Had appt with urologist, although already stated no surgery

[pd63]

Had appt and the urologist seemed to he trying to persuade me to have prostatectomy although I was clear at diagnosis no surgery primarily due to incontinence issues.He said permanent incontinence occurred in less than 5% of cases, I disagreed and said 10/15% is nearer the mark am I correct?

[Tall_Allen]

About 20% have permanent incontinence after RP.

prostatecancer.news/2016/09...

[KenPe in reply to Tall_Allen]

Does it vary from doctor to doctor so this particular one may actually have personal stats showing 5% and so it isn't fair to distrust?

[Tall_Allen in reply to KenPe]

Surgeons make that claim, but if it were true, they would publish. Do the one's making such claims even back it up with patient-reported outcomes (like IPSS or EPIC)

[JohnCh]

I fired my Urologist when he misquoted statistics on prostate cancer. My PCP recommended another urologist who was open to all treatments and I ended up with radiation.

[MarkS]

I think you're absolutely right to hold out. One thing I've come to realise is that few urologists look at you holistically. They are just interested in surgery, and most do mainly BPE surgery with just the odd prostate cancer case thrown in. I found a totally different approach from the oncologists, particularly those who specialised in genitourinary cancers.

[jethrotullag]

Do what John CH did. Run away!

Get a compatible doctor!

Have you watched Prostate Cancer Research Institute YouTube videos? Alex and Dr Scholz give excellent advice.

I had a Doctor who recommended only the biopsy option their Urology Department had, transrectal.

I ran away! Found a trans perineal option nearby.

[pd63 in reply to jethrotullag]

Doin SBRT anyway, I agree about tp biopsy as I've had 2

[bcnulater]

To have surgery or not is a good question, there are many factors to consider.

How aggressive is the cancer. Do you have a high PSA how aggressive is the cancer?

Where is the cancer in the prostate. Is it throughout the entire prostate or only on one side.

Is it still in the prostate capsule. How close is the cancer to the edge of the prostate capsule. Two prong question. The closer the cancer is to the capsule edge, the higher the chance of some of the cancer could escape spreading to other areas, glands and the lymph system. In my the case, the cancer was only on one side, did not appear to have breached the capsule wall, but he was not able to get a full 3mm clear border. There was no cancer found in the seminal glad or the 17 lymph nodes removed. It does appear a few cancer cells have escaped and as my oncologist says, there are a few Bad Boys Partying.

Age The younger you are the better the results and recovery. Once over 70, having a radical prostatectomy has additional risks.

My personal situation, was not fan of the post surgery incontinence. The doctor had given me some Kegel exercises to do after the catheter was removed. Was doing the Kegels but was frustrated with the progress. Found a pelvic floor physical therapist, was given 12 additional exercises to do. After a week of doing these exercises saw a 90% improvement, within 2 weeks and currently very happy with the results. Still an occasional small leak but nothing but not a major concern. 20/20 hindsight, would have gone to the pelvic physical therapist prior to the surgery to strengthen the pelvic floor.

Again, my person situation, I am a football (American football) high school official. Started my preseason training late June, was back on the field working 4 - 5 games a week in mid-August, during the 12-week season did not have any issues.

You will need to evaluate your situation, review all the variables, risks and percentages. Hope this helps.

Cheers!