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PD and prostate cancer

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Hello, Doctors--


I've just been diagnosed with prostate cancer: psa 5.4 and Gleason Scale 6. Previously diagnosed with PD 3 years ago.

Which of these 2 options would be better for a 67 year old man, fairly healthy:

1. robotic assisted laparoscopic prostatectomy

2. brachtherapy with removable radioactive implants


Number one, while removing all the prostate, presents the problem of connecting the bladder to the urinary track. This requires muscle control but PD weakens muscles.


Number 2 requires several treaments with comparable side effects but does not require connecting the bladder. Also the procedure could be done locally.


Would I have to stop taking my medications pior to either option and if so how many days before?

Currently taking daily:

mirapex 1 mg [3 times ]

selegilne 5mg [2 x]

provigil 200 [one x]

co q-10 1200mg [at b'fast 600mg; lunch 600mg]


Thank you for your much appreciated help.

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Usually I am not helpful with non-PD surgery but since my father had prostate cancer I speak the lingo.


Gleason 6 is not bad (middle of the road) but the doc needs to look to be sure it is not an aggressive pathology.


These days it is often good to get a second opinion from a medical oncologist and not just the urologist as there are follow-up options now that didn't used to exist. I am not familiar with the robotic; but I would say since your PD isn't severe I would do the surgery that gives you the best long-term survival advantage.

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