Long term side affects of EBRT

in my opinion, decision would be based on QoL issues:  quality vs longevity. I am risk taker but with prostate Ca I did not have chance to excercise it. Followed wrong advice which I deeply regret.

My focus is QoL. What is the use of 25-30 years of miserable life when 5-10 would be sufficient to experience all what I want

Still, 18+ months post surgery, I wish I did not have one. I do not see anything that I am better of with having surgery done.

MK

The only types of radiation that should be considered are SBRT, HDR-BT and PBT (protons). Everything else is becoming archaic. I am a member of six internet forums and an in-person PCa support group. Just off the top of my head, it seems that 80-90 percent of the treatment complaints that are past one month, involve surgery. Do we have 30 year studies on those three types of radiation? No, of course not, they only have maybe 10 years. But, those tecnologies are amazing focused to avoid healthy areas, and there are various shielding methods available, that I would not hesitate to have any of them if I ever need to leave AS.

ssw

"Yes, surgery and radiation can both have side effects but, base don what I've read and heard here, the "side effects" from surgery are more immediate and can be far more devastating than anything that might happen years after treatment w/radiation. "

During the last 10 years I have not only posted here regularly, but I have also attended various local support groups on a regular basis where I listened to lecturers about the various treatments. I have also read extensively on this subject.  The information that I have come across has brought me to the conclude the same as you. You are right on target.

Additionally at these support groups , time and time again I have come across men who were despondent, since they suffered from the side effects resulting from surgery. This was not true of radiation, especially SBRT, the latest and most precise. I have read studies about men who have had SBRT, and the side effects that were found were minimal.

Clevelandguy said:

Can be?

Yes you are right H&O, can be is a very powerful word.  One guy on this forum(can't remember his name) was back up with no ED or leakage after like 6-8 weeks, Vasco had no leakage after they took out his cath, remarkable.  Some other people have had life long severe ED & urine leakage. Surgery effects are immediate but usually get better with time where radation is the opposite with some side efects showing up years later.  The side effects depend on the amount of cancer, location of the cancer, surgeon & oncologist experience and hospital equipment for both surgery & radiation.  That's why people need to study both radation & surgery along with the possible side effects pick the best doctors and facilities and make their own personal choice.  I have listed below a few of the people that post on this forum and their problems with radiation treaments.  I am sure that you can find just as many that have had bad outcomes from surgery also.  Like I said both forms of treaments have side effects, sometimes very serious, sometimes not.  Study & choose wisely.............................

Rob Lee Jan. 2018: I completed eight weeks of radiation last October and the side effects are just now finally wearing off, specifically the proctitis that happens with some men. Diarrhea started my second week and by the end of Tx I was bleeding rectally. I don't know exactly what you mean by abdominal pain, but for many weeks I would go all day feeling like I had to defecate, and often would several times a day. Often there was a lot of gas too.

Max Jan. 2018:  I asked him about a friend who had received radiation years ago and later had to periodically have his colon cauterized to stop bleeding.  The surgeon told me that this was extremely common, he had done many such cauterizations on men who had received PCa radiation over the years.  

Vasco Jan. 2018: Radiation treatments for PCa typically create scar tissue in the urethra and bladder. In most of the cases these areas burst into wounds causing bleeding till it repairs by itself. There is no fixed period on occurrences and many guys experience bleeding many years after treatment. Doctors call it RT late side effects. 

Bluepac6 Feb 2018:  The radiation I 2011 had damaged my urethra and bladder beyond repair and my only choices were to wear a catheter bag out my penis the rest of my life or have bad part of urethra removed and my bladder removed.

Joesephg Feb 2018:  My condition was diagnosed as hematuria, and my Urologist advised that this is not an uncommon occurrence for people who have received radiation therapy near the bladder. 

Las711 March 2018:  Just had 39 tretments Prostate Radiation 4 months ago.. All went well PSA now at .08.. but I now have Radiation Proctitis.. Lower bowel area.. Dealing with it using Surcaltate enemas.. 

 

Dave 3+4

Dave, one thing I've never heard, after reading and hearing thousands of post-treatment complaints, is someone who had radiation as a primary treatment, wishing that they had had surgery instead. 

ASAdvocate said:

SpaceOAR has been around for

SpaceOAR has been around for a year or two, and is used to shield the rectum from radiation. Many radiation centers have started using it. It's like that expanding foam spray that's used to fill small cracks in houses, except that it harmlessly biodegrades.  I have read that it has not proved a difference in SBRT, probably because the accuracy of that treatment does not need insulation.

Some rad oncologists recommend Space OAR, but others don't think it makes a difference. I suppose this depends on the actual radiation plan and the radiation technology used. 

If your specialist does want to use it, I would go along. If not, let it go. It will save some money.

Steve1961 said:

Just a thought

I know everyone here means well and all info is appreciated veryyyy much...but it seems like this place is kinda like turning on the local news station...it seems like 95% bad news and only 5% good news.....I know most people come here looking for help with something that went wrong ..I get it ...butttt there has to be tons of good results out there ...we just don’t hear about them here ...but we will hear some soon  and it will be from me ...thanks everyone 

The fact that so many are responding means there got to be good news. 

It's hard to contribute if one is six ft under...

Question... how many Davinci RPs were performed versus how many SBRTs? You can compare the greater number of incidence of side effects in Davinci RP ONLY if there is an equal number being performed. Judging from stats I have seen there are FAR more Davinci RPs being performed.

I quoted an AARP study that gave percentages instead of raw numbers of side effects.. AND most importantly, it distinguished between all other surgery types and nerve sparing Davinci surgery...

Prostate-cancer treatment causes ED because the nerves involved in erection border the gland. Surgery often cuts these; radiation frequently damages them.

A special surgical approach called nerve-sparing prostatectomy can push your ED risk below that of radiation. Studies report "functional" erections in 60 to 80 percent of men who have nerve-sparing surgery. 

Just as Cyberknife is acclaimed to improve targeting, so does nerve sparing improve recovery odds in RP. And referring to older cases of radiation treatments having more reported side effects, so does RPs various older procedures... Open RP and laparoscopic non-sparing RP.

Quoting Cyberknife stats and comparing them to ALL types of RP, and not taking percentages into account is misleading.

We keep having this conversation over and over again. There are many complaints of side effects from all types of RP, but there are many many more successful NERVE SPARING Davinci RPs that do not get reported than those with disastrous side effects.

Steve... you would be a fool to listen to me for a recommendation either way. You need to gather as much real information, consult with your doctors, and seek out the best and most experienced professionals available.

I would rather have an experienced best available radiation oncologist perform SBRT, rather than a newbie inexperienced surgeon cutting his teeth during my RP.

Likewise, I would rather have an experienced surgeon with an unassailable record of minimal side effects than a rad onc experimenting with SBRT and I'm his training pigeon.