Suggest treatment for prostate cancer
Patient: My husband was diagnosed w prostate cancer from biopsy last week. He is 76 and vigorous\very active..only take supplements..no Rx....had no symptoms. Psa went from 12 to 17 in 6 mo prior reason for biopsy. It is stage one w Gleason of 7. Now we are choosing between robotic removal or radiation pros and cons. Erectile dysfunction not as important as incontinence..how can we find/evaluate statistics? How important is choosing dr s..his surgeon is 45 and has done 100..as opposed to dr 200 miles away who has done 4500... Doctor: Hi,Thanks for writing in.Prostate cancer is an important diagnosis to be discussed in detail. As the prostate cancer is biopsy proven therefore a MRI scan prostate with whole body PET CT scan is required for proper staging of the condition. While MRI scan will tell the accurate local spread of disease, the PET CT scan will tell about distant spread of disease if any.Since it is Gleason 7 category lesion, complete removal might be possible at the moment. Doing a cancer surgery is more about skill and also the stage of disease. I guess robotic resection is a better option than radiation, radiation might be required subsequently depending on the response to initial treatment.If the surgeon has done the qualified training and has the ability of doing a robotic surgery then even a younger surgeon is reliable with the skills. Statistics on incontinence and erectile dysfunction might vary with technique and stage of disease. In early stages and with a skilled surgery, there is low incidence of side effects. Please do not worry.