Prostate, high risk

[medicinewoman101]

Im just curious, why cant you guys take more than 1 or 2 nodes in a high risk prostate surgery? Why not take more, what is oncologic about 2 nodes removed? And what evidence do you base taking high risk or very high risk patients to surgery vs sending for radiation? Is that the treatment you would recommend for family and for yourself?

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[cpants]

Im just curious, why cant you guys take more than 1 or 2 nodes in a high risk prostate surgery? Why not take more, what is oncologic about 2 nodes removed? And what evidence do you base taking high risk or very high risk patients to surgery vs sending for radiation? Is that the treatment you would recommend for family and for yourself?

We do take more than 1-2 nodes routinely. Anyone doing a pelvic lymph node dissection for prostate cancer will retrieve way more than this.

Decision making for localized prostate cancer is quite complex. Surgery, radiation, focal therapies, active surveillance, and watchful waiting are all options. The best choice of therapy can only be made by physician and doctor and is based on the specific characteristics of that patient's disease (ie: grade, volume, genetics, PSA), the patient's life expectancy and comorbidities, and the patient's preferences after considering the risks and benefits of therapy. If you are asking whether radiation or surgery is better, there is good data that both are effective vs. doing nothing. A head-to-head comparison will be published later this year with the PROTECT trial.