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User

Posted 11 Jun 2019 at 16:48

So my husband had his appointment today to discuss prostate removal. His Gleason score is 3+4 ( I think that's how you say it). We've come away completely deflated as he has been told he need a to lose 2 stone before he can have the procedure (robotic) and he has to go back in 3 months. He has been told the cancer is very unlikely to worsen in this time as he was also offered AS if he wanted but we are still worried that waiting could cause a worsening. Anybody else been in this position?

Thank you

User

Posted 11 Jun 2019 at 19:46

Sorry you've arrived here, but you will get excellent support.

Prostate cancer tends to move slowly, and 3 months is not normally significant for a Gleason 3+4, although that also depends on details you haven't given us.
It would help to answer in more detail if you create a bio with more details, such as PSA scores/dates, results of the biopsy in terms of positive cores and extents, scans clear?, staging (e.g. T2?N0M0), etc. Click on my avatar to see an example.

There are two things to look at, exercise and diet.

How able is your husband to exercise? e.g. how far could he walk? Is he quite fit? Does he have a bike and cycle? Does he enjoy swimming? Does he have any health issues which prevent exercising?
Might be worth finding a personal trainer who can design a program for your husband if he's up to it.
Besides losing weight and getting fit, exercise is also known to slow the progression of prostate (and some other) cancers, and is important for those on AS too, as it significantly extends the time before intervention is required.

Then there's food, getting both the calorie intake correct, and ensuring it is of good nutritional value. It's not just a question of eating less because that can leave you malnourished, but eating the right things. Again, your personal trainer will make recommendations about food if they know what they're doing. There are some foods thought to be good or bad from a prostate cancer point if view, but initially I would just concentrate on dieting for weight loss and good nutrition - a diet for prostate cancer sufferers is a second order issue which you could look at once you get the weight issues solved.

If you can get exercise and diet correct, you could do it in 3 months, but it will be a challenge.

Edited by member 11 Jun 2019 at 19:49 | Reason: Not specified

User

Posted 11 Jun 2019 at 20:58

Also, some links on the PCUK website:

Diet and exercise support

Your diet and physical activity

There are more. Search for Diet.

User

Posted 11 Jun 2019 at 21:31

Thank you Andy62

User

Posted 11 Jun 2019 at 22:32

I waited four months for my surgery, our hospital was having the then new Da Vinci equipment installed. I lost one a half stone just by cutting out the cakes and biscuits.

Thanks Chris

User

Posted 12 Jun 2019 at 19:43

In my post-surgery appointment, my surgeon said that he encountered no problems (technically) while operating on me, and that I was easier than most. I asked what makes it harder, and, with all his legendary bedside manner, said "being fat". I guess I felt pleased I wasn't carrying too much extra weight, as anything that can improve possible outcomes can only be good.

Since then, I have had radiotherapy (positive margins and lymph involvement) and hormone treatment. During that process, I put a stone on which I wasn't best impressed with. So I went on a diet and lost a stone and a half in four months (12.5 stone down to 11). It wasn't so much what I was eating, although I did keep an eye on that, I just ate a lot, lot less. I was hungry most of the time, but that would not kill me. Small portions, start later in the morning, and no food after 6.30pm. I've since heard this is a 8:16 diet!

Good luck, hope all goes well for you.

User

Posted 13 Jun 2019 at 07:11

Losing 2 stone in 3 months is easily achievable - I’ve done it myself. There’s no magic to it. Consume fewer calories than your body burns and the weight will come off. Cutting out the cakes and biscuits is what worked for me!

Best wishes,

Chris

User

Posted 15 Jun 2019 at 16:12

Also consider intermittent fasting and alternating carbs and protein on different days if you want a faster progression

User

Posted 15 Jun 2019 at 16:41

It's a matter of willpower, basically. If you're used to eating until you feel full up, being constantly hungry is something that requires a change in your mindset. It does take self-control. I struggle late at night particularly (and, I have to confess, occasionally succumb to it). I find, though, that after a few weeks you get used to it and it becomes easier. The key for me is not to have any cakes or biscuits in the house, so if I do fall off the wagon I eat something slightly less bad, like bread, to fill me up.

Cheers,

Chris

User

Posted 15 Jun 2019 at 20:06

Thanks for all your replies. I know it will be difficult for him to change the last 50 years of eating habits but he seems determined to do it. I am just worried that delaying the operation by 3 months will result in a progression of the PCa.

User

Posted 19 Jun 2019 at 13:39

It is slow growing in most cases and weight loss to reduce risk is more important that rushing into an operation when overweight

User

Posted 19 Jun 2019 at 14:40

They always say Body Mass Index is one of the factors in the success of radical prostatectomy. I have never really understood why, unless thick layers of fat are more likely to harbour rogue metastatic cancer cells after prostate excision.

Can anyone enlighten me?

Anyway, Melanie, your Dad will do no harm by losing weight.

Best of luck to you both.

Cheers, John.

User

Posted 19 Jun 2019 at 15:02

I don't think that's specific to prostatectomy.

When I was having my pre-op check 2 weeks before template biopsy, the room had loads of people for completely different ops who had been told they were too heavy to operate on - come back in 3 months when you've lost weight. The anaesthetic is more difficult, access to the organs is more difficult, recovery is more difficult, etc. It just piles on an additional set of risks, less favourable outcomes for the patient, and more likely to need additional acute resources and/or longer stay during the hospital visit.

User

Posted 19 Jun 2019 at 16:53

Do you know how high your BMI has to be before they won’t operate? When I had my nephrectomy operation last year, my BMI was about 33 and nobody commented on my weight.

Cheers,

Chris

User

Posted 19 Jun 2019 at 21:58

Just looked back at my theatre paperwork for the template biopsy, and it says acceptable BMI is between 20 and 33 (this is not specific for template biopsy, but for any general surgery). Also max allowable weight of 115kg/18stone for the theatre I was in (from which I presume other theatres may have different limits).

I guess there may be lower limits for specific operations, and I could imagine keyhole surgery where they have to balloon out your abdomen with gas could be such a case.

There are also a couple of risk scoring systems which factor in things like BMI, Diabetes, unplanned weight loss in last 6 months, blood pressure, co-morbidities, age, ethnic background, waist circumference, etc and come out with scores, and if you exceed certain limits, approval is needed from progressively higher authorities to proceed.

My blood pressure suffers badly from white coat syndrone, and when I see my GP, I always take my home readings in. Unsurprisingly, it was sky high on the pre-op assessment 2 weeks before. They used the home readings I brought in, keeping me within the allowable limit. Really strangely, on the day of the op, my measured blood pressure was perfect - the one day I would have expected the worse white coat syndrone, it completely vanished. It's never done that before or since. After the op it was low, but that's the effect of the general anaesthetic and they told me to stop taking my blood pressure meds for a few days.

Edited by member 19 Jun 2019 at 23:07 | Reason: Not specified

User

Posted 19 Jun 2019 at 22:17

Hi I was in a similar situation being a little tubby before radical robotic prostectomy I cut out all carbs , (rice pasta bread potatoes and sugar ) and lots of crap food ... I had steak eggs chicken lamb pork fish etc with veg that’s grown above the ground ... cabbage cauliflower greens etc .. difficult for the first week but it’s a mindset change and tbh I lost nearly 2 stone and since my op I’ve managed to keep it off ... and still enjoy a good fry up ... just no beans

I hope it all goes well for you

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