I'm interested in conversations about and I want to talk about

Know exactly what you want?

Show search

Notification

Error

Radiotherapy/HT - implications

Email this conversation Print this conversation

User

Posted 09 Oct 2018 at 10:37

I have recently been advised that my Gleason 6 has developed into Gleason 9 and I will need either Prostatectomy or Radiotherapy/Hormone Treatment. I would like to hear from people who have taken the radio/HT route and in particular the side effects of LHRH injections (possibly Depot) followed by anti-androgen tablets, and supporting radiotherapy - IMRT/IGRT.

I am led to believe that the HT/Radiotherapy route is less likely to leave you with long term erectile dysfunction and incontinence problems and would be grateful for your experiences of this.

Thank you

User

Posted 09 Oct 2018 at 19:59

Both have upsides and downsides.

RP side effects are often more immediate but you do usually recover some or all of what you had before and there is more chance of salvage afterwards than with RT/HT.

RT side effects can take longer to manifest but still happen and there is much less in the way of salvage possible. I’m not sure about long term recovery from RT side effects but I am sure someone else can advise.

Both have similar first pass success rates, I understand.

The prevailing trend appears to be RP when younger / localised and RT when older / more spread.

I’ve seen conversations where people worry about treatment efficacy versus performance / continence sometimes to the extent of delaying treatment unnecessarily. Some also beat themselves up to a sadly excessive level after their treatment playing “what if”.

Best approach is to do the research, make a choice, get it done and move on. Be happy that you took positive action. There are no guarantees, whatever you choose, but as Churchill said “perfection is the enemy of progress”. Better a choice that can be later worked on than no choice at all.

Good luck in your journey.

Edit: all this will depend on your PSA levels, Gleason score etc.

Edited by member 09 Oct 2018 at 20:07 | Reason: Not specified

User

Posted 09 Oct 2018 at 20:31

Good answer from Prostate Pete.

Some side effects are guaranteed whichever route you take (dry orgasm, penile atrophy, becoming sterile) while others are possible or likely but not certain. Generally, side effects of HT develop quite quickly but most are reversible, side effects of RT are immediate but short-lived OR develop months or years later. Side effects of surgery tend to be immediate but get better over time for a significant proportion of men.

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

User

Posted 09 Oct 2018 at 20:44

This study may be relevant if you have a T3 staging:

http://prac.co/l/yavqruhe

You have to register to read but it's free..

User

Posted 09 Oct 2018 at 20:49

My Gleason was 7...been on cyproterone for 3weeks and now on zoladex 10.8mg for past 6 weeks....prostatitis /cancer symptoms subsided but now are returning...is the zoladex wearing off and male hormones coming back to life or does it mean cancer is growing again? Radio starts end of November...hormone treatment for me in first 5 weeks was a nightmare !!

User

Posted 09 Oct 2018 at 21:29

You have started with an unusual route, cypro followed by zoladex is a rare combination so your symptoms could just be tumour flare. Usually a man is given 3 weeks of casodex before zoladex to prevent tumour flare.

It should settle soon but if concerned, ring your nurse specialist. The chance of you being castrate resistant already is almost zero.

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

User

Posted 09 Oct 2018 at 21:40

How is it unusual ?....I thought the cypro prevents a tumour flare,it's just what I've read...consultant basically said I have a Gleason 7 and gave me a couple of weeks 're radio or ok...he didn't mention any hormone treatment to me at time when I opted for radio...first I knew of hormone treatment was from my allocated cancer nurse who told me to go to urology and pick up a script for cypro for 3weeks then an implant to follow....So if it is a tumour flare at this stage will the pain of prostatitis/cancer be here for good again or will it subside when I get my next implant in 5weeks ?

User

Posted 09 Oct 2018 at 22:04

Casodex is just the more common prescription I think. It is usually taken for 3 weeks immediately before the zoladex starts. Cypro is normally given 1 week before zoladex starts and then continues for the first month alongside the zoladex. Unless I am reading it wrong, you have had cypro but at the casodex pattern of prescribing?

If it is tumour flare it should settle quickly - what side effects or symptoms are you experiencing?

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

User

Posted 09 Oct 2018 at 22:04

My psa was 5.78 when tested in May and had hops appt 4days later and a biopsy 2weeks later...I had to pester my gp from Oct last year until May when he finally did the test and was stunned when results of biopsy was cancer...all along he kept saying it was only prostatitis...the pain was unreal,subsided after a week on cypro but has come back in last couple of days ...I'm not as tired now as I have been in last 5weeks and not as moody

User

Posted 09 Oct 2018 at 22:50

Local prostate cancer doesn't cause pain so you may have prostatitis AND prostate cancer - worth seeing your GP?

However, you should move this conversation to your own thread so that replies to you are not confused with responses to Mike.

Edited by member 09 Oct 2018 at 22:54 | Reason: Not specified

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

User

Posted 09 Oct 2018 at 22:56

Throbbing pain between legs,frequent urination,burning pain inside penis and pain on lower right side of abdomen where bladder is....I had the cypro for 2weeks then implant but continued the cypro for a further week...have put weight on in last few weeks but the pain totally went...and now it's back...My radiotherapy starts the last week of November but been told I definitely need another zoladex in a few weeks then possibly another one in february

User

Posted 10 Oct 2018 at 00:14

Sounds like an infection - see the GP

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

Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.