Prostate cancer patients are better off with radiotherapy then surgery - new research

[George71]

express.co.uk/life-style/he...

"In the surgery group, 47 percent needed to use urinary continence pads two years post surgery.

Meanwhile, only 4.5 percent of the radiotherapy group required the use of urinary continence pads"

The radiotherapy group did, however, report more troubles with their bowels than the surgery group.

In fact, 15 percent of the radiotherapy group reported "bowel bother" whereas none in the surgery group reported bowel issues.

[cesces]

"In the surgery group, 47 percent needed to use urinary continence pads two years post surgery.

Meanwhile, only 4.5 percent of the radiotherapy group required the use of urinary continence pads"

No diapers. That's game.

[cujoe]

George - The real test is what the comparison will be at 5 and 10 years, as side effects from surgery usually manifest in the short-term while RT's in the long-term. Duke did a study back when RALP was replacing traditional open surgery for prostatectomies and found patient satisfaction was much greater for da Vinci procedure at 6 months out (mainly due to the shorter recovery time), but at one year, the satisfaction level was the same.

Not contesting the results of the study referenced in your post, just reminding that over the long haul, OS from both surgery and RT are about the same. (Or were the last time I saw it reported.)

Be/Stay Well, Paz - K9

PS I have a good friend who was treated last year with CyberKnife and is SUFFERING from RT-induced bladder cystitis. He has failed to get any relief from hyperbaric treatments and is now having to use a catheter 24/7. He would surely not agree with the posted study and now wishes he had done surgery. As with all things, the results often depend on making the right treatment choice, the skill of the medical team, and at least some measure of old-fashioned good luck.

[George71 in reply to cujoe]

Hi cujoe,

I agree with your point about radiation ... if you get the wrong RO or they mess up -- it can be a bad outcome for sure. In many cases surgery is not a safe option due to heart problems (overall health etc) but radiation with ADT risks health problems to people with heart issues too.

[cujoe in reply to George71]

George - Another issue for us "oldER" men is the risk from both General Anesthesia and antibiotics. The GA can impact cognitive health (possibly permanently) and it also essentially shuts down the immune system. Antibiotics disrupt the gut microbiome (killing the good bugs along with the bad guys) where +/- 70% of our immune function resides. Evidence of both issues is linked below:

1. Anesthetic Technique for Radical Prostatectomy Surgery Affects Cancer Recurrence: A Retrospective Analysis - Anesthesiology - Perioperative Medicine, August 2008

doi.org/10.1097/ALN.0b013e3...

2. Perioperative pain, psychological distress, and immune function in men undergoing prostatectomy for cancer of the prostate - Biol Res Nurse - 2010 Apr;11

pubmed.ncbi.nlm.nih.gov/196...

3. Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence ,J Transl Med - 2018 Jan 18;16(1):8

translational-medicine.biom...

4. Anesthesia, surgical stress, and “long-term” outcomes - Acta Anaesthesiologica Taiwanica - Volume 53, Issue 3, September 2015, Pages 99-104

sciencedirect.com/science/a...

5. Antibiotics for cancer treatment: A double-edged sword - J Cancer. 2020; 11(17): 5135–5149.

ncbi.nlm.nih.gov/pmc/articl...

I had both GA and antibiotics for the replacement of my AUS urinary implant in the fall of 2020. It was done at a time when 3 mo interval US PSAs showed a descending trend and the last lab set a new post-surgery nadir of 0.02. Six months later I had a surprise PSA of 0.24. Did the GA+antibiotic treatment cause the rise and BCR#2 after 4 years of being undetectable and off all treatment? Well, as we all come to know well, correlation does not = causation. However, I do have my suspicions - and doing a similar procedure now, would insist on a epidural/spinal block for the surgery. (BTW, the surgical team discouraged it due to the potential 5 hr length of the surgical procedure - which involved both the removal of the failed device and implanting the new one.)

Live and learn - and hopefully don't die in the process.

cujoe

[George71 in reply to cujoe]

Thanks, That info is good to know about surgery and the option of epidural/spinal block for a new urinary valve -- you should make this info a separate post so the others here can read it. They may not see your info this deep in this thread.

[cujoe in reply to George71]

Good idea, George. Will do that when I get time. Also note that the first two papers are specific to prostatectomies and none specific to AUS implants.

In fact, it would be interesting to know if any people on HU forums have ever had a prostatectomy without general anesthesia? Guys?

[j-o-h-n]

"In the surgery group, 47 percent needed to use urinary continence pads two years post surgery.

Meanwhile, only 4.5 percent of the radiotherapy group required the use of urinary continence pads or they piss in their pants."

Good Luck, Good Health or Good Humor.

j-o-h-n Tuesday 02/28/2023 2:38 PM EST