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User
Posted 10 May 2023 at 15:51

Hi and thanks for looking at my first post on this forum.

I'm just at the decision phase of my treatment.  Prostatectomy or brachytherapy are the options suggested.

I'm T1, 3 + 4 with 90/10 ratio, 4 out of 6 biopsy samples with cancer, 15cc prostate, 4mm to 6mm lesion in 1 year, some cribiform pattern present. PSA is 1.5. I'm 57 years old with no symptoms at all. Located in the Manchester area.

The specialists are suggesting treatment rather than surveillance due to the pattern 4 presence and the cribiform (and my age).

I'd really welcome peoples comments on choices and experiences.

Thanks and all the best to everyone, Ian.

User
Posted 10 May 2023 at 16:59
Yes you can have all the treatments! The hard part will be deciding which set of side effects and long term outcomes are preferable.

Good news is you will find all the options, side effects and range of outcomes on this site, but that's also the bad news and only you can decide!

User
Posted 10 May 2023 at 19:23

Hi IRW 65,

Sorry that you find yourself here.  There are some very knowledgeable people here and I hope some of them will reply more fully to your post.

Your prostate seems quite small at 15cc.  This might mean that you could have successful treatment with very precise Radiation Therapy such as Brachytherapy.

I was diagnosed 12 months ago and was a Gleason 7 (4+3), T3a with Cribiform Morphology.  Prior to diagnosis, I had frequent urination.  I wasn't offered Brachytherapy because the cancer was too advanced.  I was offered Surgery or Radiotherapy with Hormone Therapy (HT).  As I didn't fancy the HT, and they didn't recommend having the Radiotherapy on its own, I opted for the surgery, which took place 11 months ago at The Christie.

I've had incontinence issues and erectile dysfunction since the surgery.  I've had some improvement in my incontinence level, but no progress so far with erectile dysfunction.  I've been prescribed a vacuum pump, Cialis 5mg and Alprostadil injections, but the results are underwhelming.  However, some people are able to report being fully continent almost immediately after surgery and have better erectile functioning after 12 months than I've experienced, so I may not be typical.  The fact that you have no current symptoms (whereas I had frequent urination before diagnosis) might mean that you would have a better outcome from surgery. 

It's a big decision to have to make.  There is a book called "Saving Your Sex Life: A Guide for Men with Prostate Cancer" by Dr. P.J. Mulhall.  It's available on Kindle at a reasonable price.  Otherwise, it's a very expensive American import.  If you have time to read it before having to make a decison, it might be worth a read.  It's about 10 years old, so some treatments may have improved since then.

Best wishes in whatever you decide to do.

JedSee.

 

 

User
Posted 11 May 2023 at 08:43
Thanks JedSee for your reply. Very useful comments but sorry to hear about your on-going problems. I hope they get resolved eventually.
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User
Posted 10 May 2023 at 16:59
Yes you can have all the treatments! The hard part will be deciding which set of side effects and long term outcomes are preferable.

Good news is you will find all the options, side effects and range of outcomes on this site, but that's also the bad news and only you can decide!

User
Posted 10 May 2023 at 19:23

Hi IRW 65,

Sorry that you find yourself here.  There are some very knowledgeable people here and I hope some of them will reply more fully to your post.

Your prostate seems quite small at 15cc.  This might mean that you could have successful treatment with very precise Radiation Therapy such as Brachytherapy.

I was diagnosed 12 months ago and was a Gleason 7 (4+3), T3a with Cribiform Morphology.  Prior to diagnosis, I had frequent urination.  I wasn't offered Brachytherapy because the cancer was too advanced.  I was offered Surgery or Radiotherapy with Hormone Therapy (HT).  As I didn't fancy the HT, and they didn't recommend having the Radiotherapy on its own, I opted for the surgery, which took place 11 months ago at The Christie.

I've had incontinence issues and erectile dysfunction since the surgery.  I've had some improvement in my incontinence level, but no progress so far with erectile dysfunction.  I've been prescribed a vacuum pump, Cialis 5mg and Alprostadil injections, but the results are underwhelming.  However, some people are able to report being fully continent almost immediately after surgery and have better erectile functioning after 12 months than I've experienced, so I may not be typical.  The fact that you have no current symptoms (whereas I had frequent urination before diagnosis) might mean that you would have a better outcome from surgery. 

It's a big decision to have to make.  There is a book called "Saving Your Sex Life: A Guide for Men with Prostate Cancer" by Dr. P.J. Mulhall.  It's available on Kindle at a reasonable price.  Otherwise, it's a very expensive American import.  If you have time to read it before having to make a decison, it might be worth a read.  It's about 10 years old, so some treatments may have improved since then.

Best wishes in whatever you decide to do.

JedSee.

 

 

User
Posted 11 May 2023 at 08:43
Thanks JedSee for your reply. Very useful comments but sorry to hear about your on-going problems. I hope they get resolved eventually.
User
Posted 16 May 2023 at 17:28

Hi IRW65

I am/was in a similar position to yourself. I'm 61 and was diagnosed in March with a Gleeson of 3+4, a 22cc prostate and a PSA of 8.3. Stage T2b N0 M0 (was first advised as T1c but then upgraded)

I had all the options made available to me by the MDT but have now chosen Brachytherapy. I will have this performed once we get back from holiday in August. Luckily I do not need any hormone therapy. 

I chose to go with Brachy in view of the good success rate and reduced likelihood of serious complications. I met with a surgeon and oncologist, both of whom were excellent and helped my make my mind up. They did not push any particular treatment but generally favoured surgery or Brachy due to my age and "fitness". The Oncologist then referred me to the Brachy team, who were also excellent and gave me all the time I needed. 

Anyway good luck with whichever you choose, I know that having to make this choice is far from easy. 

All the best

Tom 

Edited by member 16 May 2023 at 17:52  | Reason: Not specified

User
Posted 16 May 2023 at 20:37
If you have not seen it already try and find my LDR Brachytherapy treatment by Davekc10 thread. It chronicles my journey last year. Sorry don’t know how to post a link.

Rgds

Dave

User
Posted 17 May 2023 at 18:13

Hi,

I was diagnosed in 2016 with PSA 2.19 Gleason 3+4=7 T2 no mo and 5 samples out of 20 positive and looking back my choice of Brachytherapy was good for me with no bad side affects apart from ED and was given viagra for help in that area . 

The time in hospital was short as was the operation two Days in and out, some discomfort but did not need the pain killers or Movicol for constipation relief.

The only side affect i had was getting up to wee three to four times a nights but that improved in time and but i can still get up a couple of times but could be because of the wine i like to drink.

Psa reduced at a steady rate over the following years until i was signed off by my specialist in January 2021 with psa 0.04.

If i can help with any other questions please ask and good luck with your decision.

Regards John.

 
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