Surgery or radiation

First, if you are only under the care of a urologist, they are at their core, surgeons. Like a hammer, everything to them looks like a nail. Im sure some uros are bigger than that, but many many are biased and i see them online admitting it. Saying, hey, im a surgeon, of course i think surgery is better.
Sometimes surgery is better. Sometimes its not.


Before treatment myself, i read many technical papers and several books. I was aware of my approximate personal cure odds based on most of the major treatment pathways. The odds are different for each type of treatment and your personal PCa stage. Now imagine me sitting in front of a new urologist, and him looking me dead straight in the eyes, and saying that the cure odds are exactly the same for radiation vs surgery, and that i should make my decision based on which side effects i preferred. This happened a bunch of times...

Here is a good website to compare your odds. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrance). So if you are intermediate, pull up the intermediate chart and you can see your odds of 10-20 yr survival, etc.


https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/

You need second and third (or more) opinions. Talk to an Oncologist and Radiation Oncologist. Ask what the statistical outcomes of radiation vs surgery are for your particular grade. As one of the Mods on this site said that with surgery you WILL be incontinent and have ED that might get better over time. With radiation, you will not be incontinent and not have ED that MIGHT get worse with time. In my case, the outcomes for surgery vs radiation were statistically the same. I chose radiation that luckily did not require ADT therapy.


What might be right for one might not be right for another

Billbz65 Sorry to learn of your prostate cancer diagnosis at age 57. That said no matter your age hearing you have prostate cancer is nerve wracking. I was diagnosed at age 70 and treated with surgery first and then 5 years later with radiation and hormone therapy. Now some 10 years later my post op PSA is rising again. So in short the battle continues.
It is important to understand there are no right or wrong ways to approach this disease


Both surgery and radiation work for abut 70% of men but not all. Both treatments will result in some negative changes in sexual function - (Surgery = immediate ... Radiation = over time). If you are facing an aggressive cancer it may come back after surgery or radiation. If you do surgery first you can then be treated with radiation if the cancer returns. The opposite sequence is not usually as successful. After surgery I was able to have erections with the help of some blue pills. A lot of success with erections after surgery depends on the spread of the cancer, the skill of the surgeon and how you heal. My advice if you are considering surgery is to be sure your surgeon is with a major hospital and has extensive experience vs a local urologist at a community hospital. Ditto for a radiation oncologist - if you are considering radiation I would also look into Proton treatments vs standard external beam -


Things will be different after treatment. Catching it early is the best and it sounds like you are on top if it - Just know whatever decision you ultimately make - it was the best decision for you at the time. Feel free to reach out anytime. Dennis (ProstateCancer.net TEAM)