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Dazed and Confused

User
Posted 27 Dec 2016 at 23:30

My path to here started with an ear infection wierd i know but read on.
While at the doctors he said since you not been for any problems for quite a
long time can we do a MOT while i was there.
No problem say's i
Stethescope out listen's to my chest ....OK
Blood pressure next.... fine
Can we get some bloods nothing urgent just make an appointment with the
practice nurse or nip into the Linacre Centre (NHS walk in for bloods)anytime
OK i says
Blood taken by the vampire same day
Off i trot back to everyday life
7 days later phone call can i go see practice nurse appointment made for the
day after at 3pm
Arrived at 2.59 called in at 3.01 thought wow this is my lucky day.
Very nice nurse (heads out of the gutter boys she is a nice person).
Blood tests have come back and we are a little concerned about your
colesterol levels
so i need to cut down eating chocolate .
ok i will try
Also have i ever had a kidney stone
NO why?
Your kidney levels are a little high but nothing to worry about just drink more
water during the day.
i chortled and said The bathroom is my second home already
at this her ears pricked up oh what do you mean
Its just that i seem to be going alot more frequently now that i am getting
older
Well we can book you in for a Prostate exam and i'll do a blood test on your
PSA.
Nice nurse turned into a Vampire
Appointment made for 7days time
ok off i trot yet again back to everyday life

5 days later phone rang
hello this is you doctors receptionist,your blood results have come back and
he/she wants to see you
OK not a problem i am booked in to have an examination anyway(finger up the
bum,i am not naive)
ok thats fine see you in 2 days

Arrives for 9.10 appointment at 9.05 get called in at 9.10 i thought Wow
things are definatly improving.
NO
Doctor hadn't got a clue as to why i was there
so i had to explain somehow the conversation that i had had with the nurse
re psa blood tests and examination
ok drop your pants get on the bed think of England and she had to call
another female in as a chaperone i wasn't embarrassed but thought it was
unnessessary but hey ho
OK PAUSE
now everything above is a little flipant and jovial and some can probably relate
to it BUT stuff is about to get real
PAUSE OFF
ok you can get dressed now
right your prostate feels a little hard but i am not sure about it
looking at the screen of her computer she says your PSA test is also at
(whoosh i wasn't listening)
i will refer you to see a specialist at the hospital

7 days later i am again pants down face wall with another finger up my bum
Doctor says its hard and PSA level being what it is he wants to do scan and a
biopsy. As I tried to digest this information he said Right we will also do a
flow test so go and drink plenty of water and i will do it in about a hour
Fast i thought what's the hurry?
anyway flow test done
Biopsy done
couple of days off work see you next week for the results

23/12/2016
2 days before christmas
sat in a room with an assigned nurse
Bad news i'm afraid you have got prostate cancer
(whoosh,whoosh,whoosh,whoosh,whoosh,whoosh)
whoa
gleason 3+4=7 at 15% only left side clear on the right biopsies
psa still whoosh
blah,blah,blah MDT blah,call you later tell you what they say,blah,blah
book to read

true to his word called me on time to tell me that they would see me at
Salford Royal on the 12/01/2017

I have probably missed out loads of things that where said but i can only post
Whoosh so many times

I know that i have to go to see consultants at Salford Royal
but i dont know what is expected of me at that time
how soon will if given opions will i have to make a decision?

Hope some of you got this far and Thanks for reading

Ian

 

 

User
Posted 30 Dec 2016 at 01:35

Hi Ian, its also important to take into account any other health conditions you may have and the effects that treatment choice have on your overall health, I'm virtually the same as yourself but as I'm the type person who can cope with an additional sword of Damocles I am happy with AS.

Good luck with your choice and my best regards

Frank-n-furter

life's a b****- then you die!!!!!
User
Posted 01 Jan 2017 at 17:41

Shj54, it might be better for you to ask your question in your own right.

Nobody minds you asking questions on another person's post but it would be easy for yours to be missed and then not answered.

I can't help you I'm afraid except to say that of my knowledge gained on here, no it isn't a definite that incontinence would be permanent following RP.

I hope somebody will answer you but if not, try again but for yourself as a separate post.

Good luck though

We can't control the winds - but we can adjust our sails
User
Posted 02 Jan 2017 at 02:03

I would have thought that the most important consideration of the majority of men is to have the treatment that will provide the best chance of cure or seriously set back the cancer as the primary objective. The analysis on this link compares the results of the main treatments but does not show surgery with subsequent RT unfortunately. It should be noted that whether low risk, intermediate or high risk graphs are considered, there is quite a wide spread for each treatment. You can click on your staging and show one treatment at a time or add in treatments until all are displayed. Where an individual might slot in could vary for a number of reasons, some of them unpredictable but the graph gives a general idea and serves as a comparison for the studied treatments. http://www.pctrf.org/comparing-treatments/

Side effects, perhaps most importantly incontinence , as this can be a big and in some cases a long lasting problem, followed by erectile dysfunction are likely to the main secondary if important considerations. Again various men will experience different degrees of side effects and research will show the general likelihood for each treatment but not where an individual will be positioned on the scale (if someone produced a similar one for side effects of treatment similar to the success of treatments as above.)

Barry
Show Most Thanked Posts
User
Posted 28 Dec 2016 at 07:38

Well Ian it sounds a familiar tale. Not sure if that's reassuring or not but it's meant to be. You mention a scan. Was this an MRI or bone scan. You will have been injected with radio active 'dye' for the bone scan.

It may help you to download the toolkit from the PCUK site under publications. This contains loads of information that will help you put questions together for the consultant. There will probably be various treatments available to you but you need to research them as ultimately you will probably need to decide which treatment option to take.

It sounds like the nurse you saw was very on the ball and hopefully due to her actions they have caught it early. Believe you me there are a lot of medics out there who wouldn't have made the connection between going to the loo more often and Prostate cancer.

Try not to worry to much over the coming days it does get easier. At your appointment you should get a proper diagnosis. Ask what the staging is eg T2a etc. Take someone with you otherwise there maybe a few more whooshes as you may not take it all in. Ask whoever goes with you to makes notes as this will help you later when considering your options.

Hopefully you will be in the cure camp. But if not there is still hope. There are many men on here who were not cureable but are still hear and enjoying life many years after diagnosis

Please feel free to read my profile ie click on my avatar.

All the best
Bri

User
Posted 28 Dec 2016 at 08:58
Hi Ian

Sorry to read your story but as Brian mentioned, it's a familiar story. Count yourself lucky that the nurse picked up on your urinary issues and took it further the earlier the diagnosis the more options available.. You have some time before your appointment, and it's the waiting that really gets to many at this stage. Take the time to read the conversations on this site to understand that other men are going though exactly what you are right now. Make sure you become familiar with the terminology and understand the options available, and start to draw up a list of questions for your appointment.

Lastly don't hesitate to ask questions here - this is a wonderfully supportive community.

Good luck

Chris

User
Posted 28 Dec 2016 at 09:11

Good morning Ian and welcome

3+4 = 7 isn't the lowest it could be but it's nowhere near the highest either and take heart from the fact that it starts with the 3 and not the 4 as that's a little better, even though the end result is still =7.

Strange I know, but we are looking for positives here. The other great positive as Brian says, is the fact that your GP was so on the ball. That isn't always the case. Whatever happens now may well have been a much more serious situation further down the line and options which may be open to you now may not be then.

Get the toolkit from the site. It does help when you are writing down your questions for the consultant. Firstly though I would ring your surgery and ask what you PSA was at their last test. The receptionist will give this to you. Don't be fobbed of with anything other than the actual number and then post it on here. It might help with advice, although PSA really is only an indication that something needs looking at and that's been done. You could also ask if you can record the meeting at hospital on your phone.

There are nurses on here who will answer questions for you if you don't understand what has been said.

Hopefully, many of the treatment paths will be available to you. You will be unlikely to get help from medical staff with decision making as that is often left to the patient.

PC comes in many forms and can be either a pussy cat or a tiger. If you have the pussy cat version then you'll have time to make a treatment choice. IF it's the tiger version then you may have to make a decision much sooner.

Whatever one it is, as Brian says there is much hope as treatments are not only coming through all the time but they are now also tweaking old treatments with some success.

You will be well supported here so ask anything you like, somebody will know or advise you.

My only advice at present is to take one day at a time, don't look on the gloomy side and don't rush into a treatment decision if you don't have to.

Best Wishes

Sandra

 

Edited by member 28 Dec 2016 at 09:12  | Reason: Not specified

We can't control the winds - but we can adjust our sails
User
Posted 28 Dec 2016 at 13:45

Thankyou for your replies and advice.

just been to find out PSA from GP

4.5 i know its not the highest as i have read a few posts and profiles and i know i should chillax as they say but as everyone here knows its not that easy when it is virtually all i have thought about since the 23rd.

re the scan no it wasn't either MRI or bone scan just whatever they did when going in for biopsies

 

re scan it was the TRUS 

 

Edited by member 28 Dec 2016 at 13:59  | Reason: Not specified

User
Posted 28 Dec 2016 at 14:40
Hi there,

My husband got his PCa diagnosis on 22nd December.

Different as my husband is a 6 (3+3) and on both sides compared to your 7 (3+4) on one side.

We have been given all options re treatment and are currently thinking active surveillance but investigating the TOOKAD treatment that was all over the press last week.

They have said that TOOKAd could be considered for a 3+4 Gleason score - one side is optimal ( my husband has bilateral 3+3 so not optimal as on both sides)

It is not NICE approved yet due to equipment problems in NHS but clinical trials at stage iIII were very positive ( critique on NHS choices worth a read)

May be worth having an awareness of as I would hate someone to make a radical life changing treatment decision and then find this out afterwards.

Regards

Clare

'Time spent on reconnaissance is never wasted'

User
Posted 28 Dec 2016 at 19:22
Hi Ian

Good news that your PSA isn't too high - the consultant I'm seeing doesn't like to operate (RP) on those with a PSA >10, so hopefully you will have all options available to you.

Regarding making a decision, you should take as much time as you need - speaking to both the urologist, oncologist - and then reach a decision which is right for you and your family. The important thing is that you shouldn't feel that you have to make a decision at your next appointment.

The new treatment mentioned by Clare is very promising but we have no way of knowing if and when it will be available here - timing and postcode lottery become a real issue!

Chris

User
Posted 28 Dec 2016 at 19:56

Hi Chris thanks for your time

thanks also to Clare for the info

ATM i am leaning more towards RT/HT

rather than any of the other options but could be swayed by MDT

Active surveilance doesn't appeal to me because it would feel like i am waiting for an assassin to take aim and hoping i dont get run over by a bus

Prostatectomy seems to have a longer getting back to normal timespan

RT/HT seems less disruptive to life outside of the circle

i have downloaded the Toolkit and will read,reread and read again 

hopefully i can switch off and have a little peace until the Twelth

 

Ian

 

User
Posted 28 Dec 2016 at 21:42
Originally Posted by: Online Community Member

ATM i am leaning more towards RT/HT

rather than any of the other options but could be swayed by MDT

Active surveilance doesn't appeal to me because it would feel like i am waiting for an assassin to take aim and hoping i dont get run over by a bus

Prostatectomy seems to have a longer getting back to normal timespan

RT/HT seems less disruptive to life outside of the circle

Ian as others have said once you know your options consider what is right for you. Life on HT won't necessarily be straight forward. I would suggest you research the side effects of all treatments. If you are the type of person who can't wait for the result i.e. as in your comment about AS could you wait for 2.5 to 3 years to know if the RT/HT has been successful

Bri

User
Posted 29 Dec 2016 at 19:02

Hi Wiganian,

I was offered similar options recently at Preston.   My choice was for surgery because if there is a problem you can then have RT.   Once you have RT you can't have surgery or more RT on the prostate.   RT also means 20 to 30 trips to the hospital at 5 a week after 3 months of hormone treatment.

Good luck

Peter

User
Posted 29 Dec 2016 at 22:20

Thanks to Bri and Pete both of you make valid points

now i am back to square one

my wife has read the book we got and although she said its my decision she thinks surgery is probably the best way

i have her support no matter what i choose so i just need to look at the options again read more chill and get my head to take a few days off

Ian

User
Posted 29 Dec 2016 at 23:29
Hi Ian

Give yourself both time and a clear head or at least the best you can. 3 months would not be excessive. The thing I remember most is the intensity and shock of being told. Visit my profile. I thought I was being calm and rational when I was told however you are not really. As everyone on here its a huge impact at whatever stage or age. I didn't discover this forum until post op and don't regret our decision to op for ralp . In my opinion you are not back to square one as you are gathering good facts and experiences. You need to weigh up the impact of cancer free potential, incontinence and ED . Inquire about nerve sparing , size of lesion , location in gland as reading your posts there may be other options. Mine was multifocal and MDP advised surgery and non nerve sparing. We chewed this over and dismissed RT. We felt we were not pressured and made the best decision we could. Hope this helps. Seasonal greetings.

User
Posted 29 Dec 2016 at 23:57

Peter,

Agree with the thrust of what you say but subject to some qualification. There are a few surgeons who will remove a previously irradiated Prostate, indeed one of our much missed members 'Rob' had this done as 'debulking'. However, what is in any event an intricate operation is made very much more difficult if it has been irradiated so is not often done.

As a generalization, 3 months of HT before RT used to be the norm and it still used in some cases, although trials have shown greater benefit if this is increased to 6 months and this is now more typical. Some oncologists go further and want HT to be continued until PSA has fallen to a certain figure before RT is administered. There is also a growing tendency to extend HT longer after RT, in some cases by up to 3 years, so this aspect should also be considered

Barry
User
Posted 30 Dec 2016 at 01:35

Hi Ian, its also important to take into account any other health conditions you may have and the effects that treatment choice have on your overall health, I'm virtually the same as yourself but as I'm the type person who can cope with an additional sword of Damocles I am happy with AS.

Good luck with your choice and my best regards

Frank-n-furter

life's a b****- then you die!!!!!
User
Posted 30 Dec 2016 at 08:00

Hi Ian

Having read last months audit report on as v surgery and researching surgery side effects it is right at the bottom of my husbands list of choices showing how different we all are ) he is 53) gleAson 6 in both sides.
Going on holiday to consider further but reassured that AE is a valid choice ) though looking into an investment into FLA in the US.

Our surgeon made no mention of penal atrophy risk of loss of 1-2 inches length plus was quite blade about the 50% of his RP patients who cannot ever have full sex again. . We do get the life saving argument of course but the stats on As v surgery are v interesting to me.

Such a big decision needs as much time and research as possible. Immediately after seeing our surgeon who gave the diagnosis and recommended a RP my husband was ready to book an OR!

Good luck with your journey

Clare

User
Posted 01 Jan 2017 at 16:11

I AM adviced HT+IMRT by specialists here and am already had my firrst dose of hormone injection on Dec12th

My gleason 4+4 and psa 28 on Oct. How ever the faculty/Specialists  in India and germany is recommending RP,  as it will remove the cancer from me(

Iam now confused. can anybody advice me the after effects of IMRT andRT. Is incontinence permanent with RP ? With RT incontinence will be lesser or nil?

Shoukath

User
Posted 01 Jan 2017 at 16:17

Ian

Just posted mine, as it may b helpful.

More orless We r in the same boat.

All the best.

shoukath

User
Posted 01 Jan 2017 at 17:41

Shj54, it might be better for you to ask your question in your own right.

Nobody minds you asking questions on another person's post but it would be easy for yours to be missed and then not answered.

I can't help you I'm afraid except to say that of my knowledge gained on here, no it isn't a definite that incontinence would be permanent following RP.

I hope somebody will answer you but if not, try again but for yourself as a separate post.

Good luck though

We can't control the winds - but we can adjust our sails
User
Posted 02 Jan 2017 at 02:03

I would have thought that the most important consideration of the majority of men is to have the treatment that will provide the best chance of cure or seriously set back the cancer as the primary objective. The analysis on this link compares the results of the main treatments but does not show surgery with subsequent RT unfortunately. It should be noted that whether low risk, intermediate or high risk graphs are considered, there is quite a wide spread for each treatment. You can click on your staging and show one treatment at a time or add in treatments until all are displayed. Where an individual might slot in could vary for a number of reasons, some of them unpredictable but the graph gives a general idea and serves as a comparison for the studied treatments. http://www.pctrf.org/comparing-treatments/

Side effects, perhaps most importantly incontinence , as this can be a big and in some cases a long lasting problem, followed by erectile dysfunction are likely to the main secondary if important considerations. Again various men will experience different degrees of side effects and research will show the general likelihood for each treatment but not where an individual will be positioned on the scale (if someone produced a similar one for side effects of treatment similar to the success of treatments as above.)

Barry
User
Posted 02 Jan 2017 at 13:29

Barry

Very informative link.Still difficult to make a decision.Individual experience and
their opinion may b more helpful
SHJ54

User
Posted 03 Jan 2017 at 15:22

Hi Ian,

Hope you are OK. We are still in research mode here ... Want a plan before we share news with grown up children.

We have a 26 year old son who has to hear following grandad's death from PCs in June aged 76 (diagnosed 72) that dad is now diagnosed at 53.

Just sent MRI report to TOOKAD people in Israel. This phase III clinic trial as reported in December 2016 led to remission in half the patients. All tested had single side disease however so my husbands bilateral is 'not optimal' but they are looking at his MRI report. They consider Gleadon 6 and some Gleadon 3+4

Hope you are coping... It is not want anybody wants to hear.

Regards

Clare

 
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