I'm interested in conversations about and I want to talk about

Know exactly what you want?

Show search

Notification

Error

Confused by treatment choices

Email this conversation Print this conversation

User

Posted 24 Oct 2014 at 13:16

My husband has just been diagnosed with prostate cancer. Gleason 3+5, PSA just over 5, contained in prostate. Had biopsy, MRI & bone scan in matter of 3 weeks. Living in Spain at moment but also have home in UK & not sure where to go for treatment or what treatment to opt for. Urologist here in Spain wants to do open surgery asap. Husband seems keen on 'da vinci'. Is it available on NHS in UK? Very difficult to get any information out here - this site is proving a godsend.

Urologist says it's an aggressive cancer but how does he know?

We're very confused.

User

Posted 24 Oct 2014 at 13:53

charoinspain....

Da Vinci is available on the NHS here in the UK, it is used more than open surgery because of the recovery time,

but some cases, they need to do open surgery, the aggressive cancer has probably been determined by the biopsy and other tests

to be honest I'm not the best person to answer this , there are others who will I expect give you better info in time....

Regards, john

User

Posted 24 Oct 2014 at 14:37

One way to determine the "aggression" of your cancer is the increase rate in PSA figure over time.

I believe that an increase of 1 or more in 4 to 6 weeks determines aggressive. But the figures are subject to a spike in the PSA test date. Various activities can spike a PSA result.

Do you have other PSA results?

Dave

User

Posted 24 Oct 2014 at 14:43

Also,

Does your husband know if he would be suitable for the "robot"? Suitability depends on fitness, weight and numerous other factors?

Not everyone benefits from the supposed advantages of the robot, I did not. My recovery was slower than it should have been, I had complications. That said, I would not change my treatment choice as my results and recovery 18 months down the line are great news for me.

Dave

User

Posted 24 Oct 2014 at 17:57

Hi Charo,

There are different aspects that define a cancer as aggressive, the speed at which the PSA is rising being one of them (they look at how many months it takes for the number to double). In your husband's case, it is probably being described as aggressive because he had elements of Gleason 5 in his sample - if you imagine the scale 1-5 as describing a totally normal shape through to the most distorted, G5 is the most distorted. It is good news that in your OHs case, these are not the majority of cells (the first number represents the majority and the second number represents the next most prevalent group) and that for the time being, most of his cancer cells are in the middle ground. However, the 5s in the sample have the potential to cause a lot of problems so you are being advised to take action rather than wait & see.

I hope that has helped,

Lyn

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

User

Posted 24 Oct 2014 at 18:02

For what it is worth, your OH shouldn't assume that Da Vinci is automatically the gold standard. As DD says, much depends on the circumstances of the individual man - in my husband's case, previous abdominal surgery / whether the lymph nodes could be removed at the same time and the advice of the surgeon meant that open RP was going to be the best option for him. Sometimes, pre-existing medical problems mean that Da Vinci is not possible.

Perhaps you could come to the UK to get a second opinion before deciding?

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

User

Posted 24 Oct 2014 at 19:37

For many years we have had a place in Spain and I've never heard a bad word said about their (free) health system, friends of ours moved to Spain when her husband was 72 yrs and suffering with prostate cancer,we were there this summer he is now 87yrs still having treatment, smoking the odd cigar, and is convinced if he'd stayed in England he would have been dead years ago.On the other hand 12 months ago I had a Da Vinci prostatectomy, and can't fault the treatment I was given, and still receive today in England. In agreement with Lynn and Country boy RRP does not suit everyone, there are certain criteria to be met in Spain with regard to treatments and hospitalization in Spain ie, whether or not you have Residencia, whether or not you are of pensionable age, if or not, you pay into their health or a private scheme, is your main residence Spain or England, no doubt you know this, but thought it worth a mention. Whatever you decide, and the decision for which treatment, can only be yours, l wish you well. Best wishes Diesel

User

Posted 24 Oct 2014 at 20:51

You may want to think about follow-up after surgery. Regular appointments for some time after. Just possibly further treatments ( obviously we hope not needed ). Will one country pick up further treatment after t'other has done surgery? Where are you living most of the time etc.

Communication. Will you understand sufficiently different terms /words in Spanish ?

The Gleason 5 element of the biopsy is secondary . But we don't know figures. For example, the 3 could be 51 % and the 5 = 49%. That would = 3+5 . As would 95% grade 3 + 5% grade 5. I'm guessing the Urologist has looked at this regarding speed of action.

If a lot of the grade 5 involved then psa results may be less helpful.

Suspect NHS would want full scan results etc. before treating.

If it is the potentially quicker recovery the robot offers I wouldn't base final decision solely upon that. You want the best surgeon available to do the most thorough job using whichever method.

User

Posted 24 Oct 2014 at 22:27

Rob makes a good point,

Well worth considering.

My situation was that I was going to be temporarily lodging with a mate in Northampton. I opted for RRP Da Vinci in Reading. Okay, there were some issues for me after the op but my mate did not have to appear every day, did not and could not appear every day, as she was extremely busy with numerous business commitments and concerns that had to be attended to. Too numerous and important to mention here.

But, the after care is only a short term issue, so I would consider going to the best location for whatever treatment option you go for, and then cope with any ravelling issues afterwards.

Look at it like this, this is the most important decision you will make around now, make it a good one. And just cope and deal with any short term inconvenience.

ATB

Dave

User

Posted 25 Oct 2014 at 17:15

Just wondering if your OH has discussed other treatment options eg RT, brachytherapy etc.

May be worth downloading the toolkit to see what treatments are available

Bri

Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.