Whar to do.

User

Posted 15 May 2018 at 21:34

Hi everyone
This is the first time i,ve posted on this site.
My story.
I was diagnosed with localised prostate cancer about a month ago aged 56 gleason 7, 3+4 & psa 7.7 & told i have 5 treatment options. As, ebr, ht. Hifu & Rp.
I was refered to a surgeon at the UCLH. Told him i wasn,t too keen on surgery because of side affects & being a taxi driver maybe not being able to work again. He refered me to oncologist. Saw the oncologist last week & got the impression she was pushing me for surgery. Told her i wasn,t keen & i was keen to have hifu.she said she had been in a meeting with her colleagues & they concluded i wasn,t suitable for hifu because my cancer wasn,t very clear.I felt very dissapointed but pushed her a little. So she,s going to meet with her colleagues again to see if hifu is an option. Since i had biopsy i,ve had urinary problems. Urgency. Frequency & dripping & psa risen above 9. Oncologist said this can happen after biopsy. Can anyone relate to my story or any advice would be grateful.

User

Posted 16 May 2018 at 00:51

HIFU isn't fully approved in the UK yet so you can only usually get it as part of a trial or in one of the major oncology hospitals. Focal HIFU is slightly easier to get approval for but it sounds like the oncologist doesn't think you are suitable for focal HIFU because your tumour isn't small and defined. Very few places offer whole gland HIFU.

Have you asked about brachytherapy - that might be a suitable alternative based on your reluctance to have surgery.

There is no point you pushing for a treatment that is either not available in your area or would fail because you weren't really suitable for it.

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

User

Posted 16 May 2018 at 11:26

I cant understand why you wouldnt be able to work again as a taxi driver.

I had my robotic prostectomy last september at the age of 56 gleeson 7, and continue to drive H G V with no problem. just beginning to feel almost normal now.

For me i think i took the right option but its not for everyone

User

Posted 16 May 2018 at 13:06

Hi there
There really shouldn't be any issue with continuing to drive a taxi if you decide on the op.
I had my RALP 3 years ago at the age of 66 and like Steam Man I still drive LGV's and PCV's with no problem. I had salvage RT two years ago and started HT last year and it hasn't stopped me driving professionally.
I am not for one second advocating RP but merely saying that if you are discounting it because you feel it could affect your ability to drive for a living then you might be worrying needlessly.

All the best

Kevan

User

Posted 16 May 2018 at 16:55

I had my op nearly 3 years ago, despite nasty post op complications I was back at work driving 25000 miles a year, riding horses and farming within a few months.

Don't think there is a better option if you catch it early enough.

User

Posted 16 May 2018 at 18:09

Hi Anthony

Most comparatively young men like you (in PCa terms) have surgery where this is a good option and older men tend to have one of the forms of radiation. HIFU is usually administered privately or within a trial for NHS patients, more particularly as salvage therapy for failed RT. External Beam can be given either as a salvage treatment for failed Prostatectomy, as a supplement to brachytherapy or as a stand alone therapy. Be aware that that all forms of treatment have failures and successes. so do not be over influenced by the individual experiences of some members which may not be truly representative of men in general. There is also the matter of potential an variable side effects to consider. I recommend you get the 'Toolkit' from the publications section of this Charity as it will provide a lot of reliable information which may help you with your treatment decision which can be far more difficult when one takes into account all the pros and cons.

Notwithstanding the foregoing, it is interesting to read about the experiences of men who have had various treatments. I had External Beam RT back in 2008 and salvage HIFU, (the latter at UCLH as it happened), in 2015. It seems that this has also failed and I will write up about it on a new thread rather than side track yours.

Barry

User

Posted 18 May 2018 at 15:12

Hi Anthony,

I was in a similar position to you, I was diagnosed last November and had a lot of conversations with various health professionals, each one offered me different approaches to treatment options. I went away and, like old Barry suggests, referred to the toolkit from this site. After studying the various treatment options I went back to my oncologist and said which ones I would like to try I asked about brachytherapy, but this was dismissed as one of my tumors was to close to the wall of the prostate, I asked about hifu but again this was ruled out for the same reason. My only options were external beam radiotherapy or surgery. I decided on the surgery as I felt this was right for me. As for side effects etc, the only problems I've encountered have been incontinence (now dry after just 6 weeks)and ED, both of which can be treated. Also if you are at UCLH I would recommend attending their patient school for people considering surgery as it is a worth while presentation on the pros and cons of Radical Laparoscopic Prostatectomy. As for driving I was back on the road within four weeks after surgery, albeit for short duration drives, and now I am driving around without any problems (8 weeks after surgery). I know that as a taxi driver you would like to be back driving sooner rather than later but if you do opt for surgery don't try to rush back to driving to soon.

I hope what I have written has been of help to you but, again, as Old Barry said, do your research and make an informed decision that you believe suits you. However that said remember your oncologist has your best interests at heart and will only push you to a treatment they consider will give you the best outcome.

Wishing you all the best

Ants

User

Posted 18 May 2018 at 17:32

ED and incontinence are treatable for most but not all men.

As a taxi driver, you would need to check with your insurance company when they would be prepared to cover you again. My husband had a company car and their policy was no cover for 12 weeks after abdominal surgery so although he was fit to work after about 9/10 weeks he couldn't actually get to the office until the 12 weeks was up. With a public hire licence, you obviously can't drive without insurance.

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

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