okay, but I am not one of the lucky few. That is just incorrect information if not hyperbole. Reality is that the majority of men who seek treatment end up choosing surgery and do so rationally based on their own needs and experiences. I don't think it is accurate to paint surgery with your broad strokes and certainly not fair to paint medical professionals as you did.
This informal anecdotal survey was actually held here before and the vast majority of surgery guys reported that they were satisfied and rational customers. Of course some dismissed this as these men lying to themselves but that too isn't accurate and only serves to find a way to help prove a negative.
David, I agree that the surgery choice should not be trash talked, and it will be the correct choice by many people. I can see- especially if we had a crystal ball to tell us everything we needed to know in advance- that it would be the best choice for a known cure to give peace of mind. As in- if you could know for sure that whatever the Gleason it is contained within the capsule- then removing the capsule gives a near certain cure. The post op path can tell you for certain that it is contained, and clean SVs and lymph nodes can give us further peace of mind. And if the recovery goes very well, it is all over in a couple of weeks or so. These are all good reasons to go the surgical route. Since my surgeon "felt" mine was likely contained despite my G9 and PNI- based on my very favorable DRE judged by his 30+ years experience and possible near Guru status- and IF contained I could be offered a cure- it ended up being the choice for me, although with great trepidation. But with that G9 and PNI and rising PSA, I felt like I didn't have a lot of time to debate it. ( I had not found HW yet) So I chose surgery, though even as I was being rolled down the hallway to the OR, I was thinking "Oh Lord, is this the right decision". One of the last things I remember my surgeon saying is that I would not have any significant incontinence though I would have ED. (turns out he meant "long term incont)
Still, after it is all done, I often wonder, considering my pre-op stats, "what the heck was I thinking?". I have been fortunate to not yet experience any shortening or PD. But ED is 100% as expected(is 200% possible?), and there have not yet been any quality - and only one just barely successful attempt- experiences even with injections and pumps. (pumps will provide what is needed every time- but it just does not feel good and still seems so bizarre, so only for rehab so far). At 6 months out, I am finally a lot better continence wise last month or 2, but still far from being able to go without a pad. And I have even gone through many weeks of electro-stim/biofeedback.
So I have plenty of the SEs, and of course it could be much worse, I actually have been lucky compared to some! But, was I contained, the main reason I gambled on the surgery? No. Much as my G9 predicted, I had one focal margin and SV involvement, though luckily lymph nodes were clear. I was ( post op) given a 50% chance of not needing further treatment like SRT or HT or both, as opposed to the cure if it had been contained. I don't want to seem like I am *****ing, I made my choice and it is what it is. But I guess, just from a logic standpoint, I have to ask "what is the point of the surgery and it's almost guaranteed SEs?". Wasn't there a good statistical chance of it not being contained? If not contained, then what benefit is the surgery compared to other treatments? Couldn't some short term HT to shrink the prostate followed by seeds and EBR ( such as Prostercision(SP?) in Atlanta) have offered me at least 50% odds of not needing any further treatment, or better? There are of course still possible severe SEs with that type of treatment, but "possible" is the key word, compared to the near guaranteed SEs I signed up for. Which I don't think I would have done if I hadn't felt like there was a need to get going on that G9.
In fact, if there was someway to know it was not contained and in the margin and SV- though I probably should have highly suspected this what with the G9 and 8s and PSA 10.9 and PNI- wouldn't radiation have actually been the better choice? Can't radiation kill a G9? Since it was not contained, wouldn't I have already zapped whatever was in the margin and SV( unless it was in the nodes which it was not), and quite possibly killed it? I don't know, just seeking info. But if that is correct, then for what reason would someone choose to take on the much more likely- and some almost guaranteed- SEs of RP, if containment is not highly likely? G6s and such?
Maybe I am under rating the likely SEs of seeds combined with EBR? I know quite a few who have had that( all lower risk than me though) and they have NO SEs that they will admit to me. Of course, some ED might develop later, but at least I would have got a couple of more years and pills, pumps or injections might work better even if function decreased later. I don't know, just guessing.
Anyway, I can sure see why some would choose something other than surgery, unless there is an almost guaranteed higher survival rate with surgery. Which there probably is IF it is contained. But how can you ever know if it is contained unless you have the surgery? And needing to know is one reason I chose the surgery. But now that I know, where am I? I know it was NOT contained and that there is a pretty good chance the surgery did not cure me. I will have to wait to find out. I can't see how this has given me any advantage compared to the non-surgical approach, where I would also not know if the RT got it all, but while I waited I would likely have dry pants and an enjoyable sex life with pills. But every one's situation is different.