Template Biopsy Results Thursday

Thanks for listening.

Trish x

I always find reading all of your posts such a comfort, you seem like a lovely wise woman. Yes lots of reading and talking over the coming week or two so that Stuart makes a choice that he feels suits him best.

BFN,

Trish xx

Hi Trish

Your man is facing a dilemma many men with localised prostate cancer on this forum have faced ..... what is the best treatment option for me? I believe the best option is the one that you both want after HAVING HAD THE CHANCE TO CONSIDER ALL OPTIONS and ask all the questions you feel you need to. It's great that your specialist has referred you man to both an urologist (surgeon in my book) and an oncologist. My first specialist was a surgical urologist and he strongly recommended Da Vinci and wasn't keen for me to discuss my situation with an oncologist. One of the first questions I asked him was 'what if I wait for 2 or 3 months before I make my decision .... would it increase the risk of the cancer spreading' .... to which he answered 'it would make no difference at all' in my case (PSA 13.8, Gleeson 3+4, Staging: T1c, N0, M0). For info I was diagnosed last August and had my treatment earlier this month! I agree with Lyrical that all men are different, not only in that it seems every cancer situation has its differences but that the way they want to deal with their cancer and the risks they are willing to take are different. After talking with some folk who have had PCa they said they just wanted to get rid of it as quick as possible (even many of those with localised PCa, what I consider as a low PSA and Gleeson 3+3) and wanted their PSA to fall to as near as possible to zero ASAP. These men always choose prostatectomy and that was the right treatment for them as that's what they wanted for peace of mind.

In the months I had to study the subject I choose brachytherapy as this was the treatment I felt comfortable to have.

Clearly there are men who have all three of the main options for localised PCa, prostatectomy, brachytherapy and EBRT who have had few problems post treatment and there are those that have had nightmare experiences with these treatments and then there are those who have faired somewhere between the two extremes. The latter is going include the majority of men.

As a rule I believe that sites like this tend to have a membership that understandably belong to those that have had a problem with their treatment, are suffering with more advanced stages of the disease or are, like you and hubby, looking for advice after diagnosis. Those who have 'swanned' through their treatment don't tend to need as much support and therefore don't necessarily search for it on sites like this. Some may criticise me for saying so but I genuinely think that is the case although there are those who have had successful and fairly 'painless' treatment who are on this site to kindly support others. I would also like to add that sites like this are invaluable and many posts have helped me no end.

The evidence re. success of all three of the main treatments for localised PSA are similar. The journey reaching that success has reasonably clear statistical differences, rather than individual experiences, which you should consider.

Another thing to take into account regarding personal choices relates to past experiences. As an example, some men diagnosed with PCa have been used to 7 or 8 hours of unbroken sleep every night and the thought of having to pee during the night is horrendous for them. Other men, like me, have been peeing a couple of times very night for many, many years so a long term side affect of treatment of having to get up twice a night to pee, or pee more often in the daytime than most men, is no big deal.

In summery, if it's possible to take time to make the decision ..... have a holiday or long weekend break to get away form the humdrum of 'normal' life and reduce the pressure. Make a decision whilst you are as relaxed as you can be. Ask questions, do your research and search your hearts for your gut feelings on what is right for YOU.

Life will be different now, you can't avoid that ........ but have confidence in yourselves that you can both make the right decision, given time.

Take good care of each other and let us know how you get on.

dl

Edited by member 01 Jun 2015 at 00:00  | Reason: Not specified

I agree Lyn but you know as well as I do that the side affects of the various treatments effect men in different ways and different degrees. It is well documented that in the longer term impotence and incontinence complications occur amongst more men who have a prostatectomy than with EBR or brachytherapy although EBR causes more impotence complications than brachytherapy. EBR is associated with more rectal problems than the other two forms of treatment and a downside of brachytherapy can be retention due to the prostate enlarging and 'squeezing' the urethra.

Naturally there are exceptions to the rules but we shouldn't muddy the waters for folk trying to choose a treatment.

In addition to my frequency example there are some men who are not naturally sexually active and these men are more likely not to be too concerned about loosing their erections.

As you know I had a 'limited' TURP myself in March and after the initial couple of weeks my flow rate improved beyond what I can remember beforehand as the 'restriction' was removed. The brachytherapy last month has reversed this trend for the moment. During the day it's like it was before the TURP and worse at night. However these effects are likely to be temporary and in a couple of months should start to return to how it was after the TURP.

dl

Edited by member 01 Jun 2015 at 14:45  | Reason: Not specified