Da Vinci - Have I made the right decision?

I am sorry John but no one can tell you if you are making the right decision as no one can predict the outcome of your treatments. They certainly seem to want to throw the kitchen sink at it. Have you discussed your situation with an oncologist.? Are they keen for you to have surgery too? Has your case been discussed at a MDT  meeting. Both treatments means two sets of possible side effects.

I think some men with your pre op stats would go the HT/ Radiotherapy route rather than put themselves through surgery as well. Of course some men  go for surgery then need HT/ Radiotherapy later anyway.  What did you mean when you said your surgeon would like another victim? You shouldn't feel obliged/ bullied into surgery  to please the consultant.

I have read that there is good evidence to remove the" mothership" even if it does not clear all of the cancer in one hit as it can give you extra cancer free time in combination with HT/ RT.

I am  sure more  experienced people with will come along to give you their views.

Best Wishes

Ann

Hi CB, I agree with previous comments that before making any decision you have spoken to an oncologist as well as your surgeon to get their take on things.

The final decision is ultimately yours but have a look at this https://prostatecanceruk.org/prostate-information/just-diagnosed/locally-advanced-prostate-cancer

With seminal vesicle involvement the operation is slightly trickier and there is a fair chance you would require follow up hormone therapy and radiotherapy. This places you at a Stage  3b or T3b.

On the plus side the removed prostate etc, would be thoroughly examined by pathologists and allow for more accurate staging.

You are in the right place for information and advice.  Would also suggest you telephone the PCUK nurses on 0800 074 8383. They are marvellous.

I would add to the recommendion to see an oncologist before making your final decision. It is your choice, and the HT/RT route can be gentler in terms of side-effects.

Hi, Like you I had surgery on skin cancer, though non-melanoma, and was advised it was the gold standard.   Although they say outcomes are very similar with Prostate Cancer for surgery and radiotherapy.

Also it would be unusual for a case not to be reviewed by an MDT and it appears they've said you will have both surgery and radiotherapy.    It's unlikely you'll have surgery after radiotherapy and unlikely you'll have it when you're over 75 unless you're exceptionally fit.

There are papers that say getting rid of the main tumour, i.e. cutting it out,  is beneficial in the longer term.

It's often said Prostate Cancer is slow growing but with a 4+3 it might not be the case and actually having surgery will let you know if 4+3 is genuine as mine was upgraded to 4+4 with a proper pathology test, or maybe a later time.  Upgrading isn't unusual.

Having second thoughts isn't unusual either as I kept thinking it but if it complicates matters and raises suspicions about your doctors and them about you it might not be for the best.

So assuming you've been through a standard procedure and will have surgery followed by radiotherapy going with the flow could very well be the safest route.

Also having radiotherapy quickly after surgery is called adjuvant radiotherapy and for most cases has superior outcomes to having just the one treatment although it's usually only given to cases with the potential of recurrence.  Having radiotherapy after it's recurred is called salvage radiotherapy and the outcomes aren't as good.   So your case looks like good treatment.