QUESTION

[RBSW1]

Hi looking for info from people 3 to 7 years after RT for prostate cancer. Why you choose RT over prostate removal. Any info would be greatly appreciated. Rbsw1

[FMOH_N]

provide details on your PCa. PSA, GS, biopsy results etc.

[RBSW1 in reply to FMOH_N]

Psa 5.12 Gleason 3+3=6 3+4=7 only 2 cores out of 13 cancers . Intermediate favorable.

[drzaius in reply to RBSW1]

I’m only 1 year out from 28.5 sessions of IMRT and had G3+3 in 3 cores, PSA 4.4. But my Father died of Pca and my decipher score was high risk so I was also favorable intermediate. My PSA is now .8. It takes a while to find your low point. No real issues so far to speak of. I’m 75 years old, chose radiation because it’s much imoroved over the past 15 years. I also know of others that had RP and have leaking issues,ED, etc. After having watched a video of RP, the removal of the prostate was more complicated than I imagined.

[RBSW1 in reply to drzaius]

Thank you

[Xavier10 in reply to RBSW1]

You should try watchful waiting for awhile probably. Or if you want to get it resolved, just do the IMRT or SBRT, whatever a RO recommends. they won't require ADT with favorable. I wouldn't go with the HIFU or anything. It hasn't been proven to work. As one noted urologist told me, HIFU is a "pre-treatment." And i say this as a person that used Tulsa-Pro, unsuccessfully. Radiation improves by leaps and bounds each year. Surgery is still...surgery. I have never liked the idea of cutting and hacking inside you, especially where cancer is concerned. Let us know how everything goes.

[RBSW1 in reply to Xavier10]

Thank you will do.

[Jpl506]

G10 PSA 6.5 40% of 14 cores. Surgeons from 3 centers of excellence said I’d need radiation afterwards anyway so I skipped the intermediate step and had 5x8 40gy SBRT at UCLA with Dr. Amar Kishan in 2020. No issues to speak of 4.5 years later.

[RBSW1 in reply to Jpl506]

Thank you

[conbio]

G 4+5. Pretty simple, research shows that by far, results would be better with the 3-legged stool of ADT, EBRT, and Brachy than with RT.

[RBSW1 in reply to conbio]

Thank you

[leach234]

Gleason 8. PSA 5.2. Chose surgery at 59 years old. 7 years out. PSA still <0,02.

No incontinence and no ED. Surgery was the right choice for me.

[RBSW1 in reply to leach234]

Thank you

[MD0723]

I'm 66yr old. I was diagnosed with PC in 2020. Gleason 7 (4+3), Chemo pills for 1 monrh before Proton beam radiation started. Lupron for 6 months during Proton treatment. I chose the monthly injections of Lupron vs 1 shot which lasts for 6 months. Did not feel comfortable with starting Lupron all in 1 dose without knowing how my body would handle it. (Glad I did)I chose radiation because I feel no reason to remove the prostate & have to battle the long term urinary, ED & shrinkage side effects of having the prostate removed. Of course most doctors don't tell their patients of the side effects of having it removed. If they do, the certainly down play the side effects. They make it sound like the surgery will be a breeze- absolutely Not. Most need pelvic floor therapy to help with inconvenience after surgery.

I experienced ED during & after radiation because of Lupron. I benefited from using a penile pump during & after radiation+ADT treatment. Of course oncologist didn't mentioned the hormonal side effects of ADT.

What I have seen throughout my journey is that there are a number of individuals who have a reoccurance of PC even though they had their Prostate removed.

This is just my opinion & observation for whatever it's worth.

[RBSW1 in reply to MD0723]

Thank you

[Brightman]

I was told by my MO that with Gleason 9 and spread to 4 boney places, that if I had my prostate removed then it would spread more, so I had 25 continuous radiation treatments and retained my prostate. Even though I had side effects, probably a combination of ADT and Docetaxel chemotherapy as well, I did not suffer as much incontinence etc as friends who have their prostate removed. Your choice though. Best wishes.

[RBSW1 in reply to Brightman]

Thank you

[Mgtd]

4+3. Had radiation because it was faster, easier and equally effective. No major side effect so far.

[RBSW1 in reply to Mgtd]

How long ago did you have it.

[Mgtd in reply to RBSW1]

18 months Something to consider is age and health.

[RBSW1 in reply to Mgtd]

Can I ask your age I'm 61.

[Mgtd in reply to RBSW1]

Will be 80 in a couple of months. No major health issues other than PC. Do aerobic and resistance training 6 days a week. Healthy life style choices.

In my opinion personal opinion mental toughness, positive attitude, diet, exercise as well as life style choices really need to be considered. These effect outcomes.

[RBSW1 in reply to Mgtd]

Thank you

[paladin7]

I chose RT because prostate removal is major surgery, and RT is not invasive. The treatments are roughly equivalent in effectiveness, but with different potential side-effects. sciencedirect.com/science/a...

My opinion is that surgery should be avoided if reasonable alternatives exist.

A cousin of mine had PSA and biopsy results very similar to yours. He chose active surveillance five years ago and is doing fine. But you are a bit younger than he was at the time, and that needs to be factored in.

Whatever you do, get a second opinion, and take the time to choose a treatment that you truly believe to be best for you.

Wishing for you to have peace and good fortune.

[RBSW1 in reply to paladin7]

Thank you

[CarverD]

7 (3+4) I chose HDRBrachytherapy over surgery and other forms of RT. I weighed all the information I could find on side effects and HDRB looked the best for my particular situation.

[RBSW1 in reply to CarverD]

How long ago did you have it.

[CarverD in reply to RBSW1]

4.25 yrs ago. I had three lesions, a 3+3 and a 7(3+4) 20 % 4. Long term side effects were negligible with the HDRB. I was pretty much back to normal functioning in less than 3 months. If anything I have to urinate more often than pre-treatment. My PSA recently jumped so I'm scheduling a PSMA PET scan in the near future to see if I have recurrence and/or if it has moved out of the prostate and relocated. If I need additional treatment I will opt for HDRB again if possible.

[Chasu]

I had HOLEP and was told RP would complicate recovery. Leakage mainly

[Hope4Happiness]

I completed SBRT treatment for Gleason 7 (3+4) PCa at MSKCC in NYC in November 2021. 56 years old at the time. My PSA was 8.7 right before the treatment. My doctor: Dr. Michael Zelefsky.

I was on AS with Gleason 6 from 2017. I chose SBRT treatment after a few cores of G7 (3+4) were found on a biopsy in 2021.

From the time I first went on AS in 2017, I started investigating all my options. Will low grade, contained PC, I had a lot of choice. I met with three different doctors and discussed surgery, HD-Brachy, and SBRT. I was constantly reading the latest studies regarding long-term success rates.

After consulting doctors, assessing the pros./cons, getting input from knowledgeable folks (most notable Tall Allen here), and considering my age/diagnosis, I landed on SBRT. I felt it was the best of all worlds.

[RBSW1 in reply to Hope4Happiness]

Have you been cancer free with no side effects. How many treatments and what is the process for SBRT.

[Hope4Happiness in reply to RBSW1]

More than three years after my treatment, I am still in remission. My current PSA is ~1.

The procedure consisted of five focused radiation treatments over a two-week period -- The sessions were Monday/Wednesday/Friday/Monday/Wednesday at MSKCC.

I have had no real side effects of note -- I started taking Sildenafil right after my procedure and I still take it three to four times a week. I don't know if it is actually making a difference, but it's become a bit of a "security blanket" during "romantic times." I've had no ED, but it might be working as a "confidence builder," as it were...

[RBSW1]

Thank you

[jazzy53]

I am almost 6 years out from 40 radiation treatments and doing well. Biopsy revealed Gleason 9 (4+5) and the bone scan that revealed no metastasis. However, my doctors at Hopkins thought that, with such a high-grade cancer, there was a chance of microscopic spread that was beneath the level of detection. For that reason, they advised that radiation was a better option than surgery since they could irradiate tissue outside the prostate (including lymph nodes) to guard against that possibility. This was the consensus of a tumor board that included urologists and radiation oncologists, among other specialists. They also advised two years of ADT, which I also completed. So far, so good.

[RBSW1]

How did you do with the adt.

[cancerfox]

I had RT, BT, and ADT in 2021 for G9 localized PC because I was afraid of becoming incontinent from RP surgery, wasn't crazy about the idea of surgery, and figured I might end up needing RT and/or ADT anyway after I had the surgery. There was still some surgery involved with the BT, but it was out-patient and I felt no real effects from it other than some nausea for 3 or 4 hours from the anesthesia. So far my PSA has remained low after stopping the ADT in 2022. There are lingering side effects with either choice. Good luck if you are choosing! 🦊