Hi longshoreman,
http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/the-stages-of-prostate-cancer goes more information on tumour staging, do you have any further information on your staging, how was your Gleason score arrived at?
Have you had any scans?
Many men have been where you are now and had to make the decision that you are contemplating. Sadly there still appears to be no single treatment option that stands out above all others to treat PCa, otherwise life would be so much easier.
I am not going to try to persuade you to do or not do anything. In my view no one should, as it is you that will have to bear the consequences of your decision moving on, hopefully for many years to come.
Among the factors you may wish to consider may include, what is the life expectancy in your family? If your family longevity is to mid 60s, or 70s then watching and waiting may be suitable for you as you would be anticipated to die with PCa and not from it.
However if your family longevity indicates living to your 90s, then you may wish to ensure that PCa does not have the chance to hinder that?
Any choice of treatment has the potential for side effects, the most important one of which is LIFE itself. I suppose that watching and waiting has an increased potential for the side effect of the PCa advancing, on the premise that if you have it and do nothing to arrest it's progress it will advance, and that may in turn rule out some options later, or it may not.
Only you can make your treatment decision and everyone else's experiences can only guide you to your choice. There will be people here who have made their choice and subsequently regretted it. Others with similar staging who have made the same choice and are happily getting on with life with little or no consequences. Others still, with some post treatment consequences, needing further treatment or with reduced or zero urinary control or different or reduced or zero EF? The point is that no one else's staging, treatment choice and recovery is guaranteed to be the same for you.
As well as your body you are treating your head and how your mind will cope with PCa in you. Some people cope with the thought of contained treatment better than others, others want it out asap.
Read all about the treatment choices that you have been offered, and others that have not been offered but may be available to you at your staging, in case you might prefer another option, and then make your informed choice.
I have no regrets about my choice, and would do the same again despite the problems I have had.
atb
dave
Edited by member 17 Aug 2015 at 08:39
| Reason: Not specified
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
Originally Posted by: Online Community MemberI think I am reaching that town called "Acceptance".
However the following day I attended an induction session with 10 or so others and daily reality of incontinence and ED are very sobering.
Hello Longshoreman,
Maybe your train has not yet arrived at Acceptance?
In the "induction" did they not mention the two most important other potential side effects of an operation?
First, death on the table, I was told that although this is rare, it is a possibility, when I met the anaesthetist.
Secondly, the other significant side effect of successful operation is life, well worth mentioning.
The issues of incontinence, both urinary and faecal, did they mention faecal loss of control as a possibility, are also not guaranteed, only potential.
Permanent ED loss is also not guaranteed, only potential.
This decision is the hardest part of the process in my view, looking back it was for me. No one could or would say "THIS IS BEST". Glad that they did not.
Do your research thoroughly. Look at what others are dealing with who have had both surgical and non-surgical treatments, and then you just have to go for it. But you can change your mind up to the point you go under if surgery is your choice?
atb
dave
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
Hi,
I am 59. I plumped for a RP that I had in March. Please check out my profile to see my story so far. I would imagine everyone faced with the stark reality of having cancer cells invading their prostate will have had the same internal debates about the best way forward. Having seen my father die at aged 82 when his prostate cancer spread to his bones and lungs I had an eye witness view and made a decision that if I could in some way lessen my chances of going the same was I would take it. Four months on and I'm still here to tell the tale. Yes I wear a precautionary pad for any stress leaks and my old friend down below is at perminent rest but I'm alive and up to now my PSA is undetectable. Good luck with any decision you make. If you have't done already download the toolkit. Regards,
Paul
THE CHILD HAS GROWN, THE DREAM HAS GONE |
User
Hello Longshoreman and belated welcome from me if I haven't already said it before.
What kind of Brachytherapy. High dose or low dose.
High Dose - rods are inserted and removed for several sessions
Low Dose - radioactive seeds are implanted and remain there permanently, even after their efficacy has gone (by which time they should have done their job.
My husband was one of several on here who opted for low dose seed brachytherapy (click on the icon to read his story)
He was also on active surveillance for a year before that and he was 73, so there you are, you're a young(ish) man!!
Did they say active surveillance or watchful waiting as they are different.
As Paul has said already, have you obtained The Toolkit from this site. It gives details of all treatments and possible after effects.
Good luck with your choice.
Best wishes
Sandra
Edited by member 16 Aug 2015 at 14:28
| Reason: Not specified
We can't control the winds - but we can adjust our sails |
User
Morning Longshoreman...and welcome
I'm in a similar position, in that I'm reviewing the treatment option (see the oncologist next Monday)....it's a difficult decision to make as I know I'll be second guessing myself at every turn, all I can hope for is reaching that town called "Acceptance"...
Duncan
User
Hi
My PSA was over 16 when diagnosed. I haven't all the facts about your diagnosis ...... but if your cancer is Gleason 3+3 = 6 and shows no sign of spreading I would not rush in making your decision on treatment. I think too many folk rush as they just want to get rid of it (that comment will probably get me into trouble!).
If Gleason 6 and showing no sign of spreading consider Active Surveillance - I would. However I was Gleason 3+ 4 with no sign of spreading ..... and they wanted to remove my prostate. I wasn't keen, took 6 months to consider and eventually choose brachytherapy.
I have no regrets.
However - as I say I don't have all the info on your diagnosis .... and at the end of the day, the treatment most suited to you is the treatment you feel comfortable with. Once you make your choice ...... never regret it, it was what you decided at a certain time I your life and in the future you can't look back and forget how you feel at this very moment in time.
Take good care of you and stay in control of your future.
dl
User
Hi Longshoreman
Like you I was a Gleason 7 3+4, 60 yrs old and once diagnosed read as much as I could about the various options. I decided that I was going to be offered Radiotherapy and sort of planned how I would cope with the daily visits etc. Then after the MDT meeting it was explained to me, that like you, as a young man, (yeah right!) I would be better off having a RPP as should the cancer return, which is a possibility, I could still be treated by Radiotherapy. It was explained to me that after Radiotherapy, my Prostate would resemble a shrivelled prune which would make surgical removal far more difficult if even possible. That swayed me to go for RPP (so far hugely successful) which still gives me the option that if it did return, another bite of the cherry was possible via Radiotherapy for a cure, not for dealing with it for ever more. Its only my two pennys worth.
The following article explains far better than me!
http://www.theprostatecentre.com/prostate-information/treatment-for-prostate-cancer-that-has-not-spread/the-long-term-picture/
Post Op Hugely Optimistic Dick
User
Dick.B
Many thanks for the link, it makes interesting reading....I've read the toolkit back to front and upside down (makes more sense that way), but it's really interesting to hear from fellow suffers as to their feelings, fears and approaches...as has been said on many occasions, everyone of us is different and reacts differently to a particular piece of news or given option and what is right for you many not be right for me or anyone else....for me, the biggest 3 positive attributes from forums such as this are 1) no one criticises you for taking a particular path 2) the amount of information sharing is phenomenal 3) no question is a stupid question even though it may have been asked a hundred times before....
Duncan
User
Hi Longshoreman
As usual all the previous advice given to you on here is good. Only you can make the decision as to treatment path and it is very difficult. I was diagnosed last year, 3+4, PSA 5.4, and was given 4 options, Active Surveillance, RT, Removal of the offending prostate or Low Dose Brachytherapy. I dismissed RT because of the logistics of getting to the hospital, I dismissed surveillance because I did not think I could cope with that. After meeting with the surgeon I came away convinced that removal was the way to go, he to was a "very nice " man and was very confident in his work and the result he could offer me. Having said that, being a surgeon, he would say that as it is the nature of their profession to be 150% confident. I even pencilled in a date for the procedure. I then met with the doctor who would carry out the Brachytherapy and my confusion intensified. It took me a further 3 months to finally decide and I chose Brachytherapy. Whether it was the correct decision I will never know for certain. If eventually I am cancer free then I did. If the cancer returns at some stage I will doubt my choice, however who is to say that it would not have returned if I had opted for one of the other treatments. In hindsight I wish now I had discussed Active Surveillance a little more and maybe had another 12 months or so, hopefully, of normality. I did struggle a little with the side effects of the treatment but that is because I was unlucky enough to be in the small percentage that suffered with radiation cystitis. I am now 8 months since my treatment and back to more or less normal, albeit with a few very small adjustments to my lifestyle. The main thing for me is I have had no incontinence issues, and no ED problems at all so far.
Get all the facts, write things down that you want to ask, write their answers down at your consultation. I would advise discussing all your options with the appropriate doctors/ surgeon. as only then will you be able to make an informed choice.
Good luck with whatever you decide.
Alan
User
Had my RP at 61 16 months ago. No regrets. You can search my threads on ED and waterworks, which may help you.
Paul
Stay Calm And Carry On. |
User
Hi there
My husband was in a similar position to you, if you click my profile you will see his journey so far but he chose Brachytherapy as it fitted his personal situation and lifestyle better than the other options given.
Good luck with your journey
Maureen
"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne |
User
But it is the first time that YOU have asked it. That is all that matters to those of us who have been here awhile.
There is a member here, who's view I totally respect without reservation, who might challenge the thought/notion/idea that RRP is a first bite and subsequent treatment is a second bite at that cherry?
But that was my opinion at my 'significant' or "pivotal" time.
dave
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
One of the problems in coming to a decision is that none of the diagnostic tools is 100% accurate. When removed Prostates are sliced up in the lab, where the Gleason differs from original diagnosis it far more often results in an increased grading than a lower one. The cancer can also be more extensive than originally thought. It follows that a small number of men who are on AS are more advanced than they are led to believe. Of course early radical intervention may be unnecessary or premature but this has to be weighed against not treating whilst there is the best opportunity of a cure. For those who decide to opt for AS, it is important to be very closely monitored so treatment can be given in a timely way. This is more important than the type of treatment. All treatments have pros and cons and men can come to different decisions on what is best for them as individuals.
Barry |
User
Longshorerman....
No one can give you a cast iron guarantee....if only, everyone's condition is different and the surgeons really wont know what there up against until they get you in to theatre up close and personal and take a look inside,
I know from personal experience, mine was worse than expected but no regrets getting it done, Im well on the road to recovery and doing well, it takes time, for some lucky people its a quick recovery...there's always risks in medicine as there are with watch and wait,
I'd like to throw this into the mix, I guess youre fit and healthy at present, if so this may be an ideal time to get sorted in whatever direction you take, I had to take a fitness for surgery test before they would perform on me...and I considered myself a fit person at the time, Id hate to find myself in a position where I failed that and wanted surgery or other treatment
Good luck
User
Hello, I just thought I would say we were in a similar situation to you this time last year, OH was diagnosed with no symptoms, psa 3.7 (rose to 4.9 from diagnosis in June to Dec) Gleason 3+3 he was 57. Surgery wasn't really offered, the consultant was pushing him down the surveillance route. Or offering brachytherapy and radio therapy. Surgery would have been hard as he is a farmer and can't take time off, but they didn't say much about surgery. Anyway, by the Dec. we chose brachytherapy. Both of us found the worrying too much so wanted it treated. We were never told that if it returned the treatment is more difficult as the radiation has already been given. So I can see why removal is often chosen.
After a very hard 6 months of quite bad side effects from brachytherapy, now 8 months on and still some side effects are there. Also I wouldn't say he has ED but the old chap is just slightly deflated compared to before.
Due to all the above I know he wishes he'd stayed on surveillance. But we will never know how long he would have gone before treatment was needed. The consultant said he would need treatment at some stage but said it could be a year or could be many, many more. We will never know. We don't know if the brachytherapy has been successful yet. The psa had gone down a little just after. He had a psa done 3 months ago but we were not given the results. We go back in September.
Wishing you all the best.
Show Most Thanked Posts
User
Hi,
I am 59. I plumped for a RP that I had in March. Please check out my profile to see my story so far. I would imagine everyone faced with the stark reality of having cancer cells invading their prostate will have had the same internal debates about the best way forward. Having seen my father die at aged 82 when his prostate cancer spread to his bones and lungs I had an eye witness view and made a decision that if I could in some way lessen my chances of going the same was I would take it. Four months on and I'm still here to tell the tale. Yes I wear a precautionary pad for any stress leaks and my old friend down below is at perminent rest but I'm alive and up to now my PSA is undetectable. Good luck with any decision you make. If you have't done already download the toolkit. Regards,
Paul
THE CHILD HAS GROWN, THE DREAM HAS GONE |
User
Hello Longshoreman and belated welcome from me if I haven't already said it before.
What kind of Brachytherapy. High dose or low dose.
High Dose - rods are inserted and removed for several sessions
Low Dose - radioactive seeds are implanted and remain there permanently, even after their efficacy has gone (by which time they should have done their job.
My husband was one of several on here who opted for low dose seed brachytherapy (click on the icon to read his story)
He was also on active surveillance for a year before that and he was 73, so there you are, you're a young(ish) man!!
Did they say active surveillance or watchful waiting as they are different.
As Paul has said already, have you obtained The Toolkit from this site. It gives details of all treatments and possible after effects.
Good luck with your choice.
Best wishes
Sandra
Edited by member 16 Aug 2015 at 14:28
| Reason: Not specified
We can't control the winds - but we can adjust our sails |
User
Hi longshoreman,
http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/the-stages-of-prostate-cancer goes more information on tumour staging, do you have any further information on your staging, how was your Gleason score arrived at?
Have you had any scans?
Many men have been where you are now and had to make the decision that you are contemplating. Sadly there still appears to be no single treatment option that stands out above all others to treat PCa, otherwise life would be so much easier.
I am not going to try to persuade you to do or not do anything. In my view no one should, as it is you that will have to bear the consequences of your decision moving on, hopefully for many years to come.
Among the factors you may wish to consider may include, what is the life expectancy in your family? If your family longevity is to mid 60s, or 70s then watching and waiting may be suitable for you as you would be anticipated to die with PCa and not from it.
However if your family longevity indicates living to your 90s, then you may wish to ensure that PCa does not have the chance to hinder that?
Any choice of treatment has the potential for side effects, the most important one of which is LIFE itself. I suppose that watching and waiting has an increased potential for the side effect of the PCa advancing, on the premise that if you have it and do nothing to arrest it's progress it will advance, and that may in turn rule out some options later, or it may not.
Only you can make your treatment decision and everyone else's experiences can only guide you to your choice. There will be people here who have made their choice and subsequently regretted it. Others with similar staging who have made the same choice and are happily getting on with life with little or no consequences. Others still, with some post treatment consequences, needing further treatment or with reduced or zero urinary control or different or reduced or zero EF? The point is that no one else's staging, treatment choice and recovery is guaranteed to be the same for you.
As well as your body you are treating your head and how your mind will cope with PCa in you. Some people cope with the thought of contained treatment better than others, others want it out asap.
Read all about the treatment choices that you have been offered, and others that have not been offered but may be available to you at your staging, in case you might prefer another option, and then make your informed choice.
I have no regrets about my choice, and would do the same again despite the problems I have had.
atb
dave
Edited by member 17 Aug 2015 at 08:39
| Reason: Not specified
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
Morning Longshoreman...and welcome
I'm in a similar position, in that I'm reviewing the treatment option (see the oncologist next Monday)....it's a difficult decision to make as I know I'll be second guessing myself at every turn, all I can hope for is reaching that town called "Acceptance"...
Duncan
User
Thank you all for your thoughtful and eloquent responses. I feel a little clearer today, but that may just be a temporary blip!
I'm beginning to realise that most of the decisions I have ever taken in my life have been almost entirely intuitive and not rational. eg I once hired a plumber based on the fact that he listened to Radio 4 ( didn't do a great job, but was terribly nice ).
I now find myself being influenced by which healthcare professional has the nicest voice... and forget about the scientific evidence.
I'm meeting my potential surgeon tomorrow am.
(He has a wonderful voice ).
I'll let you know how it goes.
Longshoreman
User
Hi
My PSA was over 16 when diagnosed. I haven't all the facts about your diagnosis ...... but if your cancer is Gleason 3+3 = 6 and shows no sign of spreading I would not rush in making your decision on treatment. I think too many folk rush as they just want to get rid of it (that comment will probably get me into trouble!).
If Gleason 6 and showing no sign of spreading consider Active Surveillance - I would. However I was Gleason 3+ 4 with no sign of spreading ..... and they wanted to remove my prostate. I wasn't keen, took 6 months to consider and eventually choose brachytherapy.
I have no regrets.
However - as I say I don't have all the info on your diagnosis .... and at the end of the day, the treatment most suited to you is the treatment you feel comfortable with. Once you make your choice ...... never regret it, it was what you decided at a certain time I your life and in the future you can't look back and forget how you feel at this very moment in time.
Take good care of you and stay in control of your future.
dl
User
Hi Longshoreman
Like you I was a Gleason 7 3+4, 60 yrs old and once diagnosed read as much as I could about the various options. I decided that I was going to be offered Radiotherapy and sort of planned how I would cope with the daily visits etc. Then after the MDT meeting it was explained to me, that like you, as a young man, (yeah right!) I would be better off having a RPP as should the cancer return, which is a possibility, I could still be treated by Radiotherapy. It was explained to me that after Radiotherapy, my Prostate would resemble a shrivelled prune which would make surgical removal far more difficult if even possible. That swayed me to go for RPP (so far hugely successful) which still gives me the option that if it did return, another bite of the cherry was possible via Radiotherapy for a cure, not for dealing with it for ever more. Its only my two pennys worth.
The following article explains far better than me!
http://www.theprostatecentre.com/prostate-information/treatment-for-prostate-cancer-that-has-not-spread/the-long-term-picture/
Post Op Hugely Optimistic Dick
User
Dick.B
Many thanks for the link, it makes interesting reading....I've read the toolkit back to front and upside down (makes more sense that way), but it's really interesting to hear from fellow suffers as to their feelings, fears and approaches...as has been said on many occasions, everyone of us is different and reacts differently to a particular piece of news or given option and what is right for you many not be right for me or anyone else....for me, the biggest 3 positive attributes from forums such as this are 1) no one criticises you for taking a particular path 2) the amount of information sharing is phenomenal 3) no question is a stupid question even though it may have been asked a hundred times before....
Duncan
User
Hi Longshoreman
As usual all the previous advice given to you on here is good. Only you can make the decision as to treatment path and it is very difficult. I was diagnosed last year, 3+4, PSA 5.4, and was given 4 options, Active Surveillance, RT, Removal of the offending prostate or Low Dose Brachytherapy. I dismissed RT because of the logistics of getting to the hospital, I dismissed surveillance because I did not think I could cope with that. After meeting with the surgeon I came away convinced that removal was the way to go, he to was a "very nice " man and was very confident in his work and the result he could offer me. Having said that, being a surgeon, he would say that as it is the nature of their profession to be 150% confident. I even pencilled in a date for the procedure. I then met with the doctor who would carry out the Brachytherapy and my confusion intensified. It took me a further 3 months to finally decide and I chose Brachytherapy. Whether it was the correct decision I will never know for certain. If eventually I am cancer free then I did. If the cancer returns at some stage I will doubt my choice, however who is to say that it would not have returned if I had opted for one of the other treatments. In hindsight I wish now I had discussed Active Surveillance a little more and maybe had another 12 months or so, hopefully, of normality. I did struggle a little with the side effects of the treatment but that is because I was unlucky enough to be in the small percentage that suffered with radiation cystitis. I am now 8 months since my treatment and back to more or less normal, albeit with a few very small adjustments to my lifestyle. The main thing for me is I have had no incontinence issues, and no ED problems at all so far.
Get all the facts, write things down that you want to ask, write their answers down at your consultation. I would advise discussing all your options with the appropriate doctors/ surgeon. as only then will you be able to make an informed choice.
Good luck with whatever you decide.
Alan
User
Had my RP at 61 16 months ago. No regrets. You can search my threads on ED and waterworks, which may help you.
Paul
Stay Calm And Carry On. |
User
Hi there
My husband was in a similar position to you, if you click my profile you will see his journey so far but he chose Brachytherapy as it fitted his personal situation and lifestyle better than the other options given.
Good luck with your journey
Maureen
"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne |
User
But it is the first time that YOU have asked it. That is all that matters to those of us who have been here awhile.
There is a member here, who's view I totally respect without reservation, who might challenge the thought/notion/idea that RRP is a first bite and subsequent treatment is a second bite at that cherry?
But that was my opinion at my 'significant' or "pivotal" time.
dave
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
One of the problems in coming to a decision is that none of the diagnostic tools is 100% accurate. When removed Prostates are sliced up in the lab, where the Gleason differs from original diagnosis it far more often results in an increased grading than a lower one. The cancer can also be more extensive than originally thought. It follows that a small number of men who are on AS are more advanced than they are led to believe. Of course early radical intervention may be unnecessary or premature but this has to be weighed against not treating whilst there is the best opportunity of a cure. For those who decide to opt for AS, it is important to be very closely monitored so treatment can be given in a timely way. This is more important than the type of treatment. All treatments have pros and cons and men can come to different decisions on what is best for them as individuals.
Barry |
User
So,I met the surgeon. He was very pleasant and open to questions.
I go away feeling reassured.
I begin to reconcile that having an operation that will make me feel a lot worse is actually a better option than waiting for symptoms to appear.
RP scheduled for late October. In the words of Duncan- I think I am reaching that town called "Acceptance".
However the following day I attended an induction session with 10 or so others and daily reality of incontinence and ED are very sobering.
Brachytherapy looking more attractive. However is it better to go through a rough 6-12 months ( and wave goodbye to the guy downstairs ) than have a possible reoccurrence?
Here are my numbers:
PSA 5.4 ( now down to 4 )
Prostate volume 39cc on MRI
Gleason 3+4 = 7/12 cores, up to 50%, 5mm. Right hand side
Subsequent biopsy Right hand side positive, Gleason 3+3 in left side.
I find this a little strange i.e. no cancer detected in r/h side on recent biopsy. Anyone had similar inconsistencies?
Anyway, love to you all.
Keep on keeping on!
Longshoreman
x
User
Originally Posted by: Online Community MemberI think I am reaching that town called "Acceptance".
However the following day I attended an induction session with 10 or so others and daily reality of incontinence and ED are very sobering.
Hello Longshoreman,
Maybe your train has not yet arrived at Acceptance?
In the "induction" did they not mention the two most important other potential side effects of an operation?
First, death on the table, I was told that although this is rare, it is a possibility, when I met the anaesthetist.
Secondly, the other significant side effect of successful operation is life, well worth mentioning.
The issues of incontinence, both urinary and faecal, did they mention faecal loss of control as a possibility, are also not guaranteed, only potential.
Permanent ED loss is also not guaranteed, only potential.
This decision is the hardest part of the process in my view, looking back it was for me. No one could or would say "THIS IS BEST". Glad that they did not.
Do your research thoroughly. Look at what others are dealing with who have had both surgical and non-surgical treatments, and then you just have to go for it. But you can change your mind up to the point you go under if surgery is your choice?
atb
dave
All we can do - is do all that we can. So, do all you can to help yourself, then make the best of your time. :-) I am the statistic. |
User
Longshorerman....
No one can give you a cast iron guarantee....if only, everyone's condition is different and the surgeons really wont know what there up against until they get you in to theatre up close and personal and take a look inside,
I know from personal experience, mine was worse than expected but no regrets getting it done, Im well on the road to recovery and doing well, it takes time, for some lucky people its a quick recovery...there's always risks in medicine as there are with watch and wait,
I'd like to throw this into the mix, I guess youre fit and healthy at present, if so this may be an ideal time to get sorted in whatever direction you take, I had to take a fitness for surgery test before they would perform on me...and I considered myself a fit person at the time, Id hate to find myself in a position where I failed that and wanted surgery or other treatment
Good luck
User
Hello, I just thought I would say we were in a similar situation to you this time last year, OH was diagnosed with no symptoms, psa 3.7 (rose to 4.9 from diagnosis in June to Dec) Gleason 3+3 he was 57. Surgery wasn't really offered, the consultant was pushing him down the surveillance route. Or offering brachytherapy and radio therapy. Surgery would have been hard as he is a farmer and can't take time off, but they didn't say much about surgery. Anyway, by the Dec. we chose brachytherapy. Both of us found the worrying too much so wanted it treated. We were never told that if it returned the treatment is more difficult as the radiation has already been given. So I can see why removal is often chosen.
After a very hard 6 months of quite bad side effects from brachytherapy, now 8 months on and still some side effects are there. Also I wouldn't say he has ED but the old chap is just slightly deflated compared to before.
Due to all the above I know he wishes he'd stayed on surveillance. But we will never know how long he would have gone before treatment was needed. The consultant said he would need treatment at some stage but said it could be a year or could be many, many more. We will never know. We don't know if the brachytherapy has been successful yet. The psa had gone down a little just after. He had a psa done 3 months ago but we were not given the results. We go back in September.
Wishing you all the best.