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An unexpected diagnosis.

User
Posted 13 Oct 2018 at 16:45

My husband, a 53 year old male, had a scan then biopsies taken about 10 days ago. Yesterday we went together to see the consultant and she confirmed its cancer (T3 because its invaded the spinal vesicles) His Gleason scale is 4+3=7 Gleason group 3. 


He is going for a bone scan on Monday and will have a video conference with Addenbrooks on Tuesday. 


I've been so frightened and I know that's to be expected but I need to be strong for him. During his consultation I just sat there blubbing but he remained very calm. All the way home he kept saying, "I'm so sorry, I never wanted to put you through this" which made me feel terribly guilty. 


His key nurse at the hospital is lovely and gave us loads of info, including this site. Having picked myself up, I registered on here (he's not ready to yet) and started reading all the info and the forums. It was like a calm washed over me and instead of feeling like it was the end of the world, this site completely calmed me down, took away many of my fears and gave me so many positives. 


I look forward to chatting to people and gaining all the necessary information he will need to get through this. 

User
Posted 13 Oct 2018 at 16:45

My husband, a 53 year old male, had a scan then biopsies taken about 10 days ago. Yesterday we went together to see the consultant and she confirmed its cancer (T3 because its invaded the spinal vesicles) His Gleason scale is 4+3=7 Gleason group 3. 


He is going for a bone scan on Monday and will have a video conference with Addenbrooks on Tuesday. 


I've been so frightened and I know that's to be expected but I need to be strong for him. During his consultation I just sat there blubbing but he remained very calm. All the way home he kept saying, "I'm so sorry, I never wanted to put you through this" which made me feel terribly guilty. 


His key nurse at the hospital is lovely and gave us loads of info, including this site. Having picked myself up, I registered on here (he's not ready to yet) and started reading all the info and the forums. It was like a calm washed over me and instead of feeling like it was the end of the world, this site completely calmed me down, took away many of my fears and gave me so many positives. 


I look forward to chatting to people and gaining all the necessary information he will need to get through this. 

User
Posted 24 Oct 2018 at 10:34
It was reported again at this year’s uro-oncology conference that surgery will eventually be stopped for PCa and all men will have versions of radiotherapy / cyberknife / nanoknife / etc.

In 2016, I remember the keynote being along the lines of “future generations will look back in horror” that we used to be barbaric enough to remove the prostate surgically. I suppose this is parallel to the change in breast cancer treatment in recent years; even friends diagnosed with aggressive BCa have had lumpectomies with adjuvant RT/HT and with or without chemo ... mastectomies are no longer routine except in the most aggressive, high risk cases.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Oct 2018 at 18:44
I think you misheard - there is no such thing as spinal vesicles so they probably said the seminal vesicles had been affected. The seminal vesicles are inside and just outside the prostate so SV involvement is very common.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 13 Oct 2018 at 18:44
I think you misheard - there is no such thing as spinal vesicles so they probably said the seminal vesicles had been affected. The seminal vesicles are inside and just outside the prostate so SV involvement is very common.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Oct 2018 at 19:20
It’s great you’ve found some help from the site. A brilliant source of info and many great people and the specialist nurses are amazing also. Any questions are soon answered but remember there are no real experts on here , just people who have been or are going through the same as you. I was 48 at surgery sadly. You can click peoples picture and then read their profiles. Fingers crossed for you. PCA tends to mostly move slowly so you have time to read and make good choices without rushing

If life gives you lemons , then make lemonade
User
Posted 13 Oct 2018 at 21:05

Hi Maria, scary isn't it! We've all been there, and there's a lot to learn.


Honestly, with what you already know, you have every reason to be optimistic for the future. DON'T PANIC¡¡ There are tens of thousands of us who have been successfully treated, and hundreds of thousands, who have cancerous cells, but don't know it, and die happily of old age, not prostate cancer.


This isn't a cancer which spreads rapidly around the body, its very slow growing and there are lots of ways to cure and/or control it.  The medics will give you advice for the options recommended for you. 


I assure you that fairly soon you'll start to understand it, and it will probably become a concern and not a threat.


PS spinal vesicles indeed 😉😊 As far as I'm aware, these are normally taken out with the prostate during surgery, or blasted during radio therapy. It's not significant.


 


 


 

User
Posted 13 Oct 2018 at 21:43

 


Thank you Tykey, it is scary but today we have both spent the day talking openly about it. Our children are now in the loop and the same with the rest of our family and we do have a large and good family.


Steve's biggest concern atm is a) has it gone to the bones and b) will hormone suppressants make him feminine. Also he's a self employed carpenter and he's obviously worried about his business.  


 


Thanks Lynne, I don't think I misheard but my auto spell checker just tried to correct seminal for spinal and I didn't proof read... sorry. 


 


Thank you Chris, things seem to be moving really fast but I think that's because Ipswich hospital has just done an upgrade clinic for PC and my husband Steve was one of its first patients. He's having a bone scan on Monday and the results will be out by the following day. Reading the forums it sounds like this can normally take weeks, not hours. 


You were young to be going through that sort of surgery. Thanks for the info about clicking on peoples pictures to read their profiles. I don't even know how to write a profile atm. I'm still navigating the site but I'll get there. 

User
Posted 14 Oct 2018 at 00:42

Hi Maria


  I hope you find some comfort on this site. After the initial shock of diagnosis I think we all gather some strength to get on with life and accept that the best thing to do is to get on with any treatment that is necessary and carry on with life as normally as you can.


We have all been through all the uncertainties and worry but there is so much that can be done and so many treatments to suit the individual.  My oh has had this illness  for 8 years but we still have a good life together and enjoy things. Some aspects of life may change but take each day at a time. Wishing you both all the best.


Gilly

User
Posted 14 Oct 2018 at 03:40

Hi Maria


 


Welcome to the forum nobody really wants to join. You'll get loads of help and support on here, the Nurses are also top drawer if you need to call them privately. I'm 10 years older than your OH and was diagnosed in August this year, my cancer had metastasized into my hip and I've recently started chemo as a supplement to the Hormone treatment.


Once you get over the initial shock you will both get more focused. Good luck.


 


John

Edited by member 14 Oct 2018 at 03:44  | Reason: sic

User
Posted 14 Oct 2018 at 09:58

I was very sorry to read your story so far. The fact you are a close supportive family will really help whatever you find as you get closer to moving to treatment. It’s one hell of a shock at first to everyone who loves you. I found reading up on the condition and diagnosis really helped, the resources on this site are fantastic and via the helpline you can find men who have been through what you’re facing and have them call your husband directly. The treatment now is more advanced than even 5 years ago with most NHS hospitals having strong prostate cancer teams. If ever you feel you’re not getting enough information or appointments are slow to come up it’s definitely worth chasing. The care is often better than the admin!


Wishing you all the best. 


Mike

Edited by member 14 Oct 2018 at 09:59  | Reason: Not specified

User
Posted 14 Oct 2018 at 10:37

No, he won't become feminine! I've never met anyone who grew breasts, although we always pull each others legs about the potential. He won't be borrowing a lacy bra from you 


What normally happens is that we put some weight on around the midriff and thighs, plus loads of hot flushes. Physical tiredness is probably the biggest worry for him


 

User
Posted 14 Oct 2018 at 10:45
Breasts are a common side effect of hormones and are often permanent but there are things that can be done to minimise the problem.

Have they said that he will be having hormone therapy rather than surgery?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Oct 2018 at 17:40

Thanks everyone. When I read these replies I feel this calm washing over me. 


Steve and me have talked none stop today about every possible outcome and every possible option and the compromise of those options.... Its been a positive day.


When I read things like "8 years on" it helps to wash away so many fears. Steve isn't reading this site yet but I keep saying, "okay listen to this" and read him a reply or some prudent information and he's starting to listen and become more interested. 


"Have they said that he will be having hormone therapy rather than surgery?" Hi Lynne, to be honest I'm foggy about what they said. The consultant talked about major surgery. The key nurse said he would be pushing Addenbrooks for surgery but that they may not agree. They both spoke briefly about RT and HT but we were bombarded with so much info that neither of us took it in. Steve is saying he wants the surgery. I on the other hand, after reading a lot of the forums here, think its something he shouldn't be rushing into. That said, the consultant stressed that he must decide quickly as time was not on his side. The nurse on the other hand appeared much calmer and hopeful. If hormone treatment starves the cancer, then perhaps he should be having that before surgery? 


We get the results of the bone scan on Tuesday. The following Monday his team will have a meeting and I'm sure the consultant or nurse said something about an online conference with him at the same time... I could be totally wrong about that. The following Thursday which is a week on Thursday, he's over at Addenbrooks for a full diagnosis and treatment plan; so we have 10 days to learn, learn, learn.



You are a bunch of fantastic giving people and I can't thank you all enough. I hope, like you, we can go on to support others in the future.

User
Posted 14 Oct 2018 at 18:58

 


As part of my research I found the below book very helpful. It’s been around a while and is mentioned elsewhere on the forums. The latest edition was updated earlier this year 



Dr. Patrick Walsh's Guide to Surviving Prostate Cancer (Fourth Edition)


https://www.amazon.co.uk/dp/1538727471/ref=cm_sw_r_cp_awdb_t1_yD8WBbXGWWXBQ


I’ve just had the surgery for what turned out to be T3b cancer. I was Gleason 9 and thought to be T2a. So far so good with the usual ups and downs. 


Although I did a fair bit of research it was ultimately the faith I can in my local NHS team that lead to the route I took.


All the best


Mike 


 

Edited by member 14 Oct 2018 at 23:48  | Reason: Not specified

User
Posted 14 Oct 2018 at 19:15
Hi Maria,

I shed a tear or two when I read your initial post just now, in contrast to when I went for my own ‘Big C’ pow-wow with the Multi-Disciplinary Team evaluating my diagnostic results earlier this year, as I had already twigged I had cancer, or PCa as we connoisseurs here call it. I joked with the consultant ‘I am surprised you don’t have a big box of Kleenex on your desk!’. They helpfully recorded our conversation on a CD for me to take away - which I have never listened to.

I was totally chilled, as I had already checked out the morbidity (fatality) rates of different cancers, and it seems, in the words of one of my GPs, “PCa is one of the best cancers you can get”. Obviously, he has never had cancer......Others here who have lost loved ones might disagree, but most men die with it, not of it.

I was G4+3=7 like your man, and had a prostatectomy in June and am now cured.

Calm down Dear, it’s by no way the end of the world, unlike many other cancers. I hope you can get Hubby to come and join us here himself.

Everyone here will endeavour to help you however we can.

Cheers, John.
User
Posted 14 Oct 2018 at 19:57

Thanks Mike, I'm going to go and order that book now. 


Sorry you had to go through this but you sound positive and it looks like things are going well so far. 

User
Posted 14 Oct 2018 at 20:04

Hi Bollinge, I think its good that your team recorded all the conversation. Is that usual ? Next time we see them we will be much more tuned in but I think it would be good to have a recording because from our first meeting with the consultant, Steve and me disagree about what was said!


As a cancer survivor, I wasn't nearly as scared at my diagnosis because like you, I knew before I was told so them telling me was just confirmation with a few added extras. 

User
Posted 14 Oct 2018 at 23:41

Hi Maria,  There is a lot to learn if you want to, I learnt the most after the event.   At the time I had a very simple outlook in that I wanted surgery if it was offered.   I have since read of people who are better having Radiotherapy and others who insisted on novel types of surgery.   I was very keen to get the quickest treatment as near to home as possible as it was near the edge of the prostate, and the depths of winter.


I didn't meet the Multi Disciplinary Team. The Macmillan Nurse rang me at home after the meeting and told me what they said and what she thought they'd offer me.  My next appointment was with the Urology Consultant to be officially offered the options and say what I wanted.  What do I know except that I always wanted surgery and that was based on my experience of having skin cancer which is really rather different.  Later a doctor said that with my post operation Gleason result I'd definitely made the right choice.


I hope that doesn't sound too confusing as I sometimes surprise myself when I read it later.


All the best. Peter


 

User
Posted 15 Oct 2018 at 00:54

Originally Posted by: Online Community Member


Hi Bollinge, I think its good that your team recorded all the conversation. Is that usual ? Next time we see them we will be much more tuned in but I think it would be good to have a recording because from our first meeting with the consultant, Steve and me disagree about what was said!



I think it is standard practice in my local hospital and what a good idea, as some men go into shock when told the news, and so much of the rest of the conversation ends up going over their head!


Most smart phones have a recording function these days.


Cheers, John.

User
Posted 15 Oct 2018 at 00:56

I don’t think there is any area where the patient meets the MDT.


If you want to record the conversation on your phone or whatever, you will need the urologist‘s permission. Some will refuse. 

Edited by member 15 Oct 2018 at 00:57  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 15 Oct 2018 at 01:05

Correct again, Matron.


On my notes it says there were seven or eight members of the Multi Disciplinary Team, and at my “Dear John” consultation there were only three.


And of course it’s only polite to ask if it’s OK to record a conversation. I wonder why any consultant would object to that?


Cheers, John.

User
Posted 15 Oct 2018 at 07:27

Hi Maria B


Please read my profile, I am nearly eight years ,


Early Chemo is now the starting point


Good Luck,


 


PS I am around to answer any ?????

Edited by member 15 Oct 2018 at 07:31  | Reason: Not specified

User
Posted 15 Oct 2018 at 11:34
Hi Barry

Wow just read your story on the profile page. I've just started on the Chemo/Prostap, gives us all hope, well done.

John
User
Posted 15 Oct 2018 at 14:34

I'm glad you complained Mr Angry. Getting a good consultant shouldn't be a lottery game. Having to be assertive shouldn't even come into this.

User
Posted 15 Oct 2018 at 14:43

Hi Peter, do you regret having surgery? Like you, I had skin cancer and so like you, my immediate thought was 'surgery is the way to go' but after coming on here and trawling this site, I'm going to be asking a lot of questions when we go to Addenbrooks. There's obviously compromises to be made with what ever treatment one decides to go with. Whilst I can't decide for him and will wholeheartedly support what ever decision he makes (if he has one), as his wife, I consider myself fully involved and so if he doesn't ask the right questions, I will. 

User
Posted 15 Oct 2018 at 15:27

Barry I did go and read your profile... every word!


I love the way you add humor into the trauma. Your profile made me laugh through the tears. You have really been through the works yet here you are, like so many on here, helping others. Thank you.

User
Posted 15 Oct 2018 at 18:41

Hi Maria,  I have no regrets at all of having surgery.  So far it's gone as the surgeon said it would although rather slower recovery than he said.  I also know my true pathology which upgraded my Gleason and know there were negative margins.  If I was younger I might worry more about my sex life, but then again...


I still believe that what the Dermatology Consultant told me applies in many prostate cases, 'that you can have the laser treatment but cutting it out is the gold standard'.   Well you don't know if there's something just outside the prostate that RT might have got, but then you don't know RT has got it all anyway and you won't know for up to a year when your psa settles after continued hormones.  With an op you know in 8 weeks your psa should be undetectable, and you can have RT later.


In my opinion it's best to know when you go for the appointment what you want and how to handle worse cases, no umming and ahing.  Make sure things move on and not you'll come back to let them know. 


Regards Peter


 

User
Posted 15 Oct 2018 at 20:22

Thank you Peter, that's very helpful.

User
Posted 16 Oct 2018 at 16:46

Bones are clear  

User
Posted 17 Oct 2018 at 09:11

Fantastic news. Now that’s out of the way you can concentrate on making the right decisions , for you both. to treat the cancer .


best of luck 


Phil 

User
Posted 20 Oct 2018 at 23:54
Hi Maria,
Great news about no mets in the bones. Iam sure it’s been a long month with a lot to take it.
How are you and OH talking? Has he been on the site to look at threads and comments? You mentioned he’s self employed and worried how it my affect him. I was dx 4 years ago at PSA 392, Gleason 9 etc. One thing I found was being able to chat about it with OH, sometimes in depth and other times just wee comments. Get used to chatting about it, you need to, it’s part of life now!
There’s a lot to take in and another thing to not get caught up in is how long I got left ie 8 years. It could be 5,10,15 or whatever, treatment has progressed so much even in the 4 years I’ve been dx.
Good luck
Steven
User
Posted 21 Oct 2018 at 15:36

Hi Steven, 


No he hasn't been on this site and is still refusing to entertain the idea which is a great shame. I do hope he will eventually start taking a sneaky peek. 


ATM he's going through, "I'm going to die" stage and he's very angry and because I'm the closest to him, understandably I've become a bit of a battering ram. Hopefully after his next consultation, which I believe to be this coming Thursday (but he's being evasive even about his appointments) he will feel more focussed. 


Sorry but I've not been on much the last few days. I'm just feeling mentally drained... that sounds selfish :( I know I need to be strong but right now I'm not sure how to be. 

User
Posted 21 Oct 2018 at 19:09

We now have a copy of the letter from the urology clinic to our doctor. It goes as so:


Diagnosis: Intermediate risk adenocarcinoma of prostate T1c disease Gleason 4+3; presenting PSA 19.33


MRI shows PI-RADS 5 - T3b NOMX


Lower urinary tract assessment -IPSS 24 quality of life 4;


Q-max 19.4 m/second in voided volume of 157 ml with PVR of 120ml


WHO 0 ASA 1 BMI 26 (weight 89 kilos, height 82cm)


We understand that adenocarcinoma is the type of cancer and we understand the PI-RADS and T3b NOMX but what is IPS 24 quality of life 4? and what is T1c?


 

User
Posted 21 Oct 2018 at 19:56
It just means that your MRI result indicates that it is more advanced than the biopsy suggested
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 21 Oct 2018 at 20:03

Hi, 
I suspect the T1c was an initial diagnosis before the MRI scan... which then uprated to T3b N0 MX 
I'm obviously no expert... but with a PSA of 19.33 I'd be very surprised if it had remained at T1c .. 

I started out as a T1 ...but then progressed clinically to a T2b .... Finally after an RP my histology showed that I was in fact a  pT2c .. 
The Gleason score can also differ after analysis in the lab .. 

Best Wishes 
Luther 
 

User
Posted 21 Oct 2018 at 20:06
Hi Marie, good luck with the appointment. I found that recording it on the mobile phone helped and was good to listen afterwards. Once you no what OH is tackling and have a plan it place, I found it got easier. It’s never easy for you or OH but talking about it did help me. Also the normality of working and getting the on with things helped. I continued working through my chemo, just taking to odd day off when my body told me to, or when Christine did. Also don’t know what OH does for hobbies but keep the exercise up is very important, I found! Clears the head and soul!
Good luck for the appointment.
Steven
User
Posted 21 Oct 2018 at 20:42

Thanks for the responses and the links Mr Angry.


We both work full time Steven and we will both continue to work full time if we can. We are rock climbers haha. Rock climbing takes a lot of concentration and stamina so we may have to come down a few grades. We are also cyclists which may need to be modified to how S is feeling. As I've always struggled on behind him, dropping down a gear may frustrate S but it will be good for me. 

User
Posted 22 Oct 2018 at 01:27

Hi Maria,


I just read your profile in full and wondered how you got that skin cancer. Did you do a lot of nude sunbathing whilst doing handstands?😉


Seriously though, you don’t say how old Mr Maria is. (I just re-read your first post and I see he’s 53 - unlucky, but we do see guys here in their forties)


As for “who your friends are”, when I was diagnosed nearly a year ago, two of my closest friends in their seventies and eighties came out and said: “Oh, I’ve got it too....” - they both had kept it secret from everyone - and others would text me in sympathy and treat me with kid gloves when meeting them as if I had a death sentence.


Bearing in mind I had no symptoms before diagnosis and now post-op I have never felt so well, aged 62 and 3/4. So my prognosis is good, and my oncologist told me I am cured. Not sure I believe him though.....


I hope everything goes as well for you and Steve. I have a vision of you on an endless loop climbing like Gollum from “ Lord of the Rings”!


Best of luck, my precious.


Cheers, John.

Edited by member 22 Oct 2018 at 02:15  | Reason: Not specified

User
Posted 22 Oct 2018 at 09:52

Hi Maria


I'm a rock climber and self employed too!  I had the surgery, followed by hormone treatment and radiotherapy.  My climbing did suffer (obviously!), and the fatigue made work challenging, but almost just about manageable.  It was hard though.


Two years on, and I'm now back to fully fit, climbing hard again and working much longer hours.  And enjoying it!  It is a slow-ish recovery, but life really is not written off.  A few small changes for the side effects of all the treatment, and on we go.


Hope it goes well for the two of you.


cheers


Graham

User
Posted 22 Oct 2018 at 20:26

Thanks John, your post made me laugh. I'm glad you are doing well. 

User
Posted 22 Oct 2018 at 20:35

Hi Graham and wow, another adrenaline junky! Where do you climb? 


I think in some ways its tougher when you are self employed. Did your business suffer? S's business is still quite young and so still establishing itself. That said, he's got a good team of men who are more than capable of holding the fort for a while.


Glad to hear you are back on the rock (love the picture) and working harder than ever. You are all so inspiring.


 


 

User
Posted 22 Oct 2018 at 20:40

So Addenbrooke's had its meeting today and Steve got a phone call to say Addenbrooke's would happily carry out robotic surgery with RT follow-up. We are going to talk to them on Thursday and it would be great if any of you could give advice on the sort of questions we should be asking regarding surgery.


We also have an appointment the following Wednesday to talk about another option which is hormone treatment and RT. 


I don't know if anyone has seen that very good article in The Times today? Its about a breakthrough for prostate cancer. There's also this article in The Irish News https://www.irishnews.com/news/2018/08/08/news/breakthrough-trial-for-prostate-cancer-patients-leads-to-massive-reduction-in-radiotherapy-treatment-1401895/

User
Posted 22 Oct 2018 at 21:47
The most important question now is to ask the urologist to explain what the benefit is (in their view) of having surgery and radiotherapy / hormones - with the associated side effects of two radical treatments - when you could just have radiotherapy / hormones and one lot of side effects. And then ask the oncologist whether they believe there is a benefit in having surgery as well as radiotherapy.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 23 Oct 2018 at 16:03
Hi Maria, sorry to jump on this thread but I've just read Lyn' s latest comment and have often wondered why my dad (who's T3b) has never been offered surgery to remove the prostate, just radiotherapy which he's currently undergoing and hormone therapy? Perhaps it depends on the hospital/region? Could you perhaps shed some light Lyn? TIA
User
Posted 23 Oct 2018 at 20:23
That sounds like a logical reason Mr Angry. When dad was first diagnosed he was told by the Urologist his PCa was T3b, N0, M1 (spread to pelvic bone in 1 spot on scan) however upon meeting the Oncologist 2 weeks later he was told the bone metastasis was more likely a benign bone island. Her words...... "we are going to give it the benefit of the doubt." So instead of starting a course of early chemo back in May, his treatment plan was changed and he started 7.5 weeks of radio last week, with it being treated as locally advanced rather than advanced PCa. This stressed me a little because I was thinking if they're wrong and it is in fact advanced, his life span may be reduced even more by the lack of early chemo, however this latest news based on recent trials about how radio, alongside hormone therapy, is proving beneficial to men with advanced PCa has given me some comfort. I guess in these situations Maria / Mr Angry we have little option but to place our faith in the Specialists to offer the best treatment they can with the resources they have. I'd certainly be asking more questions though Maria before your husband decides whether to take the surgery route. It sounds like he has been given more options than some other guys with a similar diagnosis. X
User
Posted 24 Oct 2018 at 00:08
Generlly speaking, men having surgery with a T3 are more likely to need adjuvant or salvage RT/HT and operating on a known T3b is much less likely to be successful than trying to remove a T3a. On the other hand, there is more chance of achieving remission with RT/HT as it can be targeted to include the suspect areas.

It may in part come down to side effects as well - men with T3 are less likely to be able to have full nerve-sparing so ED is almost guaranteed and incontinence is more likely (although not certain) whereas RT may not lead to the same side effects and if they do, perhaps not for some years.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Oct 2018 at 07:35

Interesting study may help reassure that RP is the best choice for locally advanced cases:
http://prac.co/l/ya6j327c


 

User
Posted 24 Oct 2018 at 10:34
It was reported again at this year’s uro-oncology conference that surgery will eventually be stopped for PCa and all men will have versions of radiotherapy / cyberknife / nanoknife / etc.

In 2016, I remember the keynote being along the lines of “future generations will look back in horror” that we used to be barbaric enough to remove the prostate surgically. I suppose this is parallel to the change in breast cancer treatment in recent years; even friends diagnosed with aggressive BCa have had lumpectomies with adjuvant RT/HT and with or without chemo ... mastectomies are no longer routine except in the most aggressive, high risk cases.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Oct 2018 at 20:16

Thank you Lyn, I've now got a whole bunch of questions to ask tomorrow. I hope he decides to go with HT and RT and not surgery but at the end of the day, its him that has to make the decision. All I can do is raise his awareness about the pros and cons. 

User
Posted 24 Oct 2018 at 21:43
Don't think I am saying 'don't have surgery' - I just would want to know why they think it is worth the additional risks. My OH had biochemical recurrence after the op and ended up needing RT/HT anyway and yes he regrets the RP but even if we could turn the clock back, I know that nothing, NOTHING would have made him make any other choice at the time.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 25 Oct 2018 at 00:05
Lyn apart from a relationship with hormones and a propensity to metastasize to bones I don't think there is any comparison with breast cancer. The average "lumpectomy" would take an area of tissue larger than a whole prostate gland. Prostate cancer is renown for being multifocal too (70% v 12%?) So is more likely to require whole gland treatment.

Mr Angry retrospective studies can only report retrospectively? Yes you can take advantage of new treatments but basically the current options for whole gland treatment for T3 are the same as they have always been radiate or remove, the study was looking at the outcomes for guys who made those choices. Contrary to what I expected RP showed clear advantages if your goal is longevity and freedom from HT.

Hopefully one day less barbaric treatment than surgery or ionising radiation will be available currently they are not.
User
Posted 25 Oct 2018 at 00:10
No, that wasn’t my point - until recently they removed the whole breast but now are more likely to focus on radiotherapy, hormones and for high risk cases, chemo. Lumpectomies can take a very small area and while I can’t imagine urologists ever developing a technique for removing just the affected area of a prostate, who knows what will happen in the future.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
 
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