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Just back from Hospital staging gone up!

User
Posted 01 November 2017 14:10:19(UTC)

Hi everyone;

Just out from seeing the Consultant and my OH was diagnosed initially with a Gleason 3+4 stage 2c but surgeon now says its a T3 near the edge of the capsule.

Tumour quite large in the anterior of the prostate so it was difficult to find. 2 cores 3+3 and 1 core 3+4 on the other side out of 10 cores. PSA 14 nodes appear clear as do bones

Consultant seems to think there is more there it was just difficult to get to as its anterior.

 

Options are limited as my OH had Bowel cancer 11 years ago (curative) but he has a lot of adhesions and scar tissue due to the surgery and although the consultant didn't say as much reading between the lines I think he was erring on the side of HT and RT due to difficulties with adhesions and surgery but still looking at a cure.

 

Can I ask if there is any difference in success rates of HT/RT vs Surgery - 

I will look up the side effects of HT/RT but a few daft questions - sorry:

Can my OH still exercise when on HT?

The consultant said if he had surgery he would have taken out the lymph nodes so will RT eradicate them too?

Can he drive after Radio or am I best to drive him 80 mile round trip

Will the HT initially stop it growing?

We are a bit scared about the T3 staging.......

Now for a selfish question - we were due to go on holiday last week February first week in March - if he starts Hormone therapy next week for 3 -6 months should we postpone the holiday so he can start radiotherapy - we don't want to compromise his health and its only a silly holiday? (Although the OH is keen to go!)

Thank you everyone!

Jenny

User
Posted 01 November 2017 14:23:54(UTC)

Jenny

I don't know the answers to your questions as I had surgery but others will come along and offer advice and support.  I wish you both well.

Ulsterman

User
Posted 01 November 2017 14:41:08(UTC)

Thank you!

User
Posted 01 November 2017 17:06:33(UTC)

Jenny, let me try to answer your questions in the order supplied.

In general success rates are similar, but this is a unique case (aren't they all?). It is quite difficult to prevent overspill of radiation into the b!adder and bowel and then again, I understand surgery can be tricky with anterior PCa. I would say you need the views if a Urologist and an Oncologist to help in decision making, based upon what a CAT scan shows.

On exercise, not only can your husband exercise whilst on HT, he will need to. The treatment tends to lead to weight gain around the hips and belly, so increased exercise is essential.

Usually, RT does not target the lymph nodes. Too far away for effective focus on the prostate capsule, I think. Certainly, the point was never raised in my treatment as a possibility.

I had no problems driving to and from my RT and no discomfort in nether regions.

The HT is intended to cut off the supply of testosterone on which the PCa feeds, so the expectation is that the tumour will be reduced in size and hopefully disappear. There are no certainties, as every case is unique. From what you report, the aim of the HT/RT combination is curative.

As to the holiday, you need to ask when the RT is planned. It could be either side of your holiday or after it, I imagine. Only you and the consultants can sort that one out, but I would hope they would have regard to the beneficial effects of the holiday as well as the need to progress the treatments in a timely manner.

I wish you both luck and hope the treatment goes well.

AC

Thanked 1 time
User
Posted 01 November 2017 18:39:24(UTC)
Jenny,
It's a positive you're offered treatment for a cure.

From what I've read driving after RT isn't recommended. It can be tiring, although it may depend on fitness.

We had a 4 week holiday planned in Feb this year and I was told I'd have an op in mid Jan. However it was pulled forward to mid Dec. I was still cagey and cancelled hotels and flights that needed full payment by a certain date. It was a mistake with hindsight as we went with no problems, 24hr flights included.

Your case may be different but I'd think hormone injections would fit around a holiday although if it was me I wouldn't interfere with radiotherapy dates, except by a day or two maybe. It's often 5 days a week for RT, up to 35 days, that could be 7 weeks. It might be less sessions.

You'll return say 7th March or about 4 months from now. I'm guessing you can go on holiday if RT starts over 4 months from now. But 3 months hormones would be extending RT into your holiday.

Regards
Peter

Thanked 1 time
User
Posted 01 November 2017 18:58:40(UTC)

Research shows that the longer the RT is delayed after the start of HT the better the outcome so I imagine that if you tell the onco or the nurse specialist your intended holiday dates they will reassure you that the RT can be done afterwards. Some onco insist on 6 months HT before starting the RT. We had a 3 week holiday planned for the July and it was agreed in the May that J was going to need salvage RT/HT - the onco said that because you can't sunbathe for a while after RT, we should get the holiday while we could. J went for the planning scan and tattoos before the holiday, the onco wrote all the computer programme etc while we were away and RT started as soon as we got back.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard


User
Posted 01 November 2017 20:52:39(UTC)

Agree with AC on this plus advantageous generally to have HT for about 6 months prior to RT and during it. (I asked specialist about extending this to 7 months before RT and was told "This will do no harm, no harm at all", although there are a few cases where an oncologist wishes RT to start earlier. One thing that should NOT be done is to have a break in the RT other than the usual weekends and short Bank holiday breaks should the occur during the treatment course.

I would have thought that within reason the RT will be directed at the affected area.

As regards driving during RT, some men feel they can do this for some if not all of the RT course. It should be remembered that the varying side effects of HT will be added to those of RT. So it is not really possible to predict the extent that men will be affected rather than may be affected.

Barry
User
Posted 01 November 2017 20:53:24(UTC)
Thank you all.
Lyn that is especially reassuring.

Jenny
 
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