Prostate Cancer Community
surgery vs. radiation
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surgery vs. radiation

My father-in-law, age 65, was recently diagnosed with prostate cancer (T3b N0 M0).   Some evidence of extracapsular and seminal vesicle spread, no evidence of bone or lymph involvement (via CT and bone scan).  Biopsy should 12 of 12 cores positive, Gleason scores of 8 and 7 (4+3) for most samples.

We're trying to decide between surgery and combination therapy (hormones/radiation), and the evidence in either direction isn't definitive.  The combination therapy approach suggested is Cassodex + Lupron followed by HDR temporary brachytherapy followed by IMRT for 5 weeks.

Any thoughts on the consideration set of tradeoffs?  We're told that continence and sexual function tend to be better preserved via radiation, although hormone therapy does drop levels to castrate.
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Avatar_n_tn
Have you looked into HIFU
(High Intensity Focused Ultrasound)?

Right now, available in Canada and Mexico and
undergoing FDA clinical trials in US. Ask your
urologist; some have connections to get
the treatment for their patients.

Some posters here have raved about it.

There have also been raves for proton therapy.

Good luck
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Avatar_f_tn
I agree with the poster above, as cutting stands a better chance of spreading the cancer, you don't want the area disturbed.  HIFU can kill/cook the cancer outside the gland as well as inside without disturbing anything, as there is no cutting, just a probe up the rectum for treatment.  No HIFU doc will accept him unless they feel they can cure him as they don't want the bad statistics ~ being HIFU is so new.  Call international HIFU to find  the best doctor for his case 888-874-4384
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