Newly diagnosed. Now a decision to make.

User

Posted 19 Nov 2023 at 15:52

Hello everyone.

I'm new here but this forum is terrific with loads of fantastic information and advice.

I had my diagnosis about three weeks ago. I have a 30mm tumour and three other small cancerous areas. All are anterior on the prostate and there's no spread.

I'll be 75 in February and my options are robotic surgery, radiotherapy (no mention of hormone) and Nanoknife which would cost a minimum of £16K. I have to decide by Christmas.

I've been very lucky with my health so far so I'm quite the rookie at this surgery stuff! The most intrusive thing I've had was my recent biopsy under GA. That was the second one. The first was under a local but they missed the cancerous bits which were picked up by an MRI, so I had to go back for another burst!

Like many, many before me, I'm absolutely agonising over this and it's getting to me a bit today.

The robotic surgery should nail it but the after-effects scare me a bit. The radio seems OK but it's 6-7 weeks of commuting to Reading which may be a slog if the fatigue sets in, and what's the prognosis in the longer term?

As for Nanoknife, it's only been around since 2009 and hasn't yet been fully approved by the NHS. However, it's day surgery, or one night in the hospital as a maximum) and a couple of days to recover. The longer-term prognosis also seems pretty good but have they enough evidence to be sure about that?

This is just an introduction really but any comments would be very welcome. I'd also be most interested in the Nanoknife procedure if anyone knows of it, or anyone who's had it.

Best wishes to you all.

Mike

User

Posted 19 Nov 2023 at 19:53

Hi Mike, I'm sure you have realised from reading this forum, though no one wants cancer, at least prostate cancer is often curable, often treatable, and often very slow to progress. The commuting to Reading may be a nuisance, but the latest developments in RT mean that some patients can be treated with 5 doses rather than 37. Another possibility is LDR brachytherapy which is generally one procedure under GA, and if you are a suitable candidate is usually very effective. Personally I wouldn't want to risk the side effects of prostatectomy unless the medics were suggesting it is the only viable treatment.

Sorry I don't know enough about nanoknife to offer an opinion.

Dave

User

Posted 19 Nov 2023 at 20:44

I am sure everyone reacts differently but if I had to make the choice again I would still go for the robotic RARP. Side effects are under control and the joy of knowing that the thing is out of me cannot be underestimated. The options of Salvage RT are still there if needed in the future.

The op was waaay less than I worried about beforehand.

User

Posted 19 Nov 2023 at 22:36

You can find some impartial treatment information along with details about the disease by referring to the 'Tool kit' https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

As you say popularly referred to Nanoknife is a rather recent way of treating tumours. It is achieved by inserting electrodes in the Prostate at relevant positions and passing short bursts of electricity which blow holes into the tumour damaging the cancer DNA. It is more properly known as Irreversible Electroporation (IRE) and comes under the umbrella of 'Focal Therapy' rather than surgery. We have had very few people on the forum who have had the procedure as yet. One member by the user name of Paul London (try search facility), extolled it as a treatment he had but too early to determine whether this is typical and no long term analysis.

Edited by member 19 Nov 2023 at 22:40 | Reason: to highlight link

Barry

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