Dr. David Samadi – Radiation Therapy Vs. Prostate Removal (Prostatectomy)

hello hello dr. Muir okay my name is Steven I have a I have an enlarged prostate I was given the flomax for a long time and I even was on a Vedad for about a year and after I developed prostate cancer very small decoded in time with a biopsy so I elected to get beam radiation of 40 treatments of radiation now the doctor my doctor I was going to he stayed he because I had questioned him about any surgery he stated that surgery is not likely because of some kind of fibrosis or something with the prostate gland and it would produce incontinence if I had surgery done would you agree on that Robin the other options besides surgery yeah you’ve had you’ve had radiation already right yes okay about a year ago okay so let me tell you what what I feel about all the options and when we talk about prostate cancer there are low risk prostate cancers and there are high-risk prostate cancers and you’ve heard of the classification called listen score we urologist use that to figure out exactly what type of prostate cancer we’re dealing with here in my in my practice I like to cure the patients remove the prostate and there are many advantages of removal of the prostate which when you remove the process you’re going to know exactly what type of prostate cancer you have you will find out how much cancer you have in the prostate because that needle biopsy is a random biopsy and doesn’t give you always the best picture what’s the what’s important is six weeks after prostate surgery your PSA should go down to zero and should stay zero for the rest of your life so the advantages of the surgery is that the follow-up is very easy now what happens if you do the surgery assuming that you have a qualified experienced surgeon and the risk of incontinence would be low and some of the complications that you talked about if the cancer recurred after surgery then I would use a low dose radiation as a back-up plan so of the side effects of radiation as you know is secondary chance of rectal cancer patients can get rectal bleeding and bladder bleeding side effects of radiation comes as time goes on so if I can avoid giving patients radiation and cure them with good quality of life that’s what I would prefer if you’re doing well then I will just continue watching the the PSA yeah but the thing is that my peers say okay it’s down to within normal levels it’s three point five but the thing is I already had the radiation so what am i up to now can i still have surgery or it wait if the PSA PSA should go way down your PSA should go down to 0.4 or 0.5 it’s a different measurement as what we use for surgery if your PSA doesn’t go down or continues to go up you need to come in and we need to do another biopsy okay thank you very much very soon what was it yeah but this definitely is still available after the radiation that I had I can I can do it it’s a risky procedure and it should be done in the hands of qualified surgeon and I’ll be happy to talk to you if that if that comes yes the answer is it is possible but it’s a complicated case and it should be done in Centers of Excellence with qualified surgeons the contribution except for assuming sasago may give up so de nada a preface is agad row al military cab feedback see car America bigger than hey Mary audition and I cast in pro TV up Seija poor Lily go get to Kaname to sharpen knife he know me a her yet Rose yet too sharp a knife oh can i mr. log island Martha she had her husband had prostate cancer actually found it on a biopsy and they had done the procedure with the CyberKnife what is your opinion on the CyberKnife and that’s funny that she’s asking this question because i wanted to pick your brain about that as well how old is a patient boss oh honey no see zero three Hey 62 63 63 well what type of prostate cancer was it a low risk or high risk high did high risk and did they give him any kind of hormones okay he gets the flomax once a day okay so get the blood test every two or three months okay I think CyberKnife for individual patients is a good treatment typically you have a 63 year old is still a very young patient Peter so especially for high-risk prostate cancer patients I rather remove the prostate for many reasons because if this patient’s cancer recurred which the sometimes with high-risk prostate cancer it can after radiation or surgery the choices are very limited after radiation it’s very difficult to do surgery after radiation but it’s very feasible and it’s very easy to give radiation after surgery why the distinction why the because when you radiate the prostate like this with CyberKnife or other modalities the tissue turns into a cement it gets very sticky to the rectum and for us to be able to go back to do the surgery the anatomy has changed and it’s very difficult to do that operation so the way I do it is first remove the prostate you get tremendous amount of information as to what type of cancer how much it is and get to that PSA their continents and sexual function returns in a short period depending on the recovery as long as their PSA is zero they are cured from this cancer if the cancer comes back after surgery then you can give them radiation so you haven’t burned any bridges and we have all the options open this patient you can go on for a few years if his cancer comes back our choices would be very limited and that’s why I don’t want to go through these options too quickly now a 63 year-old is a very young patient we have people coming in in their 80s and and so on and that’s because of your cardiac stent Lipitor and Crestor men are living longer now 75 year old is not you had a 78 year old on the phone so we want to treat these patients in their 60s still cure them and remove the process a fella was the debris at Rose Bowl Oh Mr Farage to me yes thank you no sir woman he met him a ma many de come on 90 years old and I heat up then I’m gonna go si Yellin you gotta step on CN n lava cake Amemiya serious Jenna Guinea CDC al awwalin a in addict TV Mexico not a theory measure decency its delay maquette ‘lava-tay – she’s in a Janeiro move on a measure in Iraq tdz stir the Gallo months Argentina share the city plan that radiation is 90 year old and he probably got treated with radiation which is the appropriate treatment for all the patients but one of the messages from this is that now you see a lot of men in their 80s and 90s and that’s why that’s 63 year old which you know I don’t want to disappoint them I’m sure you got good treatment but the way we treat these patients are different because they live longer that’s why removal of the prostate absol for people that are living longer is much better

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