Trying to decide between radiation and surgery

Trying to decide on surgery or EBR. 61 yrs old, PSA=6, Gleason=7, fully inside prostate, no symptoms whatsoever, in good health. I am worried about urinary problems with surgery and bowel problems with radiation. Awful choice between which problem I want to have for the rest of my life. I would like radiation but am worried about the possible bowel issues. Any suggestions on how to figure this out? Yes I have read dozens of papers and checked all sorts of statistics but none of it seems to help me decide.

10 Replies

Brachitherapy is something I investigated but couldn't pass the pervious urethra test (too fat around the waist). I eventually (13yrs ago) underwent PR but lost my potency. Tomorrow I'm seeing a specialist for a pump penile implant as that is the only solution now. A leaner friend of mine had BT then, perfect under all points of view. He just passed away due to other ailments but enjoyed his life as far as he could... Tough decisions ahead Arjayel...

My husband had radiotherapy after PSA 8 and Gleason 7 six months ago. He also had hormone treatment. He had minor urinary and bowel symptoms which have now cleared up. His PSA is now 0.1. He found the worst things were fatigue and hot flushes from the hormone treatment . He is now very well and completely recovered. He is 74. Hope this encourages you.

Firstly, I don't understand the term "fully inside"...; secondly, have you gotten another opinion since you don't have symptoms??

Seems you need more information before making this decision and more input on how to handle it.

My husband had prostate cancer 5 years ago, he took the surgery option, recovery was about 2 months and then to ensure no cancer had been left had radiotheraphy for 12 weeks, so really side effect from either of the treatments. Was advised by surgeon to do pelvic exercise before surgery.

Megan, could you please clarify levels of potency and continence after PR Surgery? Business... as usual?

The incontinence was an issue just after surgery but with the exercises for pelvic floor after about 3 months and it got better as time went on, now alot better than before the operation, never gets out of bed even after a couple of pints in the evening. Potency has never really returned, as my husbands cancer had spread outside of the prostate and had to have alot of more removed. But we made a decision between us that it was live or die without the operation. He did attend the erectile clinic and was offered alsorts of methods to get an errection, but the tablets gave his really bad headaches, and the only other thing that worked was an injection into the penis at the time it is required. Neither of us could bear the thought of that. Must say we are 5 years in and he is very well, we travel on a regualar basis. If fact we have just moved home and he is keeping busy with decorating. He did join a gym and goes swimming regualar, he is not the sort to sit in the chair and feel sorry for himself. One thing I can recommend is Pomi T the best thing for prostate cancer. His bother had a high PSA started on these and now has a normal PSA.

Thanks for the info Meagan. I also went through pills, vacuum, and cabernet. Yesterday I was put on the Tuscan waiting list (8 months at worst) for a free AMS three part penile implant.

Oops... caverject... (booze would've been a nicer alternative)

Hi Arjayel,

I had a psa of 6 and elected to have the nerve sparing surgery. Seems I waited too long as the cancer was outside the surgical boundaries and I needed radiation and hormone therapy to take care of it. Until the radiation things were getting back to normal. It's been over 13 years now, psa less than 0.01 on every test. However, I have radiation cystitus in the bladder and need to have tumors removed regularly. The surgery was easy on me. The occasional leakage is a bit of a pain to deal with but it beats having cancer. I reccomend you don't wait long and do something soon.

Good luck,


Hi Arjayel,

I had PSA 9.5 and Gleason 7 Going to toilet 4-5times a night,at the end decided to go for

hormone therapy and radio therapy for I think it was only 28 goes -Mon to Friday.

It was little bit unpleasent from middle of the treatment with freequency and diarrea but

any problems was sorted by doctor at the oncology in East Surrey Hospital with temporary medicine and even erectile dysfunction after treatment. My PSA is 0.1 now

I am 74 and I wish I can treat my COPD as well.


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