Is ADT routinely given after prostatectomy

[Vortex12]

Trying to decide between prostatectomy and radiation (I understand if there was recurrence, I would have to do radiation and ADT)

Is surgery the best chance to avoid ADT altogether

Also, can anyone recommended a Surgeon at MD Anderson

I also have urinary symptoms due to an enlarged prostate, I am thinking prostatectomy might help with the BPH issues of pain and frequent urination

[Atdabeach]

You should have a team, including urologist, medical oncologist, and radiation oncologist, who together can help you understand the alternatives available for your specific case. Don't worry about choosing a surgeon until and unless you determine that surgery is the best alternative for you. And don't be scared off by ADT -- it sucks, but so does surgery, etc., and you need to choose the alternative that gives you the best odds of beating this beast, or at least holding it at bay for as long as possible!

[Tall_Allen]

You can use this nomogram to see your odds of having a recurrence, which would probably require radiation and ADT.

mskcc.org/nomograms/prostat...

[Vortex12 in reply to Tall_Allen]

PROGRESSION-FREE PROBABILITY AFTER RADICAL PROSTATECTOMY

5yrs 50 percent 10yrs 34%

Sounds like bad odds, should probably reconsider radiation

However it does show 88% of 15 year survival

[Tall_Allen in reply to Vortex12]

Survival is fairly good with permanent ADT, chemo and advanced hormone therapy, but they will all eventually stop working, and possibly leave you crippled and taking opiates for pain. Is that how you want to survive? Most men would rather be cured.

[Vortex12 in reply to Tall_Allen]

And you think the best chance for cure is going the radiation route correct? (sorry to be redundant, but I want to make sure that is what you are saying)

[Tall_Allen in reply to Vortex12]

They've never been randomly tested, but this retrospective study suggest that brachy boost therapy is 2-3 times as curative as surgery:

prostatecancer.news/2018/03...

[Vortex12 in reply to Tall_Allen]

Got it. Thank you. Then I will request brachy boost. Thanks again

[Hombre]

Hi Vortex, I had radical prostatectomy 20 years go, and also had an enlarged prostate. I was told at the time that brachytherapy was not possible because of the enlargement. I don't know if that was right, and in any case external radiotherapy seems to have improved so much over the years I might have opted for that now. But apart from ED, I have had no side effects from the surgery. Although PSA has gradually crept up, I have not so far opted for radiotherapy as I am 80 years old and have other health issues. I hope this helps and that you make a decision that you are comfortable with.

[Don_1213]

I think it might help get intelligent answers and/or suggestions if we had some idea of what your disease consists of. Filling in your BIO would be a giant step in that direction.

I'm certain suggestions for a G6 with 5% would be different from a G10 with 100%..

[Murk]

IMO find a highly rated MD Anderson Urologist & Radiation Oncologist and have this discussion. Have them walk you through the process, advantages and expected / averages of a successful outcome.

Is surgery the best chance to avoid ADT altogether -- This question should not be your first or priority but yes RP has a chance of not going through an ADT cycle if your PCa is contained in the Prostate.

Also, can anyone recommended a Surgeon at MD Anderson -- Sorry I can't answer. don't know.

I also have urinary symptoms due to an enlarged prostate, I am thinking prostatectomy might help with the BPH issues of pain and frequent urination -- Good question don't know.

I had an RP which went really well (very little side effects) but unfortunately some PCa was found on the outside of Prostate, thus was not fully contained. Everything looked clear even the Lymph Nodes. But 3 years later PSA started to rise so I went through 5 weeks of Radiation and 6 months of (Doc said it was an option) ADT.

The Science says cure success rates are lower with RP but each persaon and case is unique. Also no one has the crystal ball or hindsight up front to determine what will work best for you in the end...

Thus its critical you talk to a highly RECOMMENDED Doc's, get a second opinion, make sure they understand you and your issues, and have them layout their plan.

You will begin to visualize the going forward path which will bring comfort and confidence.

[dlste353 in reply to Murk]

How are you doing now? I also had RP, salvage radiation and ADT.

[Murk in reply to dlste353]

healthunlocked.com/prostate...

See link for my experience. Latest is after IMRT for 5 weeks and now ADT for 60 days with going for another 90m plus days, I am doing great. I get 2 to 3 manageable hot flashes a night and the Orgovyx has helped me go from 160 lbs to 165 lbs. Only other side effect is sometimes during the day the urge to urinate is like when you have had a few alcohol dinks. Its intense but again manageable, no incontinence though.

[Don717]

I was told the same due to my urinary issues, you can read my bio. I had RP 2 years ago, no issues going forward. I void like a 30 year old now and sleep almost all night. Before my RP I never slept more than 90 minutes at a time. I've been <.02 on every 3 month PSA and just got moved to 6 months. I'm extremely happy with my situation and I owe it to a surgeon my uro recommended. He's got the personality of a rock but apparently a pretty good hand. Good luck to ya!

[AliceinW57]

Hi Don~

May I ask who your surgeon was??