Hi - I am a 47 year old gay man with stage 1 prostate cancer. After separate consults with both a surgeon and a radiation specialist I am more confused than ever as to which route to take. The surgeon made it seem like that was absolutely the way to go. The radiation doctor was much more balanced and also as a gay man pointed out concerns to me on both sides that I should consider (none of which were explained by the surgeon or my urologist nor addressed in any of the literature I have read). I had been less concerned about the potential for erectile dysfunction as a "bottom". The radiation doctor pointed out that came with its own set of concerns. For surgery he pointed out that you are removing the prostate, which is a big part of what makes anal intercourse pleasurable (something of course I knew but hadn't connected). And for radiation (beam or seed) he said the area would be weakened and that anal intercourse should be avoided completely for 9 to 12 months to minimize side effects like rectal bleeding. On a more medical front, the surgeon warned that after surgery if cancer comes back around the area it can then be treated with radiation but that the reverse is not always true: meaning if I do radiation first and cancer comes back surgery is not always a safe option because of the impact of radiation - leaving extreme hormone treatments as the only option. If anyone has any thoughts, feedback or experiences about any of these I would greatly appreciate it. Best ~ jim
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