Long term side affects of EBRT

Steve, I think you were headed in the right direction initiallly. Surgery and radiation both can have lasting side effects, some worse than others. Your comment about "young" men having many decades ahead of them and there being a greater chance of radiation damage appearing seems to be valid... or at least it's one we hear a lot. What I've observed is that radiation is often chosen by guys who 1) are afraid of surgery in general, 2) have other health problems that might preclude surgery, or 3) are afraid of losing sexual functioning.

I've spoken with guys who cited each of these specifically... so I hear the same things a lot.  I suppose it comes down to what scares you the most. Surgery didn't scare me. I have had radiation, and I am living with side effects from both.  I don't believe there is a "wrong" choice here.  The worst thing you can do is to be so scared that you just freeze up and don't do anything.

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. 

Most of the information that I've read concerning the side effects of radiation were published years ago when the delivery of radiation was far less accurate and precise than it is now.  The reason this is important is that the more accurate and precise the delivery of radiation the fewer side effects that are likely to occur. 

This is especially true w/SBRT which can deliver radiation to the sub-mm level, which all but eliminates the possibility of collateral tissue damage during treatment which might result in damage to the rectum, bladder and/or urethra (which are the most common radiation side effects).

Cyberknife, which I was treated with, is one such method of radiation delivery which has been in common use for over 10 years now.  I was treated 7 years ago w/o any side effects (short or long) and 5 yr studies have not reported very high treatment success and few effects.

See for example: https://www.itnonline.com/content/cyberknife-system-provides-long-term-disease-control-prostate-cancer-patients

Just an added note, Swing is partially correct but there are a lot of people who post here that have had problems after radiation treaments and not just ten years ago.  Both surgery & radiation will give you side effects, some recoverable some not.  Just make sure you study wisely and pick the treament that suits your life & conditon with your cancer.  If you want I can post several recent posts of people with problems after radation treaments.  Neither surgery or radation is a walk in the park and both have collateral damage that they leave you with.

Dave 3+4

hopeful and optimistic said:

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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.

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

Maybe a few of the people above that I quoted might wish that, if they are online they can chime in.  But its not about that or which is the best choice cause there are none.  Radiation and Surgery both have side effects, short term & long term.  Understand them and choose wisley.  If there was a treatment that had no side effects we all would have taken it, but there is none.

Dave 3+4

Steve1961 said:

Space OR

It’s called space OR anyone heard about this apparantly  a gel that they want to inject between my rectum and prostate. .05 inch gap between the prostrate and the rectum protecting it from harmful radiation it hardens and slowly dissolved over 3 months and is passed thru your urine 

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.

hopeful and optimistic said:

.

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.

ohh men,

i missed this good discussion and all excitement

Had surgery, experienced lots of bad in my 18+ months post surgery. My QoL is on downhill ever since surgery.

I wish I never had surgery neither any other form of treatment. I was incidentally diagnosed so it was just beginning and I could easily enjoy another 10 years of good life before treatment would be needed even with my 4+3 after biopsy.

In the sixties, I would care less about ED, not same way as it is in my early fifties.

I totaly agree with H&O. Surgery SE are very harsh and hardly recoverable. 

Radiation would be my choice of treatment because it would leave me with better QoL in all regards.

MK

Grinder, Nerve-sparing RP has been around since 1982. It has been the "gold standard" for ORP, LRP, and RALP for years. Nevertheless, it very often does not work. I have read many posts by men who had it and were impotent, claiming it to be a "fraud".

Now, obviously, RP also works out well for many men. I have read their testimonials too. 

Yes, RALPs are about 85-90 percent of the PCa surgeries beimg performed. But, the times they are a changin', because now the percentages of men having RP and having RT are exactly the same. Both at 37 percent. Previously, surgery was about 60 percent. But, the skyrocketing recent acceptance of AS cut exclusively into surgery's clients.

Steve has enough info already to make his choice. We are just adding to the noise. Hopefully, whatever he ends up choosing will provide him a good outcome.