it still baffles me a bit as to why any patient who is a brachy candidate would not make that choice over surgery.
I can tell you why I chose surgery over seeds even though I qualified for both
1) My prostate and I had an adversarial relationship prior to my PCa diagnosis. It could be stubborn and make it difficult to start my stream and usually caused a weak stream. It also found humor in making my urine stream hard to stop and dribbling for a bit when I thought I was done. My prostate also didn't like to sleep more than 2-4 hours at a time, making me get up to urinate every night 1-2 times for the past 3 years. And sometimes when I was done urinating, I had the feeling I had to urinate 15 minutes later. Pretty much all these symptoms are gone. I even can sleep the whole night without getting up 1-2 times a week and the other nights I only need to get up once.
2) I saw a statistic that brachy seed patients had a relatively high incidence of having to have a TURP procedure sometime in their future. This is where a surgeon clears out the urethra of intruding prostate material, sort of like cleaning tree roots out our of a sewer pipe. It is not a major procedure at all but still not something I looked forward to
3) I have two friends who had their prostate removed by the uro who eventually did mine and had great results.
4) I have another friend who was very happy with his seed treatment and tried to convince me how bad surgery was, but he also told me (his words) that for a week or 10 days he felt like he was peeing out razor blades. Ouch.
5) I bought into the concept that if a brachy seeded prostate eventually had to be removed, it was a very difficult procedure with very high incidence of incontinence and ED.
6) Emotionally, I was one of the people who wanted the prostate out just because I had cancer in it, even though medically it wasn't an absolute necessity.
In retrospect, I made my treatment decision hastily (about
10 days after diagnosis and 2 days after my last consult) but even with all the info I have acquired from this site and other places, if I would have waited until today to make my decision I still would choose robotic surgery.
Here are some of my stats:
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)