Just curious as I have been reading through several forums and see folks with local contained Pc and are having radical proctectomy. Just wondering why many would consider the radical approach when focal laser ablation is an option with contained Pc? I realize that lesion size and quantity which is usually one lesion is a prime consideration.
In short, because there is much stronger data on the potential of the more radical approaches of being curative.
Not sure how much research you've done but to some it up as far as my own personal understanding: if you go the radical route, with surgery, it will take typically 1-12 months before you stop leaking urine especially when standing up, walking around and could take 24 months to get your erections back provided they spared both nerves and you had a very experienced robotic surgeon. With average time in the middle of those ranges of course. With radiation, you could have side effects that are delayed a couple years but generally mild. Age and pre-treatment urinary/erectile health plays a big role in ease/speed/completeness of recovery no mater what treatment you select. The big difference is if you do surgery and power through the short-term side effects, you still have radiation as a backup option if the surgery doesn't "get it all" but generally you can't do surgery as a backup if the radiation doesn't "get it all." That's the main reason I personally chose surgery (along with being fairly young.)
After my diagnosis of PCa in 2014, I chose FLA as my treatment option. The possible outcomes long term were far better than surgery or radiation. I was 1 3+4 and 1 4+3 with a PSA of 5.4. The 4+3 was ablated. I had no side effects. I left on a cruise the next day. Seven years later, the second lesion became a problem and I had it ablated.
The big difference is that FLA is not a whole gland treatment but one that treats lesions as they occur. It's not for everyone. But it was what I considered my best choice.
The other downside was paying for the treatment. I paid for the first one out of pocket. The second was covered but I'm not sure how. It just was.
If it means that I have to have an ablation every 7 or 8 years, I can handle that. The procedure is pretty simple. At this point, I'm 77. I'm not much worried about the future any more.