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Comparison surgery and radiation ?

Duane3
Posts: 6
Joined: Jul 2006

I have read books and articles and web sites. "Notably Prostrate and Cancer: A Family Guide to Diagnosis, Treatment and Survival," by sheldon Marks. M.D.(2003)
And
The Prostrate: A guide for Men and the women who Love them, " by Patrick C. Walsh. M.D. and Janet Farrar Worthington. (1997)

These books agree. They argue that surgery is a better alternative than radiation. Specifically, they claim that radiation and surgery have similar outcomes 5-7 years out; but that surgery has a significant better survival rate 10- 12 years. out

I just came from a radiation oncologists at Kaiser. He seemed on top of things. I asked about this claim. He claimed that they were not responding to recent developments. That is, the procedures have improved in the last 6 years, so we do not have a cohort who have completed 10- 12 years out.

He provided me with a paper.
"Radical Prostatectomy, External Beam Radiotherapy <72 Gy, External Beam Radiotherapy >72, permanent seed implantation, or combined seeds/External Beam radiotherapy for stage T1- T-2 prostrate cancer, "
by Patrick A. Kupeolian, Louis Ptters, Deepak Khuntia, Jay P. Ciezki, Chandana A. Reddy, etc. al.

It is from the International Journal of Radiation Oncology Biology Physics. Vol.58. No. 1. Pp. 25-33. 2004.

I have read this. It says to me that there is no measured difference between surgery and radiation for persons like myself.
Age. 65. Gleeson Score 6. PSA 4.1.

BUT, The article is in M.D. speak. I have read it carefully.

Duane3
Posts: 6
Joined: Jul 2006

I was unable to edit the above. Does anyone have an opinion on this? Is anyone interested in reading the paper as cited and decoding the M.D. speak? I think it says the treatments are equal.

Benji48
Posts: 117
Joined: May 2003

I'm not a doctor, but I would concur with your analysis that in accordance with your "stats",I.E. PSA 4.1, Gleason 6 that ALL therapies would be equally effective
Good Luck, Ben

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

Duane,

Even tho you are "more mature" than I when I had my surgery at 58, you must keep in mind the "what ifs". What if you have the seed implants and the cancer re-occurs. What treatments are then available? Or what if you have radiation or chemo and the cancer re-occurs? What treatments are available.

The surgical choice seemed the logical choice for me, since if the cancer re-occurred following surgery, there were other options still available. Also, I did not like the thought of the cancer still being in my body.

Do your research completely before making your decision.

Good luck and God Bless,

Roger

stuart
Posts: 88
Joined: Dec 2001

I can't speak for others but I chose radiation...I had both external beam radiation followed by seeds...When I was diagnosed at the age of 53 my Gleeson score was 8 which is considered aggresive...That was five years ago...My research indicated that on average the 10 year results are equal but every individual does not achieve the average...Surgery and radiation each have upsides and downsides...My recommendation is to learn as much as you can about each approach and then go with your gut feeling...

Peter51's picture
Peter51
Posts: 29
Joined: Nov 2004

Duane,

This is such a difficult question. My well read friends told me they would not do the surgery since the survival rates at five years out were equal. I told my doctor, he said 10-20 years out the stats were much better for surgery. That was convincing and I was most concerned about being here for my young children including my one year old. (This was two years ago.) Sex and erection were in fact causalities and you should consider that also. My age was younger than you, 50. My health was excellent and a longer survival rate was more likely with surgery. You are a bit older and maybe don't have young children. Granted we all want a long and healthy life but the quality should be considered as well. I am not pleased with having a tiny erection and the whole experience is not very rewarding. I believe I weighed all the facts and my age was a considerable factor. Surgery can be quite tough and the overall condition of your health needs to be determined as well. I think you are doing all you can for researching and getting opinions. You now need to weigh all the facts as they work for YOU. Once you make your choice, you'll feel better for having done so. Good luck.

Duane3
Posts: 6
Joined: Jul 2006

Thanks for your responses. I have now gone back with the head of surgery and he agrees with the analysis; the two treatments have equal outcomes for at least 12 years out.
I discovered an additional issue. I have long had disk problems with my back which I manage by exercise.
The surgery position, and a lift which they use on the surgery table would definitely raise concerns with my back and disks. I wouldn't want the pain etc. of surgery plus the pain and disability of severe back pain ( which I know well) at the same time. So, at present I am looking at radiation. Kaiser has a major brachy therapy (seeds) center near Sacramento. We continue to consider alternatives.
Note: the Marks (2003) book is out of date with his data on long term rates of surgery vrs. radiation. Things have changed for the better.
Thank you all.

shipjim's picture
shipjim
Posts: 130
Joined: Apr 2006

I am 59 and was diagnosed in Jan 2006, I too looked at all the options and decided to go surgery, there are several types and I went with Da Vinci Robotic. Least invasive of the bunch, after surgery you have options for the other treatments but that is less true for it if you do the others first. I have minor incontinence and no erections at this time but I decided sex while great wasn't worth the trade for getting the cancer out and going on about my life. My identity isn't tied to my sex life. As a side, I can achieve orgasm but not a good erection. I'm using the Osbon pump and the viagra type pills but it's only been 7 months so I keep trying.
Good luck, jj

Nomeus
Posts: 2
Joined: Sep 2006

Would you do me a favor and asked your Da Vinci doctor whether he would operate on a 76 year old who is trim and fit..never had a heart attack but did have open heart surgery six years ago as a precaution and feel great. All the doctors hjere advise IMRT radiation..but as you know the problem is if it comes back there is nothing much to do. Thanks in advance

TexasJohn
Posts: 2
Joined: Jan 2007

I was disgnosed with prostate cancer 3 weeks ago. PSA of 3.1, Gleason of 6, and stage 2a. 12 biopsy needles with only 10% of one positive. I am really struggling with treatment options. Am leaning towards daVinci surgery. Any thoughts or suggestions?

gman60
Posts: 1
Joined: Jan 2007

John I am 73 years of age, retired Navy and the Federal Government..I have just been diagnosed with stage 1 prostate cancer similar to your reading. Like you I am struggling with what to do...I am being seen at the Mayo Clinic in Jacksonville, Fl which has a good reputation for cancer treatment. So far I am impressed. The advisors there are leaning toward surgery...I am considering nerve sparing Robotic Prostatectomy...this seems to be the better approach if I accept surgery. I am looking for advice and will share what I am doing so far. First I am having my biopsy slides reviewed by the John Hopkins Medical Anatomic Pathology Consultation Service...it might cost me $200 out of pocket. The website is http://urology.jhu.edu/patients/biopsy.php...if you are interested in learning about what they do etc. It takes from 3-5 days to get results...while I doubt they will find a significant difference in their analyst..we will soon find out and deal with that when it comes. Mayo Clinic highly recommends this reading. I have read a lot and am continuing to read. If anyone out there has any feed back on the Mayo Clinic I will be thankful. Frankly, I do not know if surgery is better than radiation...I do know one thing if that devil is removed it is unlikely that it will get you (smile)unless the bloody thing returns???..Take care Gman60.

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