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How long could I delay treatment?

Posted 26 Mar 2017 at 15:35

Hi All,

Not sure if this question is answerable. I am PSA 9 Gleason 3=4/4+3 ie 7 and T2c.(Localised) My wife is due for knee replacement and i wonder how long I could put off treatment before the risk of it spreading ,so she could get her op out the way. I'm feeling largely OK and part of me would like to enjoy normal life for a while as all treatments have long-term side effects.

Any feedback from anyone at same stage as me would be greatly appreciated.

Posted 26 Mar 2017 at 19:05

I would say that the implications for putting off a knee replacement are fairly well known. The same cannot be said of your cancer.

Knees needing replacement gradually deteriorate, Social aspects apart, a month or six delay makes no difference. The rehabilitation is largely predictable.

Cancer can be within the capsule or it cannot. A month or six delay might mean all the difference. The ongoing issues are difficult to predict.

Your choice.

Posted 26 Mar 2017 at 20:36

The fact they have staged it asT2c is the concern. It would be useful to clarify whether you are actually a 3+4 or a 4+3 - the difference may make all the difference! You could also ask your urologist how close to the edge the cancer was in the positive cores - if it is near the centre then perhaps less risky than if it is up near the edge. You are asking how long before it escapes but it may already have done so - you can't know until the gland is in a pathology lab and has been inspected.

Can you not explain the situation to your urologist (or the nurse specialist if you were allocated one) and ask them for a view about the wisdom of delaying?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Posted 27 Mar 2017 at 12:38

Many thanks Lynn. I've now spoken to my nurse specialist. i have 3+4 one side and 4+3 the other so her advice is not to delay. I have yet to see Nottingham consultant re RALP . The local consultant I saw re Radical Surgery claimed that his recurrence rate was only 8% whereas he said the RALP was 25 so that was a concern . For various reasons I'm going to have to go for one or the other ,and am fearful of life changing consequences.. needs must though.

Posted 27 Mar 2017 at 14:57

What are the surgery options being offered.
Is it that your local surgeon is doing open surgery or laparoscopic key hole and the Nottingham consultant would do robotic?

Certainly the recurrence rates are important as is the experience of your surgeon in the technique being offered.

for open versus keyhole either robot Assisted or laparoscopic the main difference is the recovery time with the keyhole surgery obviously being less invasive.

When looking at recurrence rates you also need to look at the types of cancers being operated on, some surgeons or centers may have higher recurrence rates, but does this mean that the surgeons are doing a worse job or that they are taking on cases that were more difficult to start with and that some have very good stats because they only operate on the simpler, lower Gleason score cases. I think when you go to Nottingham you need to ask what are the stats for you.

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