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User
Posted 29 Jul 2015 at 16:18

 


 


I was diagnosed 3 weeks past with localised PC and a Gleeson score of 7.  On reading through the 'Toolkit (and being a big fearty) I decided to opt for Active Surveillance.


However, my consultant advised me that, due to the location of the cancerous cells, monitoring was not an option. Apparently, in 95% of cases the cancer cells are located at the side and back of the prostate but in to  my case they're at the front of the prostate and this makes it very difficult to monitor them. The options, according to the consultant were surgery or radiotherapy.


Given that, if radiography failed, surgery would no longer be an option I was inclining towards robotic or keyhole surgery.


Wrong choice again! 


Due to the fact that I had a template biopsy to diagnose the cancer then keyhole surgery, whether robotic or manual, is not a recommended option according to the consultant. The  recommended options are therefore open surgery or radiotherapy.


The thought of open surgery, with longer recovery times, does worry me. Is it so much more severe than keyhole? I'm now inclining more to radiotherapy. A friend suggested Cryotherapy, although it doesn't seem to be readily available.


I would really appreciate anyone's advice or experience of these treatments.


Thanks


Paul

User
Posted 30 Jul 2015 at 12:36

Whichever form of surgery it opted for the biggest contributor to success is the skill and experience of the surgeon. Although surgery does carry a rather greater risk of incontinence and erectile dysfunction than various forms of radiotherapy, though ED can follow RT in due course. if the cancer is contained surgery usually puts an end of it. In need RT can back up surgery more easily than the other way round. There is also the possibility that even with a radiated prostate, the cancer can regrow (as has happened to me).

Barry
User
Posted 29 Jul 2015 at 16:47

Hi Paul I had open surgery last December in hospital 3 days, wound healed well and quick , they got me to walk the next morning which helped , It may have put me aday or so behind keyhole option but all went well, all the best Andy

Edited by member 29 Jul 2015 at 16:48  | Reason: Not specified

User
Posted 29 Jul 2015 at 20:34

Hi Mo


My PSA was 8 at diagnosis, having dropped from 10 several weeks earlier. I am due to meet the medical team shortly and I'll certainly be raising some of the issues you mention about NHS Choices and Brachytherapy.


Thanks


Paul

User
Posted 29 Jul 2015 at 20:44

Hi Trish


Interesting to hear that your husband had Da Vinci surgery just 3 weeks after the template biopsy. I will certainly have to enquire as to why my consultant doesn't offer it.


Hope your husband's recovery continues to go well.


Paul

User
Posted 06 Aug 2015 at 17:12

Hi Chris


Thanks for your post. As you say, many people are uninformed.  I'm trying to read up as much as possible but come to a different conclusion each day.


I'll probably gain a wealth of knowledge but end up following the consultants recommendation anyway.


Good luck with your progress.


Paul

User
Posted 19 Aug 2015 at 17:49


Paul sometimes it can be best if decisions are made for you, and enjoy the next few weeks!

Wishing you all the very best for 21st October!

Pablito

User
Posted 19 Aug 2015 at 22:57
Wishing you well for your operation. Looking forward to updates once it s done and dusted.

Paul
THE CHILD HAS GROWN, THE DREAM HAS GONE
User
Posted 20 Aug 2015 at 10:02

Paul
I wish you well for the operation and a speedy recovery thereafter.
I look forward to updates on your recovery once you are back home.

All the very best

Paul

User
Posted 20 Aug 2015 at 11:15

Wishing you all the very best for your forthcoming op on the 21st Oct Paul

Although I had da Vinci surgery and was happy with that, it was explained to me beforehand that although a rare occurrence, if the prostate was 'stuck' to the bladder, or other complications were encountered, my surgeon would revert to open surgery.

That to me indicates that open surgery pretty much covers most eventualities whereas successful da Vinci surgery is more dependant on no unforeseen complications coming to light..

Luther

User
Posted 20 Aug 2015 at 20:33

Just adding my best wishes for your surgery

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User
Posted 29 Jul 2015 at 16:47

Hi Paul I had open surgery last December in hospital 3 days, wound healed well and quick , they got me to walk the next morning which helped , It may have put me aday or so behind keyhole option but all went well, all the best Andy

Edited by member 29 Jul 2015 at 16:48  | Reason: Not specified

User
Posted 29 Jul 2015 at 18:53
Hi Paul,

My husband had a template biopsy in March and had Da Vinci surgery 3 weeks later so not sure why he said that? Maybe it depends on the surgeon, after this keyhole surgery he is making a good recovery. Maybe others here had a template biopsy and also Da Vinci, would be interesting to hear others thoughts?

Trish
User
Posted 29 Jul 2015 at 19:27

I had template biopsy then hand laproscopic surgery. No robots near me although my surgeon helped pioneer it in London. Im actually kind of jealous everyone on here seems to have had robotic surgery . I feel like a pauper . I hope he was on good form that day !!

User
Posted 29 Jul 2015 at 20:05
Paul
some good advice already
do you think your consultant is saying no robotic or keyhole surgery because he can't offer or do that in his hospital? Under the NHS Choices scheme You can choose where to have your treatment so if there is a Da Vinci machine in a nearby health authority you should be able to go there. Your Consultant should be able to refer you. He may have a really good explanation for his statement though, so I would be inclined to ask him to explain his reasons to you and ask him why he feels robotic or keyhole is not a viable option so that you can consider things.

You are right in saying that surgery is rare after RT.

Was Brachytherapy discussed or mentioned as an option.? You have not said what your PSA was at diagnosis, it needs to be quite low for Brachy to be offered I think. Hopefully Sandra (Johsan) or one of the Brachy people will post for you too.
xx
Mo
Edited to delete a sentence repeated in error.

Edited by member 30 Jul 2015 at 06:28  | Reason: Not specified

User
Posted 29 Jul 2015 at 20:10

Thanks Teddy  -  that's encouraging to hear.  Hope your recovery continues to go well.


Paul

User
Posted 29 Jul 2015 at 20:16

Thanks for the reply Chris. At the moment there is no robot surgery available in Scotland although one unit is due to open in Aberdeen fairly soon.


Paul

User
Posted 29 Jul 2015 at 20:34

Hi Mo


My PSA was 8 at diagnosis, having dropped from 10 several weeks earlier. I am due to meet the medical team shortly and I'll certainly be raising some of the issues you mention about NHS Choices and Brachytherapy.


Thanks


Paul

User
Posted 29 Jul 2015 at 20:44

Hi Trish


Interesting to hear that your husband had Da Vinci surgery just 3 weeks after the template biopsy. I will certainly have to enquire as to why my consultant doesn't offer it.


Hope your husband's recovery continues to go well.


Paul

User
Posted 29 Jul 2015 at 20:49

There are those who believe in the long term, open surgery is a better option where the side effects of incontinence and nerve sparing for erections will recover more quickly. Read all available info, and find out what choices you have for treatment indistances you are prepared to travel.


Good luck.


Paul

Stay Calm And Carry On.
User
Posted 29 Jul 2015 at 21:08

Hi Paul,


Interesting what you say about long term side effects - I'll keep that in mind.


I hadn't really intended going outwith my own area but it's something that's worth considering in view of the information I've been receiving on this forum.


Thanks


Paul

User
Posted 30 Jul 2015 at 08:29

Hello Paul and welcome from me too.

Was Brachytherapy one of the RT options mentioned to you?
If you have the toolkit you will see there are two kinds.
High dose (rods inserted and removed over a number of sessions) and
Low dose permanent seed Brachytherapy.


I can't comment on the other forms because I only have personal knowledge of the low dose seed implants.

If you click on my avatar you can read my husband's experience of this one. A year down the line and the PSA is dropping and things are practically back the way they were before, in fact there is improvement in what most men consider to be the main area, but to be fair that is because of the help of sildenafil.

My husband's cancer was against the wall so not in the same position as yours and it may therefore be harder for the consultant to position the seeds where he wants them. You would have to ask about that.

Any questions please ask and I'll be happy to try and answer them.

Best Wishes
Sandra

We can't control the winds - but we can adjust our sails
User
Posted 30 Jul 2015 at 12:36

Whichever form of surgery it opted for the biggest contributor to success is the skill and experience of the surgeon. Although surgery does carry a rather greater risk of incontinence and erectile dysfunction than various forms of radiotherapy, though ED can follow RT in due course. if the cancer is contained surgery usually puts an end of it. In need RT can back up surgery more easily than the other way round. There is also the possibility that even with a radiated prostate, the cancer can regrow (as has happened to me).

Barry
User
Posted 30 Jul 2015 at 17:03

Hi Sandra,


The surgeon didn't specify the type of RT - I'll explore this with him at the next meeting.


The account of John's 'journey' was very comprehensive and informative - it's certainly given me a lot more information about the side effects and possible ways of dealing with them.  Thanks for that.


I hope John's recovery continues to progress well.


Paul

User
Posted 30 Jul 2015 at 22:12
Hi Paul

My hubby had a choice of several treatment routes; surgery, radiotherapy with hormones or hormones / radiotherapy followed by brachytherapy - after much consideration he has opted for the brachytherapy and is due to start his radiotherapy on 1st September.

If you click on my avatar you will be able to see his history, make sure you fully consider all options before you decide.

Wishing you well on your journey

Maureen
"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne
User
Posted 31 Jul 2015 at 17:43

Hi Barry


I take what you say about the importance of the skill of the surgeon.  I wonder if there's a mechanism for evaluating surgeon success rates. I must look into this.


Sorry to hear about your cancer recurring.


Good luck with the treatment of the node.


Paul 

User
Posted 31 Jul 2015 at 18:55
Hi Paul

This link is a bit old but may help

http://www.dailymail.co.uk/health/article-1325743/Who-best-surgeons-treating-prostate-cancer.html

Roy
User
Posted 01 Aug 2015 at 09:23
Thanks for the link Roy. Interesting to see the surgeons who have moved from open surgery to robotic.
It looks like I'll have to go outwith my own region if I want to have robotic or keyhole surgery so this information could be very useful.
Best regards
Paul
User
Posted 01 Aug 2015 at 12:43

Paul,

Don't be embarrassed to ask the hospital or the surgeon's PA about your prospective surgeon's experience and successful outcomes. Some have for example a better record on preserving nerve bundles and erections of patients but such so called nerve sparing is not always possible if all the cancer is to be removed.

Barry
User
Posted 03 Aug 2015 at 20:53

Thanks Barry  - I'll certainly ask about nerve sparing surgery and the surgeon's experience.


Paul


 

 
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