Hi Tra96. I'm sure many others can add more, but I've just gone through the same decision making process (I'm 6wks post RALP - robotic surgery) and know how confusing it is.
If I say anything wrong or misleading, please others, correct it. This is just my personal best understanding.
First, you will be looking for some clear decision criteria between the various possible treatments -- at least based on outcomes, there really isn't one. It's pick your poison. Being in the med-science field, I know something about
how to read the scientific literature, and of course read lots of them for PC lately. There are no direct comparison studies of outcomes between radiation and surgery (at least not double-blind randomized trials which is the gold standard for such a study). There is some evidence that suggests that surgery may have up to a 5 to 9% better 15 year survival rate than the various radiation treatments. But, and I want to stress this, this may just be numerology. The 'true' relative probabilities may be the same or radiation could even be better -- one would need to properly run gold standard trial to say for sure. Nevertheless, for me I figured that even if it might not be 'true', better to go with the numbers that are out there than go against them.
15 year recurrence rate (the longest time period for which they have data) for surgery builds up linearly to about
Having said that, perhaps one of the biggest deciding factors may be age and general health. I'm an otherwise healthy 50 yo. Surgery seemed the best option for me. I'm now arguing with my 76 yo father who recently got a high PSA and is in denial. But I think at that age, he may do better with the seed implants.
OK, after survival, how do the treatments compare for side effects?
The studies I looked at (can dig out reference if wanted) read to me as follows in summary:
Incontinence - better for radiation than surgery -- but probably only for the short term (first 2 years). After that 'most' surgery related incontinence is well controlled (jury still out in my personal case)
Bowel function - better for surgery than radiation. You radiate the surrounding tissues, they get hurt. Surgery can almost always avoid this.
ED - not much difference between the two treatments. All approaches result in 'dry' orgasms. All of them damage the nerves (via different mechanisms). (jury very much still out in my personal case. I have lots of blind hope and faith)
So in recap, there's no clear cut winner. It turns on smaller considerations of your personal case, what the rest of your husband's medical history is like, and what you're willing to tolerate.
Hope this helps.
Post Edited (Rolerbe) : 12/9/2008 3:43:39 PM (GMT-7)