Whole Prostatectomy or Radiation?
I'm 53 years old and was just diagnosed with prostate cancer. My first PSA reading was 9.2 and the second was 11.6. My biopsy resulted in five samples with a Gleason score of 6, and one with a score of 7 (3+4). My doctor says that I am in grade group 2, and I am categorized as "unfavorable with intermediate risk." I am leaning toward having my entire prostate removed because it is in multiple areas and on both sides. My doctor suggests the (robotic) surgery, and he can get me in in a few weeks.
Not sure what to do. Any suggestions? Thank you.
Hi
. The good news is that a Gleason 7, with the cancer contained to the prostate gives you options. I know many men suggest exploring options, such as speaking with someone specializing in surgery and someone specializing in radiation. There may be specifics related to your case and personal health history that lead to recommendations. I want to share with you this article from Len on weighing the options and making a decision: https://prostatecancer.net/living/decision-time. I also want to share this article from Dennis on overcoming decision paralysis: https://prostatecancer.net/living/decision-paralysis. Hope this information is helpful and that others chime in with thoughts. Best, Richard (Team Member) Richard,
Thank you for your response to my post. I was reviewing my results from my biopsy, and I noticed that the pathologist had amended his report more than two days after he had initially signed it. He changed one of my Gleason scores from a 6 to a 7 (my only 7 in my final diagnosis), due to a typographical error. How does that happen? Should I get another pathologist to review the slides from my biopsy? Again, thanks.- Was your biopsy a fusion style using MRI images overlayed to the live ultrasound? If so, what did the MRI show in terms of where the tumor was and whether it appeared to be contained or not? If surgery, does he know if nerve spare will be possible based on the cancer location? They won't spare any neuromuscular bundle that is too close to the cancer as it increases the chance of recurrence. Did you have a PET scan? Any evidence of spread if so?
At 52, you are young and, generally, will do better with surgical side effects. Surgical and radiation treatments have similar cancer outcomes. Surgical side effects are worse post recovery and trend to getting better. Radiation has a better side effect profile early with side effects increasing with passing time. If nerves cannot be spared if you choose surgery, you would likely do better from an ED perspective with radiation.
Good luck with making a choice but be sure to ask lots of questions and don't rush a decision.Hello, and thanks for your response. All I know is that there was ultrasound. I can't be in an MRI room because I have a bb embedded into my skull, close to the frontal lobe of my brain. I am blind in my left eye. Doctor took 12 snips of my prostate. Doc said he can spare the cavernous nerves. I have a pet scan upcoming on 12/05/25. I am going with the radical prostatectomy on 12/17. Thanks again for reaching out.
