Posted 1/27/2013 3:38 PM (GMT -7)
What is your past & present PSA? What clinical stage did your biopsy estimate?
There are pros & cons, of course, with both treatments. I don't know if the radiation side effects are as bad as they were in the past because techniques continue to be improved. But I guess some side effects still remain that must be considered.
I have a family history of PC and had always told myself that I would have the prostate removed if/when my turn came. That turn came in 2011. I might have been tempted to have radiation, but a couple things led me to go with DaVinci.
First, my enlarged prostate and associated urination problems would not have been solved even with curative radiation treatments. And if a patient does opt for external beam radiation, it is almost impossible to try surgery if the radiation should fail. This is because the radiation builds up lots of scar tissue that makes direct access to the prostate very difficult (I don't know if seeding has this same problem).
So I went with DaVinci robotic surgery. I had virtually no pain at all after the surgery, had no pain at all from the catheter and there was no pain at all when the catheter was removed a week later.
Surgery is still considered the "gold standard" for cure in cases where a cure is possible. So, all in all, surgery is a very good option -- IF -- the doctor is highly skilled in using the robot. Make sure s/he has performed a minimum of 300-400 DaVinci's so that they are beyond the learning curve.
Whatever your personal level of sexual ability is right now -- you can expect it to NOT reach that same level after the surgery. But, even a somewhat reduced performance level is usually adequate enough to have sex.
Every patient is different, every case is different, every surgery is different -- but, like many others, I am 100% continent. It's been 14 months since my surgery and erections are beginning to return and I have been continent almost since the first month or so after surgery.
So there is every reason to go for surgery IF that is what you are now leaning toward. Before making your final decision, however, you might want to consult with both a radiation oncologist AND a urologist to get the pros & cons of both treatments. It is likely that EITHER technique will cure you.
So, whatever you feel most comfortable with and confident in is the way to go.
Best of luck to you!
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-erections now happening 14 months post-op & getting stronger.