Prostate Cancer Post 3 – Treatment Decision
Updated: May 3
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Disclaimer - I am not medical professional. I am describing my experiences in hopes I may help others facing this cancer.
I consulted twice each with the radiologist and surgeon. Talking with one generated additional questions for the other.
We had a funny icebreaker with the radiologist. We waited several minutes in the exam room. I had to use the bathroom and the radiologist came to the room while I was away. He saw L. sitting there alone, backed out of the room, looked around and checked the room number, then said to L. “I thought I was seeing someone about prostate cancer!” We all had a good laugh, and I was relieved he knew he should be talking to a guy!
We learned I was a candidate for CyberKnife treatment. This is supposedly a more precise radiation delivery method that tracks prostate movement as you breath or move to deliver the dosage accurately. It would take five, 40-45-minute treatments, one day after the other. A protective gel would be inserted between the prostate and the rectum to protect the rectum. I might also have to take a medication to reduce testosterone production, but my memory is very hazy on this, so do not quote me.
We were told there is a 90+% chance of cure, that it would take roughly 18 months for the PSA to “settle” so we would know what the level should be going forward. Because the entire prostate is treated, there is a chance of damage to blood vessels that support sexual activity. There is a chance of urethra blockage due to scar tissue formation, the opposite side effect of surgery. Chances of full sexual recovery are slightly better than with surgery.
Our surgeon explained I would likely spend one night in the hospital. He indicated a 99% chance of cure with surgery, given my diagnosis. He said I would likely recover from incontinence and that 60-65% of his patients regain full sexual function without additional treatments such as Viagra/Cialis, shots, etc. He also mentioned that surgery after radiation, should radiation not be successful, is more difficult because “things get all woody down there.”
Radiation treatment was attractive due to the short time frame, no hospitalization, etc. Surgery was attractive because of higher odds of cure. On balance, I reasoned the seriousness of side effects of radiation versus surgery were about equal, though different.
After all the logical comparisons we made between the two options, the decision was a “gut decision.” Over passage of a week or so, I got more comfortable with the surgery option. I felt it would be more successful and would offer a quicker post-surgery diagnosis of success – quarterly PSA tests for the first year. I looked at how well my Dad had recovered and how long he has lived, even when robotic surgery was not available for him. L. got more comfortable with the extended recovery time and the burden surgery would place on her.
We decided on surgery.