I was in the midst of the confusion over what to do and which treatment to pursue, when I saw a patient in my office, aged 63 and in good general health, whose PSA was now rising six years after having had brachytherapy. On the day of that office visit, he was on his way to a granddaughter’s birthday party. I realized then, considering that I was 52, I did not want to be in the situation of having a rising PSA ten years later and feeling that I had not done “the most I could do” in treating my cancer. I decided that the increased likelihood of being cured with surgery was more important to me than the risks and complications associated with it. On that day, after months of deliberation, I decided that I would have my prostate removed. I felt very strongly that if I had any of the problems associated with surgery, so be it. “Damn the torpedoes! Full speed ahead!” (“Damn the torpedoes! Full speed ahead!” is attributed to U.S. Navy Admiral Farragut during the Civil War Battle of Mobile Bay.)
|I felt then as I do now, that surgical removal assures that all the cancer in the prostate will be gone; radiation of the prostate cannot assure you that all the cancer in the gland will be killed.|
It is my feeling that surgery is a cleaner process, and I knew that once I got over the surgery, the catheter, and the frustration of post-operative incontinence, I would not have the unknown of the potential side effects common to radiation. I preferred paying up front for the known complications of surgery to paying later for the unknown side effects of radiation. A secondary factor for me was the fact that I was already having mild to moderate obstructive voiding symptoms, and surgical removal would eliminate the potential for future problems with voiding. For me, concern regarding the possibility of total incontinence, which can happen after surgery, was outweighed by what I felt was a better chance of cure and the prevention of the almost certain worsening of my already symptomatic prostate enlargement.