Radiation or Surgery?

Surgery as the first option which permits radiation as a follow up should recurrence occur. Radiation as a second course of action

After PSA 10 (Mar 2023 – age 71) consulted urologist who suggested MRI which indicated presence of prostate cancer-PCa. Suggested biopsy. Confirmed Gleason 7 in 3 locations. Indicated treatment rather than monitoring necessary. Suggested 2nd opinion from radiation oncologist who reviewed scans who also confirmed treatment was necessary and outlined radiation treatment. Had PSMA scan which confirmed location of PC in the prostate.

Through this I reviewed as much internet medical information as possible.

In Aug 2023 decided to under RALP…main reasons:

_ My research suggested that the urologist was following accepted best practice for prostate cancer treatment…PSA, MRI, biopsy, 2nd opinion, PSMA, surgery or radiation.

_ RALP was likely to give the best physical outcome.

_ I had to have treatment – could have radiation after surgery, if necessary, but not surgery after radiation. Also, radiation treatment required some surgical preparation.

_ Urologist clearly outlined the procedure and post-surgery potential complications…I trusted my urologist.

_ I just wanted the “b” thing out!

Main drawback was the total cost – surgeon, assistant, anaesthetist, hospital – ~$10,*** after fund refund.

Sep 2023 – first consultation with specialist prostate physiotherapist.

Oct 2023 – RALP – histopathology report showed PCa was more extensive than scans showed – ISUP Grade Group 3, Composite Gleason Score 4+3 = 7. Grade pT3b due to bliateral seminal vesicle involvement but prostate margins appeared clear.

Negligible PSA post surgery and 3 month visits Mar and Jun 2024. After similar PSA score in Jan 2025 normal 6 month consultation extended to Oct this year.

I had typical incontinence post-surgery which became easily manageable within 6 months. Essentially continent after 12 months when I stopped using pads. My physio was a significant help and support in this…I strictly followed his recovery plan.

Unfortunately, due to nerves needing to be removed I am impotent, but was aware of this pre surgery.

I am totally satisfied with my decision and its outcome.

Hi Tomlinson45350, 

Thank you for posting your message on the Online Community. 

If you need support, please don’t hesitate to reach out to our Prostate Cancer Specialist Nurse Telephone service. 

We can help provide more information about making a decision on Prostate Cancer treatments.

You can reach us on 1800 22 00 99 (ask to speak to a nurse), or follow the link to request a call back https://www.prostate.org.au/nursing-support/ and we’ll get back to you. We’re here to help.

You may also be interested in 1:1 telephone based, peer support with a MatesCONNECT volunteer. Further information can be found here MatesCONNECT: phone-based peer support | PCFA

Kind regards,

Kirsty