Husband recently diagnosed - struggling with treatment options

There are some really good nomograms that will give you an insight into the risk associated with prostatectomy and biochemical recurrence for his initial biopsy and staging here:
https://www.mskcc.org/nomograms/prostate

Other decision making factors are:
Nerve sparing yes or no?
Has he been recommended for adjuvant radiotherapy?

The really big bonus of surgery over RT at this stage is not having to have hormone suppressants AND you will get a complete pathology that us simply not possible with RT.

The reason your consultant cannot make a recommendation is RT and RP have similar outcomes at your staging. You need to understand the side effects of both and decide which is the least worst option for you.

Edited by member 28 Jun 2019 at 06:22  | Reason: Not specified

Thanks Christian, good advice, the decision you make is the right decision at the time, and you'll never know what the alternative could have been so no regrets. The challenge now is making the decision....

1) There are a number of types of PCa, some say at least 27 and these affect men differently according to their individual cancers , staging and reaction to various treatments. That being the case, an individual does not know with certainty how he will respond to a given treatment(s) in terms of being successful in eradicating it or slowing it down and how bad the after effects will be. So a man should not be swayed by how a few men say they have fared which may be due to factors that don't apply to an individual. Nomograms are based on averages and as we know this means some do better and others worse than an average.

2) As regards RT, this largely takes the form of External Beam Radio Therapy (EBRT) of which there are several versions with some using more advanced machines and ways of delivery. There are 2 ways of delivering RT by Brachytherapy, low dose by radioactive seeds and high dose by inserting radioactive probes into the Prostate and then withdrawing them as part of the operation. Both of these Brachytherapy methods can be supplemented with EBRT if considered appropriate. For suitable candidates Brachytherapy is becoming more popular but not every hospital can administer it. Where this is the case consultants at those hospitals might not even mention the possibility, so a man could ask whether he is suitable and where he could have such treatment elsewhere if he wishes to consider more options.

Hi Dasha,  

I've written my own opinion for my own case on this several times.   I wanted it cut out as soon as possible.  I still believe in that although now realise sometimes HT/RT can be a better solution in some cases depending on the chance of it being outside the prostate and where it is.

You can frighten yourself reading a lot things. There is always a chance of recurrence although as you probably know it gets higher as Gleason, Stage, pre-op psa increases.  Although I've always hung on to the size and margin being something to consider and actually after an op you can find out more about it.   If you really want to know, I wasn't keen on asking too much although some have full print outs.

We have a knowledgeable person called Lyn who lives on that side of the Pennines like you, and I seem to recall her opinion was it's better to have RT if there is a high risk of recurrence rather than go back.  Although I'd feel sure she would put caveats on that.  My own opinion is I'd prefer both treatments if there was a strong case, but I'm a belt and braces sort of person and the type of person figures in the treatment consideration.

Some people worry about after effects whereas my priority was the best treatment whatever.

 I just noticed your appointment is with an oncologist.  When I had the urologist appointment he said if I chose RT they'd give me a hormone injection almost right away.   As it was I got him to ring the surgeon right away.  If I was in your shoes and thought an operation was likely I'd be trying to get the urologist to speak to the surgeon.  No point in keep waiting for appointments to talk about treatment. when you could be having treatment.   All the best, Peter