On the basis of several months of heavy research I opted for the treatment route that I felt would afford the best chance of dealing with my cancer paying little regard to potential side effects. (For some men the latter would carry more weight in their evaluation.) The problem for me and for many is that we can't be certain in many cases whether the cancer is well contained or has migrated even in microscopic form and where there is spread/mutation how any such spread will become a serious problem within the likely natural lifespan of an individual. Even after 10+ years since treatment I don't know whether I did the right thing. Had my cancer really spread outside the Prostate and if not might surgery have done the job completely? But subsequent scans have shown that there is no evidence of cancer outside my Prostate so was there never a migration or did the HT/RT deal with this? However, scans years after the primary HT/RT treatment have shown that either some cancer cells were radio resistant and lived on or that new cancer cells had grown within the Prostate. So in my case, in retrospect, it might have been better to have had surgery to remove the Prostate and RT to deal with any real or likely immediate spread even if the RT might have been over treatment.
With a low but rising PSA and scans again showing a small tumour in my Prostate, I did consider a Prostatectomy - a few surgeons will do this after RT but I decided against because at that stage I was told there was almost 100% chance of permanent incontinence which was a major concern for me. In the event I opted for HIFU in 2015 as salvage treatment for failed Radiotherapy. However, one or more tumours have again been identified in my Prostate by PSMA and MRI scans. Whether this/these tumour(s) is/are new or the HIFU did not do the job I don't Know but will ask next week when I am due to have another Template Biopsy. There is then the possibility of further Focal Therapy, probably further HIFU or Cryotherapy if what is found merits further treatment.
The foregoing illustrates how difficult making a treatment decision can be, particularly for men at a more uncertain stage rather than for those diagnosed at a very early stage where the cancer is believed to be well contained or for those whose cancer is strongly believed to be advanced and RT if given at all is needed to be dealt with by systemic treatment.
Edited by member 24 Nov 2018 at 01:00
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