Generally, with very high risk surgery, is not indicated as it won't be curative and will also require radiation. Radiation after surgery compounds the already significant negative side effects of surgery. As to removing the prostate to relieve the bladder condition, I definitely would want further assessment before deciding. A very bad situation would be surgery, loss of nerves, SRT, bad side effects and then still with a problem bladder. Using EBT, BT, and ADT would be better for cancer control and lower side effects than surgery.
I second this viewpoint... if the cancer has got out -- which happened in my case with just a small focal margin that was even treated while I was in the robot --- you get the lovely ADT / SRT which makes SE's even worse...
If I had to do it over again, I would do EBT or BT instead of surgery... probably BT...
The good news is that as part of the "awakening" to my situation, I changed my diet, and I feel better than when I was eating red meat constantly.
Good luck with your decision ---
7/16: BX=G6, 1 core R-apex 4mm 30% of tissue, R-apex
8/16: Hopkins=G7 (3+4)
10/16: RP w Tewari, pT2c pN0, 1.8 cm, 3+4=7, 4 comp=20%
Positive R-APEX posterior (focal) identified and treated
-EPE, -SVI, -M, -LVI, -PI
10.9 Lupron 6mth
11.17 0.02 (T=15)
12.11 <0.01 (T=14)