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Robotic prostatectomy or Radiation Trearment?

Posted 17 Dec 2014 at 10:15

Originally Posted by: Online Community Member

Fingers crossed mine was localised .First results this friday coming up .10 months on .Not a great deal of problems  they do ease with time .Roll on friday nervous but excited 

[Just to say Good luck for Friday Rontatt.

Hope you have great news in time to really enjoy your Christmas.

Best Wishes Sandra

We can't control the winds - but we can adjust our sails
Posted 19 Dec 2014 at 18:49

Thanks for all replys devonlad Gooodluck . And a great thankyou to these kind of sites ......and esp christies goodluck guys  As good as clear after 10 months .Dont leave things to late in life Ron

Posted 19 Dec 2014 at 19:16

Brilliant news. Very pleased for you

We can't control the winds - but we can adjust our sails
Posted 24 Dec 2014 at 19:48
Yessssss ...... Today I was refered to Guildford re. LD brachytherapy. Got there in the end!

Happy Christmas all (hic!)


Edited by member 24 Dec 2014 at 19:49  | Reason: Not specified

Posted 24 Dec 2014 at 20:25

Yay, just what you wanted. What a Christmas present.

We are on our L.D. Brachy journey already. Hope all goes well for you.

Were you given a date yet or do you have to wait until after Christmas to find out?

Enjoy Christmas.

Best wishes

We can't control the winds - but we can adjust our sails
Posted 24 Dec 2014 at 22:54
Thank you Sandra. Bit much to expect to be told I have been referred and given a date on the same say!

I have been told I will be telephoned early in January to arrange a consultation.

Am chuffed x

Posted 24 Dec 2014 at 23:08

Excellent - you can enjoy your Christmas more relaxed now, and many more, I'm sure!!

Stay Calm And Carry On.
Posted 27 Dec 2014 at 14:02

Congrats devonlad ...was in and out in 5 hrs all together .http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-cool.gif  Have a great newyear 

Posted 05 Jan 2015 at 15:14

I was startled at the number of men I talked to, in the Hospital, waiting for their RT treatment who were there because the surgery hadn't got it all.

RT is no fun for 7 weeks of treatment. They don't tell you of the torture 4 beakers of water you need to drink, in 10 minutes,  then the 40 minute wait before treatment.

I found the whole business hugely stressful and so did all the others I spoke to.

It's all over now but a week or so down the line I still need to pee 8 times a night, bowels are in a right state and the "tiredness" anticipated is more like the paralysis of exhaustion.

There were 3 months of hormone therapy before all the above, which wasn't so great.

They are not joking when they warn of breast development and weight gain around your middle. Fortunately the former can, I was told, be corrected by surgery, the later would disappear in time . 

I really regretted having taken this route until I met all those guys who had had surgery and were now hit with a double whammy, so to speak.

I cannot praise the Hospital Staff enough for their caring good humour and concern for me and my difficulties, so it's not all grief lads!


Posted 06 Jan 2015 at 23:35

Thanks for posting Bill

I am guessing that you had External Beam RT – am I right? Also – are you saying that in your opinion the men who opted for surgery had a worse experience in your view?

From what I have read it so depends on the individual and the stage of the cancer which option of treatment proves to be the best.


Posted 07 Jan 2015 at 01:41

Not everyone has a horrendous time with RT - John called in for his IMRT every morning on his way to work and pretty much breezed through the whole thing apart from needing a little nap some afternoons towards the end. Not all hospitals have the 4 beakers / 40 minute thing and not everyone needs an enema. John had to drink water on his way to the hospital and was usually in and out in less than 15 minutes. He didn't have any enemas.

Having said that, he was one of those for whom surgery had failed and yes, he found it upsetting to think that he could have avoided the side effects of surgery and the long haul of recovery - but hindsight is a wonderful thing.

Edited by member 07 Jan 2015 at 07:11  | Reason: Not specified

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

Posted 07 Jan 2015 at 16:26

Got to agree with Lyn, I also had RT (37 fractions) and absolutely sailed through it with no side effects at all. I am 100% happy that I went down this route, my first post RT PSA test was <0.2 which my Oncologist says is virtually undetectable although he still expects it to fall further.

I attended the Beatson Cancer Center where I was given three cups of water to drink, I then waited 30 mins for treatment which only lasted approximately 3 minutes. No enemas were given.

I have also been on HT since Feb 2014, and for the first six months was getting very manageable hot flushes but since then they have subsided. I currently have no side effects from HT (Zoladex LA), I have not put on weight, I have not felt emotional or weepy, I have no problems with breasts, depression or anything, up to now I have been very fortunate when I read how some other people have been affected.

I was put off RP which is a major operation due to all the many immediate side effects and no guarantees, and felt very positive about the RT route. What also made my mind up was the fact my PSA was 59, I had been told that many surgeons will not operate if the PSA is over 20 as the success rates were not as good. Also due to my PSA level they were going to give me Adjuvent RT even if I got the operation, so I thought to myself I need RT anyway, so there is absolutely no point in going through a major operation if I had as good a chance at cure with RT/HT and my Oncologist totally agreed with my reasoning.

But as has been said everyone is different, their bodies and even their minds react differently to cancer and its treatments, remember your cancer grows from your own cells and everyone has a unique DNA therefore everyone's cancer is also unique that is why it is so hard to find a one size fits all treatment. But we all live in hope.

Best wishes to ALL who are fighting or affected by cancer.




Edited by member 07 Jan 2015 at 21:10  | Reason: Not specified

Posted 07 Jan 2015 at 21:13

Well said Gerry - and well done for going with the treatment you were happy with. Glad all is going well.



Posted 16 Jan 2015 at 20:31

Yippe - date for LD Brackytherapy consultation came through this morning. Fingers (or should it be legs!) crossed that it will turn out to be a suitable treatment for me and they can treat me in Feb.


Posted 28 Jan 2015 at 12:59

The consultation yesterday went very well. I had been told that brachytherapy may well not be a suitable treatment for me because of lower urinary problems and a medium IPSS score (see: http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCMQFjAA&url=http%3A%2F%2Fwww.urospec.com%2Furo%2FForms%2Fipss.pdf&ei=BtnIVMfHKMrXaqbkgYgP&usg=AFQjCNF-QIoHvWgGxeYqUphwPJzE3AoD-w&bvm=bv.84607526,d.d2s).

My IPSS score came out at 18. The ultrasound detected what was causing the main problem in that a lobe of the prostate had grown and was ‘pressing’ on the urethra causing an urethral stricture close to where the urethra connects with the bladder.

However, all it not lost in that I can have a limited TURP to remove the stricture followed about 3 months later by the brachytherapy.

I also learnt that the conventional biopsy can’t reach all parts of the prostate to check out the spread of the cancer. My consultant says he will carry out another, different biopsy procedure, whilst I am under the anesthetic (during the limited TURP) to check the rest of the prostate. The cancer has apparently been upgraded by the initial consultant I had at a different hospital to Gleason 4+3 (rather than 3+4) but apparently the same hospital told my consultant that they had also had downgraded the % cancer they found when they carried out the conventional biopsy. They hadn’t told me this!

Apparently it may be possible if the cancer is as localized as they think to perform a new type of procedure where they treat (by brachytherapy) only the part of the prostate where the cancer is and not the whole of the prostate as is conventional. The wonders of medical science!

The message is if you want brachytherapy and you are initially told it's not suitable for you because of pre-treatment lower urinary problems....... check it out, get a second opinion if necessary, there may well be a solution.


Posted 06 Feb 2015 at 07:59

Barrie, Im interested in your comments. You say you had 2 MRI's, were they 1.5T or 3T? Also you imply 2 biops had no cancer? Were the biops guided? as I assume they were from the MRI.

I have 1 x 3TMRI no biop...score 2 in PZ zone which can be inflamation or tumor. 2nd MRI was last month, 4 years later, same area at 8 o'clock, seems now individual scores 3 with total of 8, which again is the inflamation or  tumor route...the grey zone. Statistically there is 19% for bad result and 81% of being inflamation.

I'm interested to see or hear whether your scores changed between the MRI's

Thx Dean

Posted 06 Feb 2015 at 15:45

I had a similar experience. I wanted brachy but was told my prostate was too large and the seeds would close the urethra. I could have asked for active surveillance but the consultant said he would recommend an immediate biopsy under anesthetic and an annual one thereafter. At 63 I could see ahead lots of discomfort and inconvenience and then the possibility of having to take action as the tumor was growing in size. So, I decided on RP using a robot as I thought that this could be 'one off' and I could be cancer free. But also crucially in my thinking was that if I had any re-occurrence of the cancer I could fall back on radiotherapy. The advice I received at the time was that this would not work the other way i.e if you choose radiotherapy first it is very hard to remove the prostate in the future if the cancer returns.  Sadly my brother has now been diagnosed with PCa and he is going with radiotherapy as he has other medical issues that suggest he should avoid surgery.

Hope this helps 

Posted 11 Feb 2015 at 09:44

Hi wightman

The hospital I now attend recommends that for brachytherapy the prostate should be less 60cc but I think some centre's prefer the size to be less than 50cc. The reason is that if the prostate is too large effective implanting of the seeds is difficult or nigh impossible as they can't reach all areas of the prostate as the pelvic bones get in the way of the needles. A large pre-treatment gland size can also, as you say, cause peeing problems (especially if the patient already has peeing problems) as the prostate gets even larger it can squeeze on the urethra. The prostate size can be reduced using hormone therapy and sometimes this is used to reduce the prostate to a size that will allow implantation.

You won't be surprised to know that patient selection criteria for brachytherapy varies between hospitals. Much of this is down to the experience of the staff at the hospital to undertake the technique.

On the 'fussy' side many hospitals have the following criteria: PSA < 10; T1 or T2; Gleason 6; no urinary problems (IPSS score 10 or less); gland size < 50cc; no previous TURP (full).

On the 'generous' side: PSA < 25; T1 or T2; Gleason 8; some urinary problems acceptable if a limited TURP will help; gland size < 60cc; previous full TURP - not recommended (which presumably means possible!).

With a PSA of 13.8, Gleason of 4+3 (7) and IPSS of 19 I am fortunate to have (eventually) ended up being treated at a hospital that's right for me.


Posted 11 Feb 2015 at 10:27

Hello, as you know my other half just had brachy 5 weeks ago. I can't find anything on his notes about the prostate size you have mentioned. With cc after? Only thing I can find is volume of 22ml. Is that the same. As I have said before he scored near enough top marks in the IPSS didn't very often get up at night or anything. He is now really suffering after brachy, most days he is weeing every half hour, with severe burning, inside and all the way to the tip of his penis, he is up up to 6 times at night too, also needing to open his bowels at the same time,he is a farmer working outside and often he has a wee outside and then I see him come running up the drive because he needs to open his bowels too! We were hoping to get by until the 6 week check but he phoned the consultants secretary this morning to say he couldn't cope, so the consultant is going to phone some time today. 

Considering he had no bladder problems before, he is finding it hard and nights exhausting.

The gp prescribed antibiotics but they made no difference.

Having said all this, I am sure what he is going through is much less than he would had he had his prostate removed. We have 3 friends that have had brachy with no side effects whatsoever. Just hoping this will all be worth it.

Posted 11 Feb 2015 at 18:13

A cc (cubic centimeter) is the the same volume as a (ml) millilitre.

Posted 11 Feb 2015 at 19:55
Thank you batholith, same thing then, so he was ok with the size of prostate, just unlucky with side effects I guess. Thanks again.
Posted 12 Feb 2015 at 09:45

Hi sjtb

It must be -particularly hard for you and hubby esp. as you farm. As mentioned before I know a local farmer who had a prostatectomy (open surgery) who had all sorts of complications and I remember helping him with calving a day or two after he came out of hospital after being hospitalised again for one of them. His op was over 10 years ago now and he's still free of the disease.

It's still early days for your man .... he does seem to be unlucky with his complication but if he had had a radical prostatectomy I guess it would be worse and he almost certainly wouldn't be back at work.

Best wishes to you both and please keep us informed.


Posted 12 Feb 2015 at 10:57

Hello, thanks Devonlad. We know of 3 people that have also had brachy, all had no side effects which makes me wonder why he has so many. One of them had it 12 years ago and now his psa is on the rise, it seems to return about 10-12 years later. Not sure what treatment our friend is having yet. 

We left a message at the hospital yesterday and they said the consultant will call, but he didn't. I did tell my OH to phone again today, but he said he has put up with it for 5 weeks so may as well wait now until we see him next week.

Posted 14 Feb 2015 at 00:14

Hi sjtb

Unfortunately cancer returning is possible with any radical treatment including Brachytherapy - however there are treatments they can provide if it does return and every year the options are getting better and better.

I would certainly press to get some answers if I was in your hubbys shoes and if I didn't my partner would nag me until I did! It's not right that you are given a message that someone would call and they don't although it may not have been the consultants fault (he/she may have not got the message or been rushed off their feet! The pressure on the NHS to perform just before an election is ridiculous but predictable whoever is in No 10!).

The specialist nurse maybe able to help if you can't get hold of the consultant.

Good luck.


Posted 14 Feb 2015 at 09:14
Yes I lnow devonlad. I would have kept phoning the hospital had it been me. But he wouldn't. We are going Monday if he is well enough. He rarely gets ill, but now has a bad cold that is going onto his chest, he is so tired which I expect is why he has a cold, our 5 year old said "Dad, ill?" Because he can't remember him ever being like this.

He is still weeing every half hour day and night, so is exhausted. He said it burns so much, also up in his back passage, surely that is causing harm?

I have tried to get him to rest, but he is too busy, mucking out day yesterday, that is always a long job. I offered to help, but I can't operate the loader on the tractor (well, I'd give it a go, but would make more mess!)

Just looking forward to Monday, if I can get his cold cleared a bit, there are notices up in oncology saying not to enter if you are ill. He will need to see his gp on Monday too if we are home from hospital on time as a cold always goes to his chest. Thankfully he usually seems to only get a cold every other year, but always gets a chest infection, resulting in a good month on antibiotics (I am sure the bad chest is from all the dust and chemicals farmers suck in!)

Hopefully we will get some answers Monday.

Posted 16 Apr 2015 at 20:01

Hi Devon_Lad, can you empty your inbox please.


Posted 17 Apr 2015 at 20:35

All the best for Monday-your OH deserves a break.El.

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