, I was never in the facility more than a half hour, and this included changing in and out of a hospital gown. I went to work everyday, (I did have to leave early which I considered the one bright spot in this ordeal) and played in my weekly golf league. I was also influenced by the fact that my Urologist, who would have done the surgery, said it was the right route for me. Also, my older brother had the surgery 8 or 9 years ago, and did have both ED and some incontinence, which has now improved, but the ED never went away. My tumor was both low volume, (.6mm in 1 sample) and low risk (GS 6), so maybe that's why my Urologist thought I was a good candidate. I guess there is no way to know how I would have done with Surgery, but I definitely have no regrets, and would even recommend radiation. Actually the Q&A section at the bottom of the page from Sloan Kettering (link below) helped me too. While I'm sure there are many success stories, there were a lot of people writing in asking about their complications. https://www.mskcc.org/blog/prostate-surgery-complications-what-patients-should-know

      about 1 month ago
    • meyati's Avatar
      meyati

      One of the gentleman asked if I could get treatment before him, because it took me 8 minutes to finish treat and fix my hair nicely. it took him about 15 minutes to undress and get into his form-He was not an invalid. Then it took about 40 or 45 minutes for the actual treatment. He had a large tumor that surgery and chemo had messed up. He won a 1.5 million lawsuit from the initial clinic for malpractice. I just find myself that radiation is probably better

      about 1 month ago
    • Cancerc's Avatar
      Cancerc

      My experience is with breast cancer and i would choose radiation over surgery. I feel like there are more complications with surgery. but that is just my personal opinion. I don't know what the stats are.

      Of course they tell you the radiation could cause cancer. ha! Here is a list of some thing people have said about prostate surgery

      28 days ago
    • BoiseB's Avatar
      BoiseB

      Perhaps a second opinion would give you more information

      28 days ago
    • mustarrosa's Avatar
      mustarrosa

      I’m scheduled for robotic surgery October 8. I just can’t get over the fact that I have prostate cancer. I’m glad to have caught it early with a Gleason score of 6. I want it out.

      27 days ago
    • meyati's Avatar
      meyati

      @mustarrosa----I felt contaminated-my body betrayed me. Getting a second opinion takes time and money.

      The conundrums are that the the 2nd opinion could be the one in error, and the first opinion could be correct. The next is that if the 2nd opinion is from a doctor in the same clinic/system, is the 2nd doctor's opinion truly independent? ASCO or something I read actually addressed these 2 opinions in the last few months.

      A year ago--this last opinion was really pounded into me. My real record said that I was vile-foul-mouthed trouble maker, and the new oncologist, at a new and separate clinic, said that he didn't want me as a patient.
      I had so much trouble with the old staff for some reason---going up for an appointment and that appt person wasn't there---they said I made it up-I learned to drive over-and make the appointment and send an Email to confirm it. At the very first appointment-the nurse navigator made 3 appointments on the same day- same hour in 3 different parts of the city. I stood at the desk and cried, while they told me that I'd be serious about keeping the appointments-with straight faces.

      Part of the problem was at the beginning, that I had a rare cancer- and that first doctor was trying to remove the other 2 from my team. My son drove me to the offices- I walked in with my nose sideway--tumors over my face- and covered with stitches- and they did anything that I wanted. Insurance made it almost impossible to get rid of that old doctor. His notes flavored the doctor that replaced him, and insurance and medicare say that I have to go to that particular type of clinic to be covered, and for my rare cancer to be tracked.

      27 days ago

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