I've been reading a lot of threads on why a lot of you picked surgery vs radiation. The most common reason was that if surgery failed you could always use radiation as a backup, but if radiation failed, surgery was not a viable alternative.
Here's what is confusing to me: I understand that if the cancer is contained in the prostate that the cure rate using surgery and radiation is the same. The most common cause of surgical failure is when the cancer has penetrated beyond the prostate and a positive surgical margin was not achieved or that the cancer has metastizied (high gleason and high PSA). It also seems logical to me that a higher positive margin can be achieved with radiation because you can radiate the area around the prostate.
A reoccurrance after surgery is not a local reoccurance as the prostate does not exist. You can have a local reoccurance after radiation because there is still a prostrate; does any one have any stats on how often this occurs? I would guess that most reoccurances after either surgery or radiation are due to the fact that the cancer had already spread outside of the scapel or radiation beam.
I also think that an effective backup to either a surgical or radiation failure would be hormone therapy rather than more surgery or radiation. How often does the 2nd procedure really cure the cancer? Any stats? Do most reoccurances end up on hormones or chemo anyway?
Can any of you shed some light on my confusion? The side affects of all treatments are substantial and stacking the side affects from multiple treatments is not very appealing to me.