I have been diagosed . On biopsy my gleason score is 4+4=8 with a group grade of 4. I have many autoimmune diseases PBC Sjogrens Scleroderma

[bargerat]

My surgeon is reluctant to do prostatectomy because of potential healing problems and my age 74. The cyber knife doctor is very hesitant because of severe complications due to autoimmune diseases. I am leaning towards prosatectomy

[Tall_Allen]

The other alternative is just to use hormone therapy to manage the cancer (not cure it). You may find this useful to fill out:

webcore.mskcc.org/survey/su...

[bargerat in reply to Tall_Allen]

thanks for web site interesting results. I am leaning strongly towards surgery. appreciate input

[Max-well in reply to bargerat]

Are you familiar with the TULSA procedure? It may provide you with a safer alternative to the Cyber Knife. Please contact the Busch Center in Alpharetta, Georgia.

[MJCA]

Please heed what Tall_Allen suggests. He is an expert in the field. If the PC is not encapsulated, why would doctor even consider a prostatectomy? Please consider how life will be by adding a prostatectomy to all your other medical issues.

[bargerat in reply to MJCA]

the pet scan did not show any cancer outside the prostate.

[MJCA in reply to bargerat]

My misunderstanding. I googled grade IV which states it had metastasized.

[allie2020]

I had my RP in 2018 at the age of 67 but I was 3+4 with a relatively small amount of 4. I just hope you will take your time and do your homework, visit specialists, etc. If you do decide on RP, PLEASE find the very most experienced and skilled surgeon available. This is above my pay grade but Tall_Allen's idea of ADT only might be a viable alternative. My strong opinion is that surgery is only a good option if the cancer is contained within the prostate. Please don't rush into anything and I wish you the very best.

[bargerat in reply to allie2020]

Thanks

[babychi]

Surgery has so many negative side effects for most men. Periods of incontinence, ED, slow healing time, whereas you could get a second opinion from a cancer specialist on radiation treatment. We are G8/9 and still fit and have close to zero issues 5 years on. Research. Research.

[Tally111]

I have been through RP followed by ADT and radiation. It's been three and a half years now but the side effects especially of incontinence continue to trouble and sometimes embarrass me. In hindsight I should have avoided the operation.

[j-o-h-n in reply to Tally111]

Embarrassed? Just tell them you're lucky......you piss all the time......I've been pissing all the time since 12/01/2012. Screw what people say or think......

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/27/2023 1:50 PM DST

[gsun]

Have you discussed brachytherapy?

[dentaltwin]

I did not know that there were problems with radiotherapy in the setting of autoimmune disease, but a quick scan of the literature confirms this is the case. Ditto for surgery. However, this is relative risk, and the risks may or may not be sufficient to make treatment an absolute no.

Central to all this might well be your rheumatologist, who presumably knows your medical history well. Especially if you know that neither the urologic surgeon nor the radiation oncologist has had a talk with your rheumatologist, it could well be that measures may be taken to reduce the risk to an acceptable level. This is an important decision, and having all the information may help your doctors make the best decision.

Full disclosure--I had a radical prostatectomy 5 years ago. I never considered radiation, and I don't regret having had the surgery. Still, I should have gotten that consultation with a RO. I was considered intermediate/favorable pre-op.

[bargerat in reply to dentaltwin]

thanks

[fourputt]

Our cases are different because of age at surgery and I had no autoimmune disease nobody really knows exactly what their side effects will be until after surgery.....most everyone is different. I will say take your time and get the very best surgeon you can find and after surgery (and after your catheter is removed) .....walk. First around the house then in the driveway then in the street, as you feel like it. Don't push yourself with any schedule and do it only with your doctor's approval but do it. Your QOL for the rest of your life will start with recuperating from the surgery itself that that will start with getting "your legs back under you". Good luck and I'll be praying for you.