A Yooper said...
John, you also stated "the main reason he recommends surgery is because of my age (54), from everything thing I have read he (Dr. Han, John Hopkins) is one of the best urologist out there, so I am inclined to go ahead with his opinion." Well, yes, as a surgeon he is going to be pre-disposed to recommend surgery, in the same manner a radiologist is most likely to recommend some form of radiation treatment. Nothing wrong with that and it is certainly understandable as these medical professionals are going to lean with what they know and have practiced - it's your job to decipher it all!
The comment about "because of my age (54)" resonates loudly with my own personal situation as well - I was Dx'd at age 55. When I met with the Head of Urology at one of the most prestigious medical facilities in the Midwest, he told me that same thing - he was recommending surgery because at my young age and excellent physical health, I had a better chance at not having the side effects associated with surgery; my answer to that was, sure, I have a better chance - but the counter point to that is at my young age and excellent physical health if the side effects are not overcome, then I face living a long life in hell. He didn't appreciate my boldness, but this is My life, My body, My quality of life we're talking about here. . . .
I would also, again, urge John to take his time and consider all of the good options that he has, but I have a few thoughts on these couple comments, Yooper.
I agree that practitioners are inclined too recommend their own treatment modality, but with respect to the advice that radiation is less appropriate/proven for younger patients, this is not something that one hears only from surgeons. To the contrary, many radiation oncologists to give the same advice, so I wouldn't be so quick to write it off as merely a surgeon's bias.
And as far as the implication that surgery has a higher risk of resulting in "a long life in hell", while I guess this is subjective, it seems to me that the side effects of surgery, even when they do not resolve on their own, are virtually always highly treatable and unlikely to result in anything that most reasonable people would consider "hell". On the other hand the potential serious side effects from radiation, although uncommon, seem to much better fit that descript
ion both in terms of their severity and permanence.