Prostate Cancer which way to go

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User

Posted 05 Feb 2018 at 11:04

This is my first time on here. Am 72, diagnosed on my birthday Dec 19th 2018 with Aggressive PC. Was given a Bicalutamide 50 mg. pills start of January, then the Hormone injection mid Jan., another one due on the 13th Feb. Shrewsbury Hospital been fantastic. Doctor recorded a PSA of 10. Off for a Biopsy quickly. Results on Dec 19th. Last week saw a Doctor Oncologist at the Lingen Davis Clinic in Shrewsbury, and had RT explained to me along with a Clinical trial called STAMPEDE. Am seeing a surgeon Urologist tomorrow, I rightly or wrongly think he is going to talk to me about Open surgery or perhaps Keyhole Surgery.

I am told the Cancer is Aggressive, but is contained in the Prostate ( I hope that might be Good news!!)

My family and many friends know and are very supportive, as is my darling wife, who is I know as worried as I am. I have read many replies on this forum, and my frustration is that I do not know which way to go. Radiotherapy---open surgery---or Keyhole Surgery. I do have AXA PPP, have not used it as was told that NHS was quicker, and it certainly has been very quick.

I live in Telford, so do wonder where the operations are performed if I went down that path.

I do realise I have to make my own mind up, but any help would be much appreciated.

Thanks for reading this and many thanks to the many posts i have already read. Keep positive, and I am trying to do so.

John

User

Posted 05 Feb 2018 at 12:51

Hello John,

My husband was diagnosed last August with aggressive pca (Gleason Score of 8 4 + 4). The cancer was confined to the prostrate but we had a slight complication that he had a very large prostate. We were offered either radiotherapy and hormone treatment or robot assisted surgery, however both the oncologist, surgeon and urologist all felt that because of the size of the prostrate, combined with a Gleason 8 surgery would be preferable. Initially the prostrate was too big for surgery and almost filled the pelvic cavity, making the operation technically very challenging. He had three months of hormone therapy (bicalutamide followed by Prostrate injection) which shrunk the prostate by half and we received clearance for surgery in December.

My husband had his surgery on 26th Jan and was discharged within 24 hours. The catheter has been uncomfortable but that will be removed tomorrow as we then start the next phase of this journey. Full surgery results will be in about five weeks.

We were lucky in that we really didn't have a hard decision to make as we were steered towards RARP, and we both felt that it would give reassurance that the cancer had been removed, we would also have the pathology report which will tell us exactly what stage the cancer was. If Steve has a recurrence in the future, we then have the option of salvage radiotherapy and hormone therapy.

We have a friend who has gone down the radiotherapy and hormone route with a mid aggressive pca. He is now almost two years on and doing well, again he had no choice as he had kidney damage which prevented surgery. He has had a few bowel problems, but nothing that has drastically affected his quality of life.

We know that we are going to face challenges in the next few months, around continence and erectile disfunction, but as a couple this experience has brought us closer together and we will deal with each challenge as and when, or if it occurs.

My advice would be download the toolkit from this site, sit down with a cup of tea with your lovely wife and have a read. Also try and talk to someone who has been through this and can share their experience. Once you have made your decision you will feel better. As I understand it both options have similar outcomes and only you can decide what is right for you.

Good luck on your journey, with the support of your family and lovely wife you will find a way.

Jox

User

Posted 05 Feb 2018 at 23:25

Hi John,

I had Gleason 4+3 and was basically offered RT or RP. I chose RP, keyhole. There are those who say which one makes little difference to outcomes. Post-op I was graded 4+4 and the doctor said with that grade I definitely made the best choice to get it out. Although some might debate it I never had any doubt. Treatment over in 2 weeks rather than 2 years. Can still have RT if needed. Knowing the bulk is out. Time will tell. Good luck, Peter

Edited by member 05 Feb 2018 at 23:27 | Reason: Not specified

User

Posted 08 Feb 2018 at 11:40

Statistically speaking, the 'outcomes' of all the first line treatments on offer are really much the same.

Of course, the individual variation is huge, even for those diagnosed with 'local' PCa.

However, the real difference is in the side effects of treatment; both immediate and long term. You'd do well to read up on them - some are universal, some are not - and see what you are prepared to live with (bearing in mind existing issues, general health and lifestyle).

Also bear in mind that each specialist may try to 'sell' their own solution to your problem - they're only human - and you need to factor in some correction occasionally.

Whatever you decide, Good Luck - it's a bumpy ride, but at least it's a long one!

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