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Surgery or Radiotherapy?

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User
Posted 04 Apr 2017 at 11:27

PC confirmed. Current details:

PSA: 9.8

Gleeson: 3+4

All 6 bi-ops from left positive with slight bulge. T3a staging NO MO but Perineural invasion. Everything else negative and mpMRI is indicating capsule threatening but no indication that it has actually broken through and no disease reported beyond the prostate.  

All 6 bi-ops from right side negative.

 

Consequently fairly immediate treatment is required. 

Despite the slight bulging and T3a staging both surgery and radiotherapy has been offered.

I would therefore, like to hear from those who have been in the same/similar position, or who can just offer some helpful advice, who may be able to help decide which is the best route to go?

Do both treatments provide the same outcome in successful eradication of the disease? I do appreciate that if radiotherapy is chosen then later surgery is then not possible/offered and that short/long term or permanent impotence and incontinence is a much higher risk with surgical removal. It has already advised that nerve sparing on the left would not be possible and there is no guarantee that the right side can be spared? 

 

User
Posted 05 Apr 2017 at 17:26
Originally Posted by: Online Community Member

After having read the MP MRI, TC, bone scan and biopsy , the uro firmly suggested best option for OH was robotic surgery. We agreed. Hope it was the right option.
Crossing fingers, toes, legs , arms and everything possible to be crossed including eyes : (

A bit nervous as the operation date approaches.
Lola

The difference Lola is that fortunately your husband is T1 or T2 - if he was T3 you may have been advised differently.

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

User
Posted 05 Apr 2017 at 21:08

I had robotic surgery in January and so far so good and my treatment has been excellent .
All I know about RT is that once you embark on this route it's difficult to be operated on and I do appreciate it's the only option to a lot of guy's due to age and other health problems.
You're in great company here with loads of help .
All the best to you

User
Posted 02 May 2017 at 16:21

hi im new to forum been diagnosed a month,psa 4 gleeson 4+4.ive my visit to consultant tomorrow to find result of mri and bone scan and to discuss treatment...im hoping i dont have to make a treatment decision there and then.does anyone know "normal" timescale for decision making?though nothing seems normal at moment,thank you.

User
Posted 02 May 2017 at 16:54

Hi Welly,
you should not have to make your decision there and then. Indeed if you are offered alternative treatments you may want to discuss the pro's and con's of each with the relevant specialist. I.e. if you are seeing a Urologist tomorrow s/he will be able to discuss the surgical options but should refer you to Oncology to discuss Radiotherapy or Brachytherapy.

Don't be rushed into a decision. You need to make sure you are happy with whichever path you choose.

All the best

Julie

User
Posted 02 May 2017 at 20:43

Hello

I chose surgery, and almost immediately followed by hormone treatment and radiotherapy.  Serves me right for being 53, Gleason 9 and t3a.  Basically, hoping it's the best shot of getting rid of any wayward cancery cells which at Grade 5 could be rather unwelcome.

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User
Posted 04 Apr 2017 at 22:28
Hi ridge.

This gets asks a great deal. You should be able to use search to find posts. This is just one http://community.prostatecanceruk.org/posts/t12187-Surgery-choices

.

To help others who I'm sure will reply. How old are you ? How fit are you ?

Also there are more than those 2 options.

Hope this helps . Have a look at my profile.

Ask MDT / consulate about lesion location and PNI.. If surgery will they offer RT soon after ? Ie adjuvant RT.

Gordon

Edited by member 04 Apr 2017 at 22:35  | Reason: Not specified

User
Posted 04 Apr 2017 at 22:32

Hi Rudge,
Not sure I can answer your question but didn't want your post to get missed.
I do know that choosing a treatment path is a difficult one but the fact that you have choice is positive. Both routes can provide cure.
Hopefully someone else will come along with more advice soon.

User
Posted 05 Apr 2017 at 14:30

After having read the MP MRI, TC, bone scan and biopsy , the uro firmly suggested best option for OH was robotic surgery. We agreed. Hope it was the right option.
Crossing fingers, toes, legs , arms and everything possible to be crossed including eyes : (

A bit nervous as the operation date approaches.
Lola

User
Posted 05 Apr 2017 at 15:38

Hi Rudge,

It would help those making a reply if you post a summary of you diagnosis in your profile as this information tends to get lost over time within threads (or conversations as mods call them on this forum.

I would not place too much reliance on what a few individuals say about how they fared with one or another form of treatment. They may not be representative and their medical situation may not be the same even if it is interesting to follow and support them. Your best guidance comes from your consultants but additionally from good sources such as in the 'Toolkit' on this site and from other reliable sources which provide general but of course not individual guidance

Barry
User
Posted 05 Apr 2017 at 17:26
Originally Posted by: Online Community Member

After having read the MP MRI, TC, bone scan and biopsy , the uro firmly suggested best option for OH was robotic surgery. We agreed. Hope it was the right option.
Crossing fingers, toes, legs , arms and everything possible to be crossed including eyes : (

A bit nervous as the operation date approaches.
Lola

The difference Lola is that fortunately your husband is T1 or T2 - if he was T3 you may have been advised differently.

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

User
Posted 05 Apr 2017 at 21:08

I had robotic surgery in January and so far so good and my treatment has been excellent .
All I know about RT is that once you embark on this route it's difficult to be operated on and I do appreciate it's the only option to a lot of guy's due to age and other health problems.
You're in great company here with loads of help .
All the best to you

User
Posted 05 Apr 2017 at 21:40

Thanks a lot for your replies, Tony, Lyn. Encouraging words
Best wishes from Spain,

Lola

User
Posted 06 Apr 2017 at 20:05

Thanks for all the replies and comments.

 

User
Posted 06 Apr 2017 at 20:28
Hi rudge I too was offered the three options and I have a friend that had the surgery and he has had problems .I have another acquintance that also had surgery and has had no problems.(both robotic) welcome to the minefield.

I Weighed up all the options and I finally opted for Brachatherapy and I thought I was going for the permananat seed Brachay but instead the oncologist told me I was to have the High dose rate version

Please read my post where I go through all of my treatments which finished four weeks ago

Let us know what happens as we all need guidence and you are right if you have RT you cannot then opt for surgery in the future.However that may soon change as in Europe they are now doing a procedure to cut out the prostate after it has been Nuked

If the radiation does fail there are quite a few options now being employed for further treatments

My PSA at diagnoses was 32 it rose to 47 and then on hormones alone it fell to 3.2. I then had fifteen sessions of RT followed by my Brachayrherapy and now my PSA is .1

My gleeson was 3+4 as well and the cancer had not escaped the capsule.

User
Posted 07 Apr 2017 at 10:22
Hi,

I had a similar diagnosis and has keyhole surgery two years ago. Please feel free to check out my profile.

Paul

THE CHILD HAS GROWN, THE DREAM HAS GONE
User
Posted 07 Apr 2017 at 19:52
Hi,

I had the robotic surgery in December 2015, I am now receiving radiotherapy, the Pc escaped from the pod, I'm hoping this does the job for good.

Best of luck

James

User
Posted 07 Apr 2017 at 21:00
I never had any doubt surgery was the best option for me as it leaves RT as a further option. I was happier to suffer side effects than leave the tumour in me for a moment longer than necessary as it was close to the edge.

I was told some people are more willing to tolerate leaving the tumour longer.

The surgeon said it was a good choice as post op they upgraded Gleason to 4+4 from 4+3.

User
Posted 15 Apr 2017 at 15:51

Hello Rudge,

I chose hormones plus radiotherapy, which I have just completed, with no regrets. You might like to refer to my posts of today and 24 March for more details.  Good luck,

Paul

User
Posted 02 May 2017 at 16:21

hi im new to forum been diagnosed a month,psa 4 gleeson 4+4.ive my visit to consultant tomorrow to find result of mri and bone scan and to discuss treatment...im hoping i dont have to make a treatment decision there and then.does anyone know "normal" timescale for decision making?though nothing seems normal at moment,thank you.

User
Posted 02 May 2017 at 16:54

Hi Welly,
you should not have to make your decision there and then. Indeed if you are offered alternative treatments you may want to discuss the pro's and con's of each with the relevant specialist. I.e. if you are seeing a Urologist tomorrow s/he will be able to discuss the surgical options but should refer you to Oncology to discuss Radiotherapy or Brachytherapy.

Don't be rushed into a decision. You need to make sure you are happy with whichever path you choose.

All the best

Julie

User
Posted 02 May 2017 at 20:43

Hello

I chose surgery, and almost immediately followed by hormone treatment and radiotherapy.  Serves me right for being 53, Gleason 9 and t3a.  Basically, hoping it's the best shot of getting rid of any wayward cancery cells which at Grade 5 could be rather unwelcome.

User
Posted 11 May 2017 at 11:43

Hi Rudge

I find I'm in the same boat as yourself which way to go? at first when I was diagnosed with p/c with a small 7mm iliac in the lymph node I was sure I did not want to go down the surgery line but on further discussions I was told I would have to carry on with hormone therapy for 18 months and my radio/t would not start for 4 months, today I spoke with the surgeon who cleared up a lot of my questions, but as still not given me on my choices there is so many things to consider. I spoke with one friend who had the surgery but they did not get all the cancer so he still had to have radio/t afterwards. So why have the surgery, but on the other hand they are more likely to get the cancer and its got rid of a lot quicker, so I say again which way to go? Anyway rudge all the best and what ever choice you make I hope its a success.

 
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