Best treatment for us under 55?
Discussion and personal experience for males under 55. I fall into this category with a recent diagnosis of prostate cancer—intermediate risk Gleason 3+4, PSA 6.6, Stage II. I’m considering robotic prostatectomy or radiation treatment (HDR brachytherapy).
I've talked to a surgeon and a radiation oncologist. I ask myself, and (I know it is unpredictable), what will be my status in 5, 10, or 15 years?
Surgery will remove the prostate and will immediately drop PSA, hopefully cancer-free. Risks/side effects include incontinence, erectile dysfunction, dry orgasm, and penis shrinkage.
Radiation therapy - PSA does not immediately decline. Risk/side effects include difficulty urinating or the urge to urinate more often, erectile dysfunction, potentially dry orgasm, penis shrinkage, and extended issues related to the radiation treatment (including secondary cancer to the bladder or rectum).
The decision on what procedure to go with is not an easy one. In the unfortunate event that cancer returns:
Surgery - radiation treatment is an option.
Radiation treatment - surgery/removal would be difficult.
I had the radical prostatectomy in March 2022 when I was 52. I had a similar situation with 3+4 and PSA 6.91. I opted for the surgery primarily because as you said if it returned I could still have radation where as with radiation it was much more unlikely I could have surgery afterwards. I only had to stay in the hospital for one evening after the surgery and I was released the next morning. I experienced most of the symptoms you listed but incontinence and erectile disfunction were very brief for me and things are back to normal. Since the surgery, I've been having PSA checks every 3 months and so far they've all been below <.1. I was recently given clearance to move to every 6 months. Obviously, every situation/outcome is different, I wanted to share my experience. I wish you the best on your decision making and outcome.
I was 52 (Apr 2020) when I was diagnosed. I chose RP due to my age and the fact that it would given me the best 2nd chance of being cured with salvage radiation. 2 yrs after RP, my PSA became detectable. I had salvage radiation and wen on ADT (Lupron) for 18 mths. I've just finished up with the ADT. I'm hoping my body and mind will begin to get back to normal. I had just about all of the side effects. Nothing debilitating but very bothersome.
