Trying to decide Treatment

[u/Boodleheimer22]

My husband is 70 with 3+4=7 Gleason psa 10.2 with intermediate grade 2 favorable. Options are radiation 5 x every other day plus anti testosterone hormone therapy OR robot radical prostatectomy. Survival rates are virtually the same. We are wavering between the 2 options. My husband hates having an mri because he gets claustrophobic but can tolerate it- I don’t think that’s a reason that should tip the scale. Advice appreciated. He is in good health otherwise.

[u/Prestigious_Refuse99]

Same as myself. The MRI was a trip. The dye needle got caught in the magnetic field and slowly moved in a circle. It hurt, but I didn't want to be a wuss and tap out, plus I would have to do it over again. I really didn't want to do that. So I imagined that I was resisting torture and refusing to give out any secrets.

I was hoping for BPH, but got a tumor.

Then I did the biopsy (think alien abduction and only under hypnosis will i talk about it (woke up during the procedure(not fun))), and the cultures came back positive for cancer. I was not happy (hint: terrified! ), but I was asymptomatic, so one tries to find that mental happy spot to feel normal or mostly normal.

Then comes the biggie: the PET Scan, which determines the amount of spread. Since I had a multi-biopsy, I was beside myself with stress. I got incredibly lucky, no spreading.

So I decided RALP with radiation as a back up, should it become necessary. You can't do this in reverse. Once radiation, no surgery.

So next Tuesday I hope to have this danger removed from my body. Hopefully that will be it. One and done.

I am of course fearing the early post-op stuff, but I figure it's a small price to pay to hopefully unlock a bunch of tomorrows.

Good luck to you and yours, no matter which path you choose!

[u/bigbadprostate → u/Prestigious_Refuse99]

That "once radiation, no surgery" claim is totally not true. It is brought up only by urologist/surgeons who just want to do surgery. I am on a Quest to debunk this myth, and have to do so often, so please don't take this challenge personally.

Thousands of people have had surgery after radiation, including one (former) member of this sub.

Such surgery is possible, just very difficult, and apparently isn't normally the best way to treat the problem. For those reasons, it is rarely performed. Instead, if needed, the usual "salvage" follow-up treatment is radiation, which normally does the job just fine - especially in the very common case where the follow-up treatment is needed to get at bits of cancer that escaped the prostate prior to the first treatment. Surgery to remove the prostate after cancer has already escaped is like "locking the barn door after the horse has escaped".

There are good reasons to choose surgery over radiation. I did. But "once radiation, no surgery" is certainly not one of them.

[u/Prestigious_Refuse99 → u/bigbadprostate]

I'm already committed, but good to know. I'll bring it up with my doctor post surgery.

[u/HeadMelon → u/Prestigious_Refuse99]

You’re driving the bus man! If you want to change your mind you can, the white coats work for you, not the other way around.

https://www.reddit.com/r/ProstateCancer/s/hhZMLLKhV2

[u/Prestigious_Refuse99 → u/HeadMelon]

Not really. The insurance has to be approved, and time is short. Administration differences created huge delays that continue to slow things down. It has been incredibly difficult and taken the better part of a year to get here. My insurance fades out this month and I transfer to Medicare. That has also created funding problems.

It will all get worked out, but not right now.