Prostate surgery, RASP
Hubby is scheduled for robot assisted simple prostatectomy next month. Very large prostate, 160cc. Surgery is similar to TURP, except there will be incisions. Later after healing, he will have radiation. Meeting with the RO on the 18th to discuss what radiation treatments will be suggested. My questions are, is there anyone age 72(turning 73 month after surgery), that had surgery, then radiation at his age? Are side effects worse for an elderly man? Want to ask the RO, if radiation can be taken off the table, as the prostate will be basically cored, with just the capsule left. Wouldn’t all of the cancer be removed with the RASP? Couldn’t we just have PSA checks every couple of months? Would like hubby not to have radiation if possible. Doctor said there will be almost no incontinence or ED. Won’t radiation cause ED and incontinence? I’ve read the stories, but most of them were problems coupled with radical prostatectomy and radiation.
Appreciate any feedback. Thank you.
Hi
. I can tell you that many men have both surgery and radiation, although the radiation following surgery is often used if PSA or some other test indicates that the cancer was not contained to the prostate.
Concerning the RASP, as I noted in a different string it generally is not considered a cancer treatment because it leaves the outer capsule intact which may contain cancer cells. Has it been determined whether any cancer has already escaped the prostate? I ask because, if not, a total prostatectomy could be an option to avoid radiation. Of course, only a doctor can provide the proper diagnostics.
Concerning the side effects, it is concerning if you were told that there would be no issues with ED or incontinence with radiation, as both of these are known potential side effects (see our editorial team article here: https://prostatecancer.net/treatment/radiation-therapy). Every case can be different. My father-in-law had a combination of Cyberknife radiation and traditional radiation with very few side effects. Others experience more issues. As noted in the article, different types of therapy carry different risks and the doctor should be able to explain. If you feel your concerns are not being addressed don't hesitate to seek another opinion. Wishing you the best. Richard (Team Member)thank you so much for replying to my query. The urologist said that there would be little to no incontinence after the RASP. The procedure is to remove the core of the prostate, and hopefully most or all of the cancer. But, he will need to undergo radiation to eradicate any cancer remaining after RASP. We meet with his radiation oncologist next Thursday. I am preparing a list of questions. Even though RASP is the supposed future in treatment of BPH, it is still a surgery, with incisions, and the need for a catheter for a week. Maybe, I am naive, but I’m hoping that there is a radiation treatment that will treat BPH and the cancer. Hubby will be 73 a month before surgery, then of course, he’d be 73 during radiation. So researching still continues .
Also, want to ask RO about doing a PET scan before surgery. His urologist went immediately to surgery recommendation, negating any need for further biopsies or MRI’s. I think he should have the PET scan to make sure there hasn’t been any spread since June.
Hi
. I assume you are referring to a PSMA PET scan and I completely understand you wanting to ask about it. It is the gold standard for finding prostate cancer spread beyond the prostate (see: https://prostatecancer.net/clinical/psma-imaging-scan). As a non-medical professional, I can't say if there would be a reason to not get one or why it might not be helpful, but I do know that the surgery doesn't give an answer to the question about any potential spread. Best, Richard (Team Member)
Thank you, Richard. I always appreciate your input.
We meet with the RO on Thursday. I am anxious to hear what he has to say about treatment options. I do hope he understands our interest in the PSMA Pet scan before surgery. But, it might not be possible as we are just a month away from surgery, and don’t know how booked up the scans might be.
The urologist was t interested in doing further biopsies or MRI’s, just jump right to surgery, so he might go along with her plan. We will see….
