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Apr 23, 2023Liked by David Thornton

Hi David....many years ago, my father was told he had a very tiny, almost microscopic prostate cancer. He watched his psa number over the course of months and then decided he wanted to treat it. They offered him radiation or prostatectomy. He was told either option in terms of treatment would be just as effective, but that radiation would preserve the thing my dad was concerned about with prostatectomy (incontinence and/or erectile dysfunction), and also that radiation would be a much simpler and painless procedure. I did a lot of reading and research on my own about it, and I personally felt that a prostatectomy was a better option, as it seemed from what I read that a complete prostatectomy had a greater chance of fully eradicating the cancer. Furthermore my dad was told that if he chose radiation, down the road if the cancer came back, they would not be able to operate/do a prostatectomy as the radiation would have damaged the tissues and prevent proper healing, so a future prostatectomy after radiation would not be possible. He was certain however that radiation was a better option for him. His cancer was tiny, he felt radiation would eradicate it, it would be painless, and he was obsessed about the potential issues of incontinence and erectile dysfunction. He made his decision and went with radiation. I didn't feel good about his choice, but it was his choice. And let me tell you, radiation was not as simple a procedure as they indicated it would be. He started developing pain partway through the radiation treatments. The pain increased after each radiation treatment, and became so intense and unbearable that he had to take morphine. He barely finished the treatments. It turns out that the radiation beam burned part of his colon. You would think that the radiation beam would have pinpoint precision, but it still burned part of his colon. And these radiation treatments were done at a world class cancer hospital, not some small town hospital. The pain he went through with this was brutal and urelenting, and only partially helped by the morphine, and it went on for months after the radiation was stopped. I'm sure part of his colon was permanently damaged. And many years later, his cancer came back again, but now surgery was not an option because he had done radiation, and so he was relegated to using hormone treatments (pellets under the skin in his abdomen, not fun either). After being a witness to what he went through, from beginning to end, I resolved that I would tell whoever I could that I would never, ever recommend radiation as treatment. Everyone has to make their own choice, I understand that. But no urologist ever told him about the potential for adjacent tissues to be burned from the radiation treatments, and the indescribable pain he would or could suffer from that, that was never mentioned. It was so much worse than any pain he would have had from a prostatectomy. And then, the door for further surgical procedures down the road was closed to him because of his radiation. So I'm saying all this to tell you: you wonder if you made the right choice having a prostatectomy. To me, it's really the only wise choice. I fervently wish my dad had chosen prostatectomy.

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Thank you for your story and I’m sorry for your dad’s bad experience and for what you all went through as a family. God bless you all and I hope that all is well at this point.

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Apr 24, 2023Liked by David Thornton

Thank you David and wishing you a speedy and complete recovery.

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Apr 24, 2023Liked by David Thornton

The colon is an important avoidance sector in treatment planning for external beam radiation therapy. Modern systems have great capabilities to do so, as well as performing better beam shaping, use of implanted markers to ensure correct alignment, 6 degree of freedom couches for better patient placement...

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Apr 24, 2023Liked by David Thornton

Thank you for your response. I agree that radiation treatments must have improved since he had his radiation, which was around 1994. I just find it unconscionable that such risks would not have been mentioned to him by the urologist oncologist at the outset. And then when it happened, he had no choice but to deal with it. I'll never forget his suffering from his colon being burned.

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