jkwleo

https://www.curetoday.com/view/orgovyx-manages-testosterone-reduces-side-effects-in-prostate-cancer

Seems Orgovyx pill is a good option too because testosterone recovers quicker. Other than the drug cost, it is a solid option.

Please ask your medical professionals. You've already had radiation in the area from your SBRT, and surgery on radiated tissues is more challenging than on non-radiated tissues.

Some surgeons are doing these procedures--but many will not. Anything is POSSIBLE. But is it a good idea? The risk of complications is very real.

It is always possible that the surgeon can work around the burnt out prostate and grab some lymph nodes, for pathology if nothing else. I had robot assisted inguinal hernia surgery after surgery and radiation and the doctor just said it is a slow process dissecting scar tissue and adhesions that takes more time. The surgery was a piece of cake compared to prostate surgery. Probably would follow up with RT if cancer is there. Just afternoon thoughts….

My hernia surgery was outpatient and I felt pretty good afterwards. I was 68 at the time also and in good shape after a couple of years of prostate related stuff. There were weight restrictions, etc given the nature of the repair

Some of the same advice applies for all abdominal surgery, constipation is not your friend and straining will not be helpful so prepare for that prior to surgery day. I did not take any narcotics for pain as there was never any problem just using over the counter pain stuff. Anesthesia recovery is a function of how long the procedure takes so all good things to ask doctor about when you meet up. Prostate surgery is more intense, complicated, and longer so you can have more issues the few days after surgery. Hopefully it will be more like hernia surgery.

Your urologist will be able to answer those questions so make sure you have a list for your meeting. Doctors like patients with lists so they don’t have to give the boring standard speech from memory.

Fundamentally, an RO is not going to be able to answer a question about whether surgery is a good option. Your urologist is a surgeon, he can answer that question better. Ultimately, asking an RO about whether surgery is a viable option is like asking a BMW mechanic about how to fix your Tesla.

You have to seek opinions from both surgeons and radiation oncologists, weigh the advice given, and make your decision. We can help you with which questions to ask, but in the end, it's your call, and yours alone.

As halbert suggested, only you can sort through this mess after discussing with both doctors. You can always seek out other opinions as well. Some quick thoughts...

To Urologist - Will proposed surgery to remove lymph node cure me (or provide durable remission) and not require radiation treatment? Why would I not proceed directly to radiation treatment at this time if RO is confident it can be done?

To Radiation Oncologist - Have you determined that the lymph node is prostate cancer and the cancer is limited to that area so RT is the appropriate solution and will cure me (or provide durable remission)? Is there merit in the proposed lymph node surgery?

Good luck.

Since what you're really asking is something different, I'll put it this way.

In your shoes, with a known 'hot' node, I would likely go for radiation. Why? The surgeon will probably tell you that 'we'll take the node, and you'll be fine after recovery time'. Personally, I'd prefer a 'wider shot', I'd probably even go with the radiation plus ART for a few months, just to be 100% sure.

What I wouldn't want, is a year or 2 or 5 from now--to have to do it again. Plus, as Mumbo suggests, why do surgery if radiation is going to be needed after surgery anyway?

In the end, as we've said, you have to make your decision, based on whatever is most important to you. That is really the thing with this disease, and the basic principle of this forum: Ultimately, your treatment decision is yours to make. We can share our thoughts, our own experience, our own perspectives on what we think we might do in your shoes--but in the end each of us weighs the available information and makes the decision.

And then, we, your brothers and partners in this thing, will walk with you through it, and be there to celebrate on the other side.

my RO discussed with me today: either surgery and radiation is good for me at my age. so I will be in the surgery room soon.

As I understand, you're going in for a lymph node resection, correct? This would be similar to other abdominal surgeries, but not necessarily like a prostatectomy.

The big thing is to follow your surgeon's pre-surgical advice related to diet. You'll want to do what you can to improve your muscle tone in your abdomen and pelvic areas. Walking is good. Eat healthy with plenty of veggies and minimum red meat. Stay hydrated.

Be prepared for a directive to not do anything involving lifting more than 15 lbs (7 Kg) for a few weeks after surgery. Don't be surprised if you get constipated-taking a stool softener like dulcolax will help. If the surgery is laparascopic, don't be surprised if you have upper body or shoulder pain after the surgery--the gas they use to inflate your abdomen can end up there and cause pain until it is absorbed.

Don't be surprised if it takes a few weeks to get your energy back. If they tell you to cough, or give you a thing to breathe into that forces you to cough--use it. I've had post-anesthesia pneumonia, it's no fun at all.

Good luck!

got surgery done on Monday:
Final Diagnosis:
A. Lymph nodes, left pelvic, dissection:
- Fifteen lymph nodes negative for metastatic carcinoma (0/15)

B. Lymph nodes, right pelvic, dissection:
-Thirteen lymph nodes negative for metastatic carcinoma (0/13)

Urologist's comments:
a total of 28 lymph nodes which is a very very high number for this surgery.. all negative... not sure what that tells us about the scan?

What should I do now?

Hello halbert, I am recovering quite well....the tube was out a day later. I can walk around around but not do much. surgeon wasn't too happy because he thought he found the root cause.
you are absolutely correct..the shadow triggered the surgery, then nothing says that why PSA was trending up.