Hello Andy and welcome to the site
What Brachytherapy was it that they mentioned as there are two kinds
Permanent Seed Brachytherapy which sjtb's husband and my husband had or High Dose Brachytherapy which is not permanent.
Brachytherapy by the way is another kind of radiotherapy whether radioactive seeds or a "rod" inserted
My husband's Gleason was also 3+4 which is a "Good" result believe it or not. He also has a small prostate requiring no shrinking with hormones beforehand. The fact that Brachy and surgery have been offered means that there isn't any spread and that the cancer is contained within the prostate
I am assuming that as Active Surveillance wasn't mentioned by you that it wasn't an option but I would enquire about it before you make any decisions.
It could be that it isn't an option for you anyway or it could be that it was offered but is not a treatment you would be happy with. It isn't for everyone. We had it for a year which gave us time to get our heads round the other options. Had John's PSA not started to rise he would have stuck with that.
None of us can advise you, only point out what we did and what it has been like for us but realistically that isn't any help to others in your situation because what happens to us isn't necessarily going to happen to you.
Yes there are side effects of ALL treatments, certainly in the initial stages of recovery, but that doesn't mean they will be permanent.
All you can do is check everything out very carefully, question your consultant regarding his success rate in whatever option you edge towards.
Have you downloaded the "Toolkit" from this site? It might help.
Edited by member 23 Feb 2016 at 12:20
| Reason: Not specified
We can't control the winds - but we can adjust our sails |
User
I think your GP is naive to think that the risk of side effects is reduced by having a smaller gland. It doesn't work like that unfortunately.
It is also a bit too late to consider active surveillance as you are already well into HT. I assume that is why you didn't mention it as an option. I suppose if you were really keen you could ask the consultant about stopping the HT but I bet he isn't keen.
it is extremely unusual to be put straight onto HT when surgery is one of the possible options. Are you in the UK or overseas?
On a like for like comparison, surgery and EBRT have the same outcomes in terms of remission at 5 years and still being alive at 10 years. Brachy seems to be a little better but is still too new to have the long term data.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
Thanks to every one who replied back to my post, its really good to know there are people out there who have experienced what I am going through and are willing to give sound and solid advice.
I did not question why I was put straight on to the HR treatment after a MRI scan but just thought this was the norm has I know two or three guys who were put straight on to the one or three monthly injections. I live in Staffordshire and if I choose Brachy then this will be carried out in Northampton or if choose surgery then it's carried out locally. I went to see a specialist nurse today at our local cancer unit for further advise, so now I just need to sleep on it before I make my decision tomorrow. Just one last note about HT treatment. My GP did say it's the norm to have between three and six monthly injections before any radio therapy or surgery is preformed. Is this just some thing that's carried in Staffordshire or is it done elsewhere?
Keep living the dream and beat this thing once and for all.
Andy
User
Must be a Staffs thing - in our area they wouldn't do surgery on a man that has had hormone treatment. But it has given you 4 or 5 months to think, research and make a decision. Good luck
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
Hi Andy,
Sometimes even post radiation treatment, you are asked to have HT which can vary in time anything upto 3 years. You could ask how your consultant sees this in your case as you seem to be quite severely affected by HT. I believe HT is not usually given after surgery unless it does not do the job and further treatment is required. It might be a good idea to ask whether your cancer is thought to be well contained as if this is the case it improves the chances that the surgery will remove all the cancer.
Barry |
User
I am waiting to see the Consultant on 1st March, to decide on Brachy or High Dose RT. I was put on HT 7weeks ago even though my Prostate size is normal. I didn't query it, but after reading some of the quotes above, I'm wondering if it really is necessary.
User
Hi adidave9. I have said this before, my other half was told that the hormones shrink the prostate before treatment. As his prostate was normal size he was told whichever treatment he took (out of radiotherapy or brachy) he would not need hormones. I did ask why he wouldn't need hormones and was told it was completely unnecessary.
Seems conflicting advice as most men that have had radiotherapy on here have had hormones. Though I don't know many that have had it with brachy because they will only perform brachy if the prostate is normal size. It must be something that depends on the consultant.
User
Originally Posted by: Online Community MemberMust be a Staffs thing - in our area they wouldn't do surgery on a man that has had hormone treatment. But it has given you 4 or 5 months to think, research and make a decision. Good luck
Without wishing to sidetrack this thread too much..... As far as I'm aware in my area they don't prescribe hormone treatment prior to surgery either.
As a non medical person with very limited knowledge.......how would a reliable PSA test be obtained after surgery if someone was on hormones?
I thought that an undetectable PSA was regarded as reliable indicator as to whether surgery was a success or not?
If hormones are in the equation that test will not be reliable surely?...
Just askin' http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-smile.gif
Luther
User
A friend of mine, had surgery but with a rising PSA thereafter he was put on HT as a restraining measure as it helps neutralize stray cancer cells (apart from helping to shrink the prostate). He was then given RT and his PSA has since been undetectable for many years. So I believe HT is likely to be given post surgery only if it seems that surgery has not been a complete success.
Barry |
User
Originally Posted by: Online Community MemberI am waiting to see the Consultant on 1st March, to decide on Brachy or High Dose RT. I was put on HT 7weeks ago even though my Prostate size is normal. I didn't query it, but after reading some of the quotes above, I'm wondering if it really is necessary.
Adidave, I think we have confused you unnecessarily. If you look at all the men on here that have had RT in recent years, I can only think of 2 or 3 that had RT without HT. The two treatments work in tandem, HT isn't only to reduce the size of the gland - it also damages each cancer cell so that the radiotherapy causes a more fatal blow. until quite recently it was standard for men to have HT for 3 months prior to RT starting - these days we are increasingly seeing men taking them for 6 or 9 months before. All the science indicates that the longer the HT the more successful the RT is.
That is a completely different matter to HT before surgery. HT does not contribute anything to making surgery more successful, it can affect the Gleason score once the gland is in a Petrie dish and it takes away the opportunity to get the reassurance of an undetectable PSA score post surgery. So a man that has had HT prior to surgery would need to stop taking it a little while before the op or accept that he won't know for sure that they got it all out. As Luther points out, a rock and a hard place :-(
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
That is interesting to know Lin. About why hormones are needed. I wonder why our consultant said it want necessary then? He said prostate was a normal size so it would not be needed. That was even if he had gone down the EBRT route instead of brachy. I suppose we have to just trust our consultant. They obviously do things differently.
User
Hi Andy,
Referring to your original post, I have had no incontinence issues whatsoever, and I was dry from day one.
However, my MacMillan Nurse said I was lucky as only 4% of RP patients fall into this category, and of course, I know how lucky i am.
I have never done pelvic floor exercises, but I have for the last 8 years swum 2.5kms freestyle every morning. I'm sure that this along with the skill of the surgeon has helped considerably.
I wish you all the very best with your decision.