Decisions, decisions.....

Hi all,
Well, I’m new to this club but thought I’d share some of my experience so far. Where should I begin?
I’d previously had no symptoms so I didn’t have any idea that anything was going wrong inside me. However, I had the chance (through my work) to get a full BUPA medical and I thought ‘why not?’ It seemed like a great opportunity to get myself checked over – I’m 56 and in reasonably good health.
On the day the medical was very thorough, including cholesterol tests, ECG, the works. All the results were very normal – I just had to wait for the results from the blood tests.
This is where the problem started – all the tests were fine but my PSA was 7.1 so I was recommended to get this checked out. At my GP, the test was 6.5 – still too high.
Both the Doctor at the medical & my GP did a DRE but didn’t think there was any issue. However my GP referred me to a Urologist who did think the prostate was a bit enlarged (I think its been sized at 41) and that there was a hint of a ‘bump’.
First step was an MRI scan which showed a ‘small suspicious area’.
Following this was a biopsy which unfortunately revealed that on the left side of the prostate, 2 out of 5 samples showed cancer. This was Gleason 8 (4+4). On the upside, it looks localised and was graded a T2B.
Clearly ‘something needs to be done’ which I expected to be a pretty straightforward decision to do an RP.
Since then I have seen an Oncologist who was more optimistic than I’d expected. He feels that I'm a slightly unusual case - my PSA and T score are medium risk, but the cancer is aggressive and thus high risk. Accordingly treatment is a good option and offered:

1. 5-6 months hormone therapy by monthly injection, then:
2. Seed Brachytherapy swiftly followed by:
3. 5 weeks External Beam Radiotherapy

He felt this would have a high chance of success and would retain the prostate (or at least what might be left of it after all that).
My concern would be the side effects – each of these treatments has possible effects. I’d imagine having all three treatments ongoing over the same time could increase the likely effects.
Has anyone experienced such a combination of treatments??
My next step is a bone scan (to see if anything has spread although it’s considered unlikely) and a chat with the surgeon to get his view on an RP. After this, I will have a difficult decision to make...….

It's always interesting to read how individuals respond to their respective treatments but it should be remembered that they do not necessarily represent the experiences of many men. Let's say, as has happened, a member said he was permanently incontinent following surgery. You might think, I won't have that treatment then. However, permanent rather than temporary incontinence is very rare but is a possibility you will have to factor in along with other pros and cons when making your treatment decision.

Suggest you list the Pros and Cons of each form of treatment as shown in the 'Toolkit' and can be found elsewhere and also try to establish whether in the case of surgery this would be by 'nerve sparing' to increase the chance of preservation of sexual erections and how likely it would be that surgery might have to be supplemented by HT/RT.

Wish you well in making your choice.

Best of luck with the op. I went through a very similar anount of hand wringing and as you no doubt discovered,  there’s no easy way to come to a conclusion even with the masses of data out there.

My own story is here: https://www.facebook.com/connell.mcmenamin/posts/10214747181606087

thankfully, so far I've come out the other side with a good result and limited side effects (which continue to improve).

The only advice I would give is take it easy with your recovery. You may look and feel surprisingly well, but it's easy to overdo things. I thought I felt back to normal after about 6 weeks, but at 12 weeks I felt so much better. 

hope it all goes well!

Connell