Prostate removal?

[Suds4me]

Good morning all. My question is....why would my urologist talk me out of having my prostate removed after I told him that was my thought after I found out that I have prostate cancer. My cancer didn’t spread , so then we decided to have 45 days of radiation treatments and 2 years of Lupron ( 1 shot every 3 months) and just had my 4th shot last month. My PSA numbers for every 3 months have been 0.01.

[Tall_Allen]

There can be many reasons that you were not a good candidate for surgery. There's no info in your profile: age? comorbidities? Gleason score? imaging studies (e.g., bone scan/CT, MRI)? PSA prior to treatment/pattern? stage on DRE?

[judg69]

My advice is don’t argue and instead happily accept your good fortune. Seems as though you have a fair-minded urologist with your best interests in mind, judg69

[Jimhoy]

The 45 days of radiation was in lieu of surgery. That was the cake...... the Lupron is the icing! The insurance policy to starve off anything missed / hiding!! You would have likely gotten ADT with a surgery option too!!

[Hidden]

I was told that my prior TURP surgery for BPH (enlarged prostate) made me a poor candidate for prostate removal surgery.

[Don_1213]

You might talk to your urologist about the 24 months of Lupron. That used to be the standard of care. That's changed in the past 2 years - 18 months has been shown to not be inferior to 24 months (and by implication, 36 months) - and Lupron damage to the body is cumulative, the longer you're on it the worse the side effects will change your health.

I assume you were "high-risk" (Gleason 8-10 or PSA > 10 I believe) since your treatment plan was identical to mine.

If you need a reference for your urologist to the study determining 18 months is sufficient,: pubmed.ncbi.nlm.nih.gov/299...

[dadzone43]

If the cutting doctor does not want to cut, s/he has good reasons. Ask him/her why. A fair question --and your body.

[Murk]

Would be good to know your situational facts as asked above. I had a Gleason score of 10 with no signs of metastasizing so went for robotic surgery. All went great but the down side is I need to watch my PSA level and there is a fair chance that will require radiation and ADT in the future.

[Suds4me]

Thanks for the reply’s. My Gleason was a 10 . The cancer didn’t spread and my PSA was 8.4 . I was 74 at the time and he told with surgery,I might have too many side effects,so we opted for radiation treatments (45). The last 4 PSA have been 0.01 and he has me taking Dutasteride and Tamsulosin along with Prosteon for bone health with exercise.

[Don_1213]

Sounds about identical to my disease and treatment. G9 or G10 depending on which read is believed. PSA low - 1.3 when I started radiation (45 treatments). And 18 months of Lupron (started about 6 weeks before radiation started.) Finished the Lupron April 2nd of this year (18 months), it should have started wearing off in June. Feeling less of the Lupron side-effects, and my PSA has remained unmeasurable since I finished the radiation treatment. Also on Dutasteride and Tamsulosin - have recently had a weak stream when peeing. That might be improving. Maybe.

Good for you! May your PSA remain undetectable!