How can one predict the need for radiation after having the prostate removed for prostate cancer?

• If you are choosing to have a prostatectomy because “you’ll be cured”
• Or if you think that you’ll have the option of having radiation if cancer comes back
• Or if you think “well if I have the prostate surgery I can have radiation but not vice versa”
• Or if you think one or the other gives you a better chance of cure

Well…It is true that you can have radiation after surgery but it is difficult to have the surgery after radiation, however is that really an advantage of one treatment modality over the other?

• Radiation is easier to tolerate voiding wise after the prostate is removed because the irritative nature of the radiation of the prostatic urethra is not an issue because it is gone with surgery- that’s a plus
• Just because you can do radiation after the prostate is removed doesn’t mean you’ll have any advantage for cure
• If you knew that you had a 20% chance of needing radiation ( i.e. the psa goes up after your surgery) would you just choose radiation from the get go and not have a prostatectomy and all that stuff (ED and incontinence) that goes with it
• I don’t think many patients who choose prostatectomy think about the percentage chance of needing radiation and if they did would they make a different decision
• You see the radiation therapist is very aware of the chances of capsular penetration and will amend their radiation to suit…i.e. seeds and external beam with or without hormone therapy

Is it a lot like the igloo cooler and that it keeps things that are cold cold and things that are hot hot…..the question is …..

“How do it know.”

Well the Partin Tables- The male diagnosed with prostate cancer should know of these tables and how to apply to their decision making. These tables predict the chance of capsular spread and hence the potential need for more treatment after prostatectomy-cool huh?

So even though you can have radiation after surgery is a true statement  in the big scheme of things it might not be a point that really a therapeutic difference in one’s decision making.

I have a Partin Table link  in the right side bar and the internet is replete with “googlable” sites that explain it use.