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Time to treatment

User
Posted 01 Sep 2016 at 09:04
Hello all. I have been diagnosed with prostate cancer. PSA 12.7 Gleason 7 (3 + 4)T2a N0M0. The capsule appears to be intact but bulging. Had an MRI at the beginning of august and a biopsy ten days later. I got the diagnosis on the 25th. The urologist said that he would try and get me an appointment to see a surgeon and an oncologist this week ( I have to be away for work from Saturday for two weeks). However it looks like I won't get to see specialists until the end of the month and treatment won't start until November. My question is given that the capsule was described as bulging should I be concerned or is that wait normal.if I should press for earlier treatment how do I do it. Perhaps bulging is a technical term and if the medics thought a break out was imminent they would act more quickly.
User
Posted 01 Sep 2016 at 21:14

It might be that the Macmillan nurse is allocated to his case by the hospital Bri, and that she does actually have access to his scans and test results. Some hospitals use macmillan to provide the clinical nurse specialist function.

Benjlt, the NHS is supposed to get treatment started within 31 days of deciding which treatment is best after a cancer diagnosis. But the 31 days is put to one side when the delay is because the patient is away or wishes to seek second opinions or an appointment date isn't convenient or whatever.

If you were a T3 it might be a bit more risky but with a T2a diagnosis, a couple of weeks isn't going to make much difference. The T score is only a guess anyway - like Bri, my husband was upgraded. He was diagnosed as T1 with a tumour so small it didn't even show on the scan. Once they operated it became clear that the whole prostate was affected and it had spread to his bladder. He had his op about 4 weeks after diagnosis but it hadn't spread in that 4 weeks. he was just unlucky.

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

User
Posted 02 Sep 2016 at 08:43

With any cancer, the golden rule is to act fast; the faster the better. But you can take some reassurance from the fact that PCa is relatively slow: With lung cancer, two months could easily make a significant difference. With acute leukaemia, that delay would almost certainly be fatal. But with PCa, the risk of a few weeks delay is small.

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User
Posted 01 Sep 2016 at 14:11
Hi Benjit,

Welcome, I don't have an answer for you but I'm bumping you up the list. I'm sure someone will come along soon with an answer for you.

In the meantime you could order the toolkit from the publications section here or speak to one of the specialist nurses.

Arthur

User
Posted 01 Sep 2016 at 14:46
Thanks. I have had a chat with the Macmillan nurse since this post and she has reassured me that they think it extremely unlikely that the cancer is about to break through.
User
Posted 01 Sep 2016 at 16:37

Hi there I don't want to be all doom and gloom but I'm not sure how the MacMillan nurse can say that without having access to your scans and consultants clinical opinion.

The consultant may mean the prostate is enlarged or that the tumour is right up to the edge. It sounds like he means the latter to me as I think he would have said enlarged if describing it as an enlarged prostate. But that is just my opinion.

I was dx T2b and Gleason 3+3 but following my op (approx 2.5 months later) it was regraded to T3a as it had started to break out of the capsule. I don't think anyone should be complacent with Pca. Having said that November is only 2 months away

Bri

User
Posted 01 Sep 2016 at 21:14

It might be that the Macmillan nurse is allocated to his case by the hospital Bri, and that she does actually have access to his scans and test results. Some hospitals use macmillan to provide the clinical nurse specialist function.

Benjlt, the NHS is supposed to get treatment started within 31 days of deciding which treatment is best after a cancer diagnosis. But the 31 days is put to one side when the delay is because the patient is away or wishes to seek second opinions or an appointment date isn't convenient or whatever.

If you were a T3 it might be a bit more risky but with a T2a diagnosis, a couple of weeks isn't going to make much difference. The T score is only a guess anyway - like Bri, my husband was upgraded. He was diagnosed as T1 with a tumour so small it didn't even show on the scan. Once they operated it became clear that the whole prostate was affected and it had spread to his bladder. He had his op about 4 weeks after diagnosis but it hadn't spread in that 4 weeks. he was just unlucky.

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

User
Posted 01 Sep 2016 at 21:23

Had the same though Bri expressed in his first sentence. If it was me, I would contact the secretary of my consultant asking for his/her views on urgency of treatment. With surgery there is usually a few weeks before the operation but with RT, as soon as this option is chosen, hormone tablets and or injections can be started immediately where appropriate. HT helps reduce the size of tumours and restrains the cancer thereby making RT more effective. However, it is unlikely that this would be the most important consideration in deciding which treatment to opt for. Research and discussions with your urologist and oncologist about treatment possibilities in your situation can help here as there are pros and cons to all treatments with differing risks and type of side effects.

Barry
User
Posted 02 Sep 2016 at 08:43

With any cancer, the golden rule is to act fast; the faster the better. But you can take some reassurance from the fact that PCa is relatively slow: With lung cancer, two months could easily make a significant difference. With acute leukaemia, that delay would almost certainly be fatal. But with PCa, the risk of a few weeks delay is small.

 
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