I feel the 2 biggest reasons to have surgery first is #1-They take several lymph nodes out of the pelvis area at the start of the surgery and look at them for cancer cells to see if it has spread to the lymph nodes (9 were taken out of me and looked at during the pathology dissection) and #2- the total prostate and surrounding tissues removed are sliced up during the pathology examination and they can tell if it has spread outside the prostate to either the seminal vesicle or to either of the nerve bundles. If it shows it has spread or there is positive margins, adjuvant radiation therapy or hormonal therapy can be started at a much earlier period, hopefully before it spreads to the bone or lung tissues. Give yourself the option of having as many strikes as possible available to use in the cancer fight. 3 strikes are a whole lot better than going to bat with only 2 strikes available. Salvage surgery is possible for recurring Pc, but only in a few narrow cases. My Pc came back after 18 months and I am currently is salvage proton radiation treatments. The information that was obtained from my pathology report was very useful in understanding why my cancer recurred and why surgery did not get all of the cancer. I did not have any problems with surgery, and I give that to a very experienced surgeon. I understand why some people hate the thought of surgery, but I for one feel surgery is much less of an intrusion in your life than having to go thru 2 months of radiation treatments. I have just finished 12 of 35 treatments and remember 12 days after surgery, I was able pretty much lead a normal life. I still have 4 1/2 weeks of being out of town, staying in a rental condo, not having much control of my time, going thru daily treatments and having 100cc of saline solution put up my you known what. I do not regret having surgery first in any way and would not do anything different, but everyone and every case is different. Your Urologist, based on your biopsy numbers, will have an opinion, but do your own research. Get a second opinion from a surgeon and a radiation/oncologist. Be informed and make your own decisions. Someone told me this is kind of like building a home and trying to decide on the exterior, a brick layer will tell you brick is best, a vinyl siding contractor will give you hundreds of reasons vinyl is best, and so will someone who does stucco. Personal inconvenience, physical discomfort, and lack of interest in doing your homework are not reasons in making your treatment choice. Remember 28,000 men die each year from prostate cancer.
Prostate Cancer diagnosed Dec. 18, 2006
Biopsy 12/13/2006 Gleason score = 3+5=8
RRP Jan. 5, 2007
Pathology - negative margins from succesful surgery
10 mg Cilias M_W_F for 8 weeks
Almost no leakage after 5 weeks
Used Vacurect pump for 4 weeks before useable erection.
Presently using injections - PGE and Trimix caused really bad pain.
Now using Bimix - Bingo, good times are back.
1-yr PSA .02