Robotic prostatectomy vs radiation/hormone treatment

By Badgerfan2963

1 min read

72 years old and generally healthy. Had a TURP in 2019. No cancer found. In the past year, PSA climbed to 12. MRI and CT scan followed by biopsy indicate cancer. Currently scheduled for a bone scan and urogram to determine if cancer has spread beyond the prostate. Looking at robotic-assisted prostatectomy or radiation/hormone treatment. I will be meeting with both the surgeon and radiation oncologist within next week. The urologist recommends another TURP if I proceed with radiation/hormone treatment.

What questions should I be asking surgeon and radiation oncologist?

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Richard Faust Community Admin
Hi Badgerfan2963. It is great that you are seeking out information on treatment options. You didn't mention what your Gleason score came back as. This can certainly make a difference in your options. For example: there are multiple types of radiation therapy and you may want to ask what is being recommended and how your Gleason score plays into that recommendation. In addition, the results of the scans to determine if the cancer is still contained to the prostate will also greatly impact your choices. This article from our editorial team gives a general overview of prostate cancer treatments: <a href='https://prostatecancer.net/treatment' target='_blank'>https://prostatecancer.net/treatment</a>. If you have additional information members of the community with similar situations may be able to offer some insight. Please feel free to keep us posted. Best, Richard (ProstateCancer.net Team)
kenneth1955 Member
Hey Badger You have to ask what you want out of it. See where the cancer is. Also at 72 are you still into sex. If you have the Robotic Prostatectomy your sex life will be over. If you have the other the nerve bundles will not be touched. Good luck with what ever you decide. It is up to you.....Ken
Dennis E. Golden Moderator & Contributor
Hi Badger - I have met a lot of men over the past 10 years - through our coaching and foundation. Following a diagnosis many have opted for treatment - and some have not. Which way you go with this decision depends on your values and how you view life. On average guys naturally lose their sex drive as part of the aging process - some faster than others. Some are impacted drugs they are taking for other diseases. Often with that performance in the bedroom becomes less of an issue. In the end there is no right or wrong answer if you do what you believe is best for you. ... Dennis(ProstateCancer.net Team)
Guy Meredith Moderator & Contributor
 Badger, You ask what questions you should have for your urologist and surgeon. I would suggest asking about quality of life side effects from the treatment. Doctors often tend to give generic answers and information so you need to drill down and ask how you as an individual will be affected based on your age and physical condition. What are the odds in all cases? As an example, my urologist told me that at age 74 I would experience impotence and incontinence after surgery, but these would improve over time. Drilling down, the reality is that the odds are not in my favor of recovery in time to enjoy a full life. She told me that radiation would have the same side effects, but a few years down the line. For me as a now 75 year old individual it is more important to be able to enjoy full sexual function and freedom from diapers for at least a few more years rather than wait to see whether I ever would. The radiation oncologist gave me a 30% chance of eventually becoming impotent, did not give me odds on whether I would ever experience bladder problems. And sometimes doctors don't have all the information they need so you need. I was told that my sexual function would "take a hit" from hormone treatment as my urologist and two radiation oncologists were not aware that men can continue to function sexually while on hormone treatment to prevent penile atrophy. In fact I and some other men are able to fully function while on hormone treatment and preserve sexual health. I am now 8 months out from hormone treatment and fully functional. Dig deep and get the answers that consider you as an individual.
Bobby Bofinger Moderator & Contributor
My experience, echoed by others on this site, was that my Urologist did not discuss all available options with me at the time the diagnosis was confirmed. Not to delve into why that happened, but to simply recommend against making any snap decisions when it comes to your treatment. Spend a reasonable amount of time researching, learning, and weighing pros and cons. Every provider will tell you that his solution is the best! Just let it all sink if for a bit... And while you do that, don't be shy -- talk about this with anyone that will listen. You might learn about something from an unlikely source, something that you had never herd of or considered. That's what I did and that's how I found out about proton therapy. I am now 4 months post treatment and so far, everything advertised has been true. No bad side effects at all. It really is worth the time to research proton therapy. You might start by looking at this site <a href='https://protonbob.com/' target='_blank' rel='noopener noreferrer ugc'>https://protonbob.com/</a>. Read more about the book: <a href='https://www.goodreads.com/book/show/53530139-you-can-beat-prostate-cancer' target='_blank' rel='noopener noreferrer ugc'>https://www.goodreads.com/book/show/53530139-you-can-beat-prostate-cancer</a>. If nothing else, after reading the book, you will be in a position of strength, capable of asking solid, informed questions.