We felt like people shopping for treatment today. The radiation oncologist made radiation sound like a walk in the park, NO side effects per him (incontinence or impotence, which I find hard to believe), and the best thing since sliced bread. I asked him point blank what he would do if he had this stage and was this age, of course, his immediate answer was 'radiation'. He claims to see virtually no side effects with either radiation or seeds. It wasn't till I brought up possible migration of seed that he said, oh yeah, we have the patients strain their urine for awhile. He also said he had one incidence of a guy with radiation tx that had a rectal fistula of about 600 patients. Had done about 350 seed implants. That requires anesthesia for prostate mapping, then also for the seeding itself, and it seemed like there was one more instance of needing anesthesia. I don't have my notes right here with me.
At the end of the conversation I asked him if he kept statistics on all his patients and any degrees of incontinence or ED and he said, well, yes, 'loosely'. AHA! Why is it with this disease, you don't get any percentages or hard facts? He cautioned that surgery carried a MUCH higher risk of ED or incontinence, which is not what I've read. I've also read that if you need surgery later it is more difficult. Not so, he said. He also said that you wouldn't have surgery anyway if there were a recurrence, the next step would be hormone therapy.
We walked out after the appointment and Jesse looked at me and said NO WAY NO HOW am I letting anyone put radiation into me! So I guess that is that. I just found the information presented much more positive that what I've been reading in books. I have also heard that if there is a problem prior to surgery with the urine stream, it is likely to be made worse with radiation. He did mention a risk of not being able to pee and having to do caths after the seed implants. AHA again!
I have a book written by a urologist who at first chose radiation, but during the mapping when a catheter was put in the staff had a hard time passing the cath, meaning he had some degree of BPH and obstruction. He then surmised that rad tx was likely not the best for him, and with Jesse having some stream issues for a few years, I think that would be more likely for him, too.
Anyway, at least we explored it. He also told us Jesse's stage is a T1c and the cancer was on the right side.
On we go to next opinion (director of urology at IU) on 3/16. We are going to a DaVinci support group meeting at 6 tonight. I get to go in a room with the ladies, Jesse with the men so we will compare notes after. Until then!