So one thinks it is out and another does not? So who do you believe?
If I thought it was out, I sure would be leaning way more towards RT.
If I thought it was contained, I would probably also be leaning towards RT. But as TA has pointed out, you want to avoid overkill with RT also, thus increasing the odds of SEs even with RT.
You can get some bad SEs with primary RT of course, but I suspect the % of patients with bad, life changing and life long SEs are a good bit higher with surgery. So for me, having had surgery and it's SEs, I would never make that choice again unless I could be convinced that that I had a significantly higher chance of suffering and/or dieing from PC if I did not have the surgery.
Of course, that really might not be very useful info for you, as it is strictly my personal opinion based on my personal experience. Even though I am convinced- based in part on the posts here by other surgery patients- that these bad SEs are much more common- and immediate- with surgery, there still are others who amazingly recover in most ways fairly quickly from their surgery, with very few long lasting and major SEs. They have dry pants and have sex again and even feel pleasure during/after sex, and an apparent cure of PC.
No doubt they would recommend surgery. Because if you are among that lucky group, then there are some advantages to surgery. You have the path report, which is a very helpful bit of info, and after recovering in a few days or weeks, you are done assuming your PSA stays undetectable.
But one thing a % of even those lucky guys do not have: if it has escaped from the prostate(like my case), they do not have the benefit of having radiated an area slightly larger than the prostate during the primary treatment. Many of us in that group will get to do the RT later, in addition to the surgery. And any salvage treatment is likely to have worse SEs than any primary treatment alone.
If I were you, I would heavily research what the odds of cure of survival is for a G3+4 who has RT vs surgery, especially if it has outside of the prostate. If the odds of a cure seem definitely better with surgery, then you may want to go that way.
Post Edited (BillyBob@388) : 4/16/2015 8:34:09 PM (GMT-6)