Newly diagnosed, and worried
Biopsy results: Gleason 7 (3+4), group 2. Want to be more aggressive than "active surveillance", so am looking at surgery or radiation. I've read that radiation precludes later surgery if there's a reoccurrence - is this true? What about proton therapy versus photon therapy - advantages and disadvantages to both?
As for surgery, I'm worried about the side effects - especially incontinence, less so ED (I'm 70 and divorced). How common are these issues, and what's the experience like?
Thank you for any advice/shared experience you might provide.
I found that Dr. Mark Scholz of the Prostate Cancer Research Institute has the latest and unbiased information on prostate cancer treatment. You can find additional videos and information on PCRI.org and Youtube. https://www.youtube.com/watch?v=aGEVAWx2oNs
https://www.youtube.com/watch?v=WiJLRMbo5ns
https://www.youtube.com/watch?v=ArL2XD5Bx5ITalk to as wide a variety of providers as possible as they often just sell their own specialties. Providers tend to talk in generalities "Most men... depending on..." so make sure to drill down and find out how the treatment will affect you as a unique individual.
When I went for one second opinon the answer I got was obviously based on actuarial tables, not me as a person. I was not happy.
At age 73 I had the same diagnosis as you and asked for an MRI to learn the location of the cancer to see whether that would affect my decision. I asked for an MRI which showed the cancer in a location that would guarantee ED with surgery. One of my major goals was to retain sexual function.
Also, I was offered active surveillance, but the cancer was too close to an escape route for this layman to feel comfortable.
I was told that I would be impotent and incontinent after surgery, but it MIGHT resolve in a couple of years, depending... On the other hand radiation MIGHT cause ED and incontinence a few years down the road. I decided to go with radiation so I could have the guarantee of enjoying sex and living wihout a diaper until maybe I became too old or senile to care. Too, with radiation the odds seemed to be in my favor.
I also elected to have hormone treatment. I put myself on a regime of one erection a day to bring in the needed oxygenated blood to maintain erectile health. Normally we do this through nocturnal erections, but without testosterone that doesn't happen.
Hormone treatment causes menopausal symptoms and was actually the most difficult part of the treatment. Not fun. Ask any post menopausal woman.
It didn't take long to recover from the treatment. I had maintained sexual function throughout.
Best of luck.
Guy B. Meredith, moderator.
I was diagnosed with prostate cancer last month. Biopsy had 4 of the 12 cores cancerous. Diagnosis is T1c, Grade Group 3, Gleason score 7 (4+3), Intermediate risk (unfavorable). I'm 58 years old and PSA is 5.2. Before my treatment consultation with the Urologist, I was really leaning toward radiation instead of surgery (I wanted to keep the prostate for obvious reasons). However, there were a few reasons that changed my mind: 1) my Gastroenterologist advised against it (I have moderate Ulcerative Colitis and take Stelara injections every eight weeks). He mentioned that if the beams hit other organs in the area (colon, intestine, etc.) it could lead to radiation proctitis. He told me of patients he was treating who had radiation therapy and mentioned they were experiencing bleeding and other side effects. I didn't want to take the chance of that, and 2) the Urologist did mention that radiation does hit other organs and make them "leathery". He also said if the chance the cancer reoccurred, surgery was not an option because of the potential condition of those organs. So, like you, I have heard of this. Combined with some career and lifestyle changes on top the fact that the nearest radiation therapy facility is an hour away from where I work and I deal a lot with the public, radiation therapy was not really an option.
https://www.youtube.com/watch?v=XeCfJ885PvE
I found Dr. Scholz of the Prostate Cancer Research Institute to be my "go to" for current and unbiased information.
Guy B. Meredith, moderator.
I eventually opted for the radical prostatectomy and will undergo that procedure next month. I would also add to do your research to listen to a variety of opinions. I found out that sometimes the medical provider stressed their own opinions rather than the medical facts. Know you have a lot of options. Blessings! My Gleason was the same as yours. Choice of waiting or radiation. My Dr said removal wasn't a good option due to the side effects. Two of my friends that had removal said that if they had the choice again they would go for the radiation. I couldn't see waiting because since my PSA has been rising continually from 2 to 12 in the last 5 years so it would most likely continue and then action would probably be mandatory. I'm 2 weeks down and 6 to go and I'm posting the progress.
