Radiation or Prostatectomy?

My husband has recently been diagnosed with prostate Ca - it's stage 1, 3+, one of the quadrants, close to the outside edge, shows 70% involvement. We're struggling with which way to go - he's been told if he goes with seed implant he will need 5 weeks of radiation first. The other option is surgery. Like many others facing this, we have to decide which way to go. He's 62, very active runner, we've been married 30 years, 3 grown kids, we're not worrying about impotence - more worried about getting rid of the cancer altogether and getting back to an active lifestyle. Do you have any thoughts or opinions, without knowing his full history? THanks for any info to shed light on this important decision.

[Ash Tewari, MD, M.Ch.]

What is the Serum PSA value and the gLeason grade on biopsy?

Many factors such as age, Serum PSA values, biopsy results have to be taken into consideration while deciding treatment

Recent publications undergoing surgery for clinically localized prostate cancer may have a better survival compared to those electing radiation or observation.

Those with locally advanced cancer.i.e. when cancer has spread locally to the organs around the prostate are better treated with radiation therapy.

Those patients with cancer that has metastasized i.e spread to distant organs are treated with hormonal therapy.


This answer is not intended and does not substitute for medical advice- the information is for patient education only.

Follow-up with a urologist is essential

[TWOCENTCIGAR]

Wait a second!!!!!!

Let's be factual DOC!!!!!  What's wrong with you?  It all depends on WHO is delivering the procedure!  A "radical" is exactly that and I would never let anyone cut out my prostate!  Just ask NY Yankee Manager Joe Torre that!  He had surgery and upon sending the specimen to the pathology lab, they learned he had positive margins and therefore required radiation!  Not to mention the incontinence and impotence rates associated!

I would elect prostate brachytherapy with a stranded technology!  I'd also reccomend a premier Radiation Oncologist and hospital!  (ie. Mt. Sinai of New York City and Dr.'s Cesserati or Stock)  Where do you live?

Providing of course he's an ideal candidate for treatment!  Active surveilance never hurt anyone as MOST men die with prostate cancer and RARELY from it!

Hope this helps!