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Advanced Prostate Cancer
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ADT or incontinence ? if you had to pick

I have been treated twice now for Prostate cancer, the first time with Proton radiation and then after a recurrence with Cryo and IRE (irreversible electroporation) on a G8 cancer. Over the last year my PSA has been creeping from .3 last to 2.4 today, I have been on Avodart since my cryo and I am told I should double the PSA results to account for the effect of the Avodart I am 60 years old and hope it is still confined to the Prostate and could be still treated. If my choices were to be to attempt a cure through some sort of treatment that would leave me incontinent or go on ADT and remain continent, which would you choose?

7 Replies

That’s a difficult one but I never had a choice due to the extent of my cancer so I would go for the incontinence with a chance of total cure. I hope your results are good and it is in the prostate only, let us know. ADT is ok but total eradication of my cancer would be a dream. 👍


I would treat the cancer as hard as you could. Are you talking surgery after you had radiation? Can be done but a bit harder.

Two years ago I was 58 when they found my G 8 cancer, which spread to the pelvic area. I first had surgery. That was followed by 38 rounds of radiation and Lupron with Zytiga. Like most men I was leaking quite bad for the first four months or so. Now, almost two years later I still wear pads but I leak less than 10 grams a day.

Even when I was leaking over 700 grams a day I still tried to make the most out of.every day. I went on walks, bike rides and scuba diving (my wet suit was really wet). You Learn to always have some backup pads and learn where the restrooms, outhouses and even where the occasional trees are located. I thought I would never get better. But like over 95% of men who had surgery, I did.

Yes having even temporarily incontinence sucks, but the side effect of not being agressive with your cancer sucks even more. With a G 8 you have advanced cancer. Like me, you are only 60 years old. You should have decades of life left. I would be aggressive with treatments. If you go with surgery however, make sure that the surgeon has done not hundreds but THOUSANDS of these operations. Best chance for regaining control.

I would also get a CT/bone scan to see if the cancer had spread. Finally, like me you may be a canadate for ADT after surgery or whatever other treatment you were thinking about so it may not be an either/or question . Yes the side effects of ADT suck, but the side effect of still being here outweighs that.


Im hoping that further Cryo and IRE may be an option.

1 like

Dr_Who----makes a lot of sense---so many men care more about their sex life then their own life. Be agressive. Just look at Walmart, CVS, etc., and see how many Packs of Men's diapers are sold. as well as pads. It is now a Multi-billion dollar business---who would of thought?



In Japan, stores are selling more adult diapers than baby diapers. Other places in the world won't be far behind.


If the choice was between continence and sex life, I'd sacrifice the sex life. At our ages sex might be a half hour a week. Incontinence is an every day bother. I know that isn't exactly the question you asked, but in evaluating my treatment options that's how my thinking went. I am Gleason 8 too, diagnosed July of 2016. Good luck on a durable remission.


Difficult choices in life have so often been left to our professionals, however, the quality of your life is yours to live. Thank God for the wisdom and experience of the men and those who love us on this site, but the health your soul is at sake...choose wisely pilgrim.



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