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Advice on treatment outlook

User
Posted 26 Jan 2019 at 18:43

Just recently diagnosed with PC  I am 47 and had a PSa of 21 and 19, my bone scan is clear and my DRE was fine, I have had a pet scan at the london clinic on Thursday and a template under general anaesthetic yesterday, the consultant urologist told me before biopsy that the Pet scan showed one suspect lymph node, has any body had the RP with lymph removal

Also should I see an oncologist as well or does it seem RP is the best option

Thanks in advance

User
Posted 27 Jan 2019 at 01:14

You will know more when you get your biopsy results. Radiotherapy is so effective these days that the outcomes are similar to surgery, so yes, see an oncologist too.

I had two out of twelve lymph nodes cancerous, but am still all clear seven months after prostatectomy.

I urge you you order the information folder called the ‘Toolkit’ from PCUK.

Best of luck.

Cheers, John

https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit

Edited by member 27 Jan 2019 at 01:16  | Reason: Not specified

User
Posted 27 Jan 2019 at 07:41
If they have seen you have spread to a lymph node it’s likely they won’t offer you the surgery path at all , and instead be offered HT/RT combo by Oncologist. I had surgery and 5 of 18 lymph’s were cancerous, but they didn’t know beforehand. I’m currently in the s**t so to speak with rapid psa rise. I was 48 at surgery. I wish you luck

If life gives you lemons , then make lemonade

User
Posted 27 Jan 2019 at 10:04

You should definitely see the oncologist too. They have a different perspective on things, and the difference is useful in throwing light on what really matters to you.

As has been said, your choices may already be slightly limited - but you need both sides of the story.

The outcomes are broadly similar, as Bollinge said, but the possible side effects and risks are very different. It's vital you get the maximum input, so that where there are choices, you make the best one for you.

This is not quite the same as 'the right choice' - but in PCa, there isn't just one 'right choice'; it always depends on your lifestyle, age, expectations, etc.

The toolkit is a great place to start.

Edited by member 27 Jan 2019 at 10:05  | Reason: typos, clarity

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-- Andrew --

"I intend to live forever, or die trying" - Groucho Marx

User
Posted 27 Jan 2019 at 11:25

Did you know there was cancer in the lymph nodes before surgery. 

My consultant has said it is in one as it showed after the Pet scan 

What do you feel your prognosis is 

User
Posted 27 Jan 2019 at 12:06
If you mean me, the spread to the two lymph nodes was only evident following the post-operative biopsy of what they removed.

One oncologist told me I am ‘cured’ - what a silly thing to say - and another one assured me ‘It won’t kill you’.

The statistical prognostication of the Memorial Sloane Kettering Hospital Nomogram says I have a 96% of living over 15 years, given my specific condition, by which age (78) I might be dead of something else.

So to be frank, my diagnosis has not really bothered or worried me at all, even from the first raised PSA figure 14 months ago. So whilst my PSA remains undetectable, I am carrying on being cured.

If I had had liver, pancreatic or lung cancer, I would have a totally different mental outlook!

As I said before, you’ll be much wiser when the biopsy results come through.

Cheers, John.

User
Posted 27 Jan 2019 at 16:56
There is a massive difference between possible cancer in a lymph node in or near the prostate bed and possible cancer in a more distant lymph node.

If the surgeon has suggested that it can be removed during the RP then it is not so bad. Some surgeons remove a number of lymph nodes (or even all nodes in the pelvic cavity) routinely, regardless of whether any looked suspect. Other surgeons remove them only if there is a reason to think they are cancerous. At our hospital, they don’t remove lymph nodes during keyhole / da Vinci RP so suspect nodes means the man is diverted to open RP so the surgeon can get a good look round.

The only downside to having a number of nodes removed is the risk of lymphodema later, which is why many surgeons only take them if they have to.

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

User
Posted 27 Jan 2019 at 23:43
So if going with surgery suggest you ask Surgeon beforehand about his/her attitude towards removing more than apparently affected nodes.
Barry
 
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