My stepdad has prostate cancer and the doctor told him if they try radiotherapy and it doesn't work you then cannot remove the prostate as it is damaged so he opted for the operation and we are waiting for a date now. The doctor gave him the options but kind of said we would prefer to operate. We are in West Yorkshire and the doctors here were adament that the operation was the way forward. I personally would rather have it removed if it was me but you might need some more guidance from your doctor before deciding.

Hi getwwellsooner. Welcome to the forum.

I was in exactly your position back in 2010 when I was newly diagnosed with prostate cancer and given the same options as you. 

Even before I my diagnosis had been confirmed, I had done a lot of research and concluded that surgery was the way forward.  There is no risk-free option, but the factors that I considered were as follows:

- I was being referred to a hospital that was using Da Vinci robots and had several teams who were doing a high volume of operations each year (100+ per team).  Results from the USA indicated that such teams have the most consistent results with a high cure rate and low rate of side effects. 

- With surgery, the side effects are worst immediately after surgery and slowly get better over time. With radiation, side effects may sometimes manifest some time later. 

- With surgery, if it has worked then one's PSA drops within six weeks to less than 0.1 (written as < 0.1). In the rare event of a recurrence, then it shows up quickly in the PSA, giving very early warning.  With radiation, the PSA drops to a low value, but may naturally fluctuate, which I thought would just increase one's stress level in future years.

- My research also confirmed Danielle26072's post that if the radiation failed, surgery was no longer an option, but if surgery failed then radiotherapy still was an option. 

And so I made my decision and had surgery in December 2010.  My PSA dropped to <0.1 and according to my latest test last month it is still at that level.  I recovered 99.9% continence within 6 months and no longer used pads. In the years since I have had a handful of minor accidents, with none in the last few years. I continue to do the pelvic floor exercises even now.  I could only have one-sided nerve sparing so my erections are weak but even at this late stage they're improving. Strange to say, as a consolation prize my orgasms improved considerably after surgery so whilst penetration isn't possible, there's still plenty of fun to be had in bed!

In the end, you have to throw the dice and live with result. If you throw a 6 then that's great, but if you throw a 1 then life may be less tolerable. I threw a 5 and I have no regrets. Your chances of throwing a 5 or 6 are definitely better with a high volume team led by a highly experienced surgeon who has done 100+ radical prostatectomies in the last 12 months. 

Telemando has given you a thorough and highly informative piece of advice. My cancer was in the vocal cords but I have a very close friend who is now regretting that he didn’t opt for surgery over brachytherapy ( internal radiation ). He opted for this as he was told it had an 85% success rate and side effects nowhere near as bad as surgery. Unfortunately 2 years on the cancer is back. An operation is not possible as the radiation has basically fused internal organs. He has no chance of a cure and is now reliant on hormone therapy which may or may not work. In hindsight he would have made a different decision. George Monbiot an eminent journalist for the Guardian wrote a very good piece on the reasons for his choice of surgery over radiotherapy earlier this year.. you may find it in archives. He is now back behind the typewriter and is very happy with his choice. It’s a big decision with major repercussions..... good luck !

Thank you all for sharing your experiences it was a great help and confirmed my surgery decision.  Much appreciated This the first time I have ever used a chat room of any kind !