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Consequences of radiation over robotic surgery

mcin777
Posts: 33
Joined: Feb 2013

While radiation is less invasive than robotic surgery...does it open you up to other kinds of cancer down the road.  I understand that  it has about the same success rate as all other modes of treatment...but does it increase the risk of other kinds of cancer.

Is cyber knife as good as Brachytherapy?  Dr.  told me that if I did Brachytherapy that I would first have to take hormone shots for several months to reduce the size of the prostate.  Are there other methods for reducing the size of the prostate?

One good note (maybe it is good/maybe not)  I had a PSA a little over a month ago and it was 9.3   Just had another test and it is now 5.39

Mcin

 

 

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Mcin,

Recent 5-6 year studies of CK for low risk patients show a biochemical free relapse rate of 97%, which (I believe) is slightly better than historical brachytherapy results.  The big advantage with CK over other forms of radiation, in my opinion, is the very, very low incidence of adverse side effects.  There were also highly encouraging results for men with intermediate and advanced cancers treated with CK.  

Earlier forms of radiation treatment were indeed linked to higher risk of some types of cancers.  I don't recall specifically what the risk percentage was but I do believe it was very low even then.  Moden radiation technologies are more precise in their application and are much less likely to deliver harmful dosage rates to surrounding tissue and organs.  In any event, most ancillary cancers caused by radiation took years or decades to develop, which given the typical age of diagnosis for a prostate cancer patient is less of an issue than when radiation is used for younger patients.

As far as reducing the size of your prostate, you may wish to discuss the option of a TURP with your urologist. 

Good news about the drop in PSA levels.

i would discuss any questions about risks involved with the various forms of radiation treatment with your radiation oncologist.

Good luck.

 

K

Beau2
Posts: 246
Joined: Sep 2010

As I recall, you need to shrink the prostate before brachy because you want to minimize the amount of radiation that is needed to effectively treat the organ.  Too much radiation can damage nearby tissue and result in unwanted side effects; therefore, you reduce the size of the organ before you radiate it. 

 

When I was making my treatment decisions (almost 5 years ago) it was my understanding  that men who had large prostates that were treated with brachy had more urinary problems then men who had small prostates and were treated with brachy; therefore, I felt that the issue of successfully shrinking the prostate was important.  At that time I could find very little data on the success rates of shrinking the prostate with HT.  I asked my Uro what he would recommend if the HT shrinkage did not work and he indicated surgery.

 

Again, my experience is 5 years old and there have been a lot of studies since then; therefore, I would recommend you ask your RO for studies covering the success rates of shrinking the prostate with HT pre-brachy, and studies of urinary side-effects of treating large prostates with brachy.

 

I ended up choosing surgery.  Guess I got lucky as I had no urinary problems.

ob66
Posts: 218
Joined: Apr 2010

     Will not argue which is more effective. The only point I wish to make is that it is difficult to have surgery after you have had radiation. The converse is not true. Because I was Stage 3, and because I showed an ever so slight increase in PSA, ultrasensitive, after 10 months post surg, I also had radiation therapy. Four years plus later, and zero PSA readings. So far, so good. I am pleased with my aggressive approach, for my aggressive problem.

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