Prostate Cancer choosing between Radical Prostatectomy and External Beam Radiotherapy including hormone treatment

I have just been diagnosed with Locally advanced Prostate cancer T3 N0 M0 - CPG 4.

I have been recommended Radical Prostatectomy or External Beam Radiotherapy to include hormone treatment and I am really struggling to choose between them.

I understand that urinary incontinence will be much higher with surgery than with Radio/Hormone therapy as will erectile issues. But bowel control problems are lower with surgery.

Then the list of additional potential issues with Radiotherapy and hormone treatment including bone, memory, heart disease, breast swelling secondary cancers do not seem as likely with surgery.

So I am struggling to balance all of these off to make a decision.

So any help in advice as to which to take would be really appreciated. 

One other question. Why is hormone therapy given with radiotherapy? Is it because there is risk of the cancer not being removed with radiotherapy? And how likely is this with surgery?

Thanks Tony

  • Hello Tony and thanks for posting.

    Treatment decisions are often challenging and many people do struggle with them, but I'm sure you know, only you can decide what to do. 

    I think it is important that you understand all the information you have been given by your specialist team to help you decide what to do. Do look at the benefits and disadvantages of each treatment, and think about what you feel best able to cope with. There is often quite a lot of information to take in and it can feel overwhelming, so I would encourage you to get back in touch with your team to talk it through again. Talking to the team of doctors and nurses involved in your care can be the most helpful as they know all about your individual cancer as they are familiar with all your medical details. Talking to family and friends can also be useful.

    We have some information on our website on how treatment decisions are made. Prostate Cancer UK has also some further information on their website.

    Hormone therapy is given alongside radiotherapy because there is a risk that radiotherapy alone won't fully destroy all the cancer cells. Hormone therapy shrinks the cancer and makes it more sensitive to radiotherapy increasing the chance of getting rid of it. With surgery, the cancer is physically removed so there is no need for hormone treatment unless follow up tests ( PSA levels ) show signs of remaining cancer.

    You may find it helpful to know that Prostate Cancer UK have an online forum and you may find it helpful talking to other men going through similar things and hear about their different experiences. 

    I hope this is of some help, Give us a ring if you would like to talk anything over. The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Kind regards,

    Celene

  • Evening  sorry about your diagnosis  it's *** I was diagnosed  early December like you I had decision  to make I'm 56 prostatectomy  or radiotherapy  I read so much stuff  but what tipped it for me was if you have radiotherapy  and cancer comes back it's unlikely  there do a prostatectomy  . I had prostatectomy  5 weeks ago I stopped wearing pads 2 days ago I did my pelvic exercises  before and after catheter  came out  think I was 1 of the lucky ones  still got long way to go but better every day good luck with your decision  my only advice  be 100% sure if you get chance let us no your decision  good luck

  • Hi, I was diagnosed two days ago and it was the scariest and saddest day of my life but the kids came home, who couldn't called, and collectively we all decided on prostatectomy with more questions to ask the doctor next week.

    Reading Crouchy story has also helped me with the decision. Thank you

  • Hope all goes well good luck  

  • I find talking helps I'm very lucky my wife kids friends been brilliant  I as probably  you will went through a little stage off feeling  guilty  for putting  everyone through this I felt I was hurting the people I love the most thankfully  they soon talked that out off me . You realise  yes your going through  this but so are they I went to amending at hospital  last wed was nice chatting  to people  who have been and who are going through  it  so keep talking  don't bottle  it up that helps no one and certainly  don't help you 

  • Thank you, truly do appreciate the feedback.