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User
Posted 29 Sep 2019 at 22:37

Diagnosed 7years ago now psa rising, considering surgery, but have had radiotherapy and brachytherapy and worried about risks 

User
Posted 30 Sep 2019 at 22:05

Andy, your last point about the adhesions, is what worries me, the first time I spoke to my surgeon he was dead against it, but he went away to talk to a colleague and two minutes later he was all for it, I feel really confused!

User
Posted 01 Oct 2019 at 14:42
Radiotherapy essentially turns the prostate to mush and makes a clean surgical separation from the surrounding tissue extremely difficult.

Best wishes,

Chris

User
Posted 04 Oct 2019 at 11:08

Originally Posted by: Online Community Member
Thanks Andy, have recently had a biopsy and pet scan, due to see oncology next week then the surgeon week after. The surgeon in question has done many of these procedures and comes highly recommended, but I now have reservations after reading many stories on this forum,  and would now like to know what other treatments are out there 

Garyga

Hi Gary, why not print a copy of the concerns you have and the views and opinions expressed here and take this with you to your next meeting?  You can then ask specific questions about the concerns and make notes on the reply given.

You may also consider that the best "advice" is given by the qualified in response to and after due consideration of  questions posed by the subject dealing with the issue.  Bear in mind that forums may have more people who have had issues than those who sailed through? 

What ever you decide, only you will live with the consequences, so think well and choose wisely.

atb

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 13 Apr 2020 at 15:07

I wish you well Carl and hope you do not have to wait too long, I find the waiting very hard, it gives me too much time to think!

User
Posted 13 Apr 2020 at 15:16

Thanks for your reply, before surgery my surgeon thought there might be some cells outside the prostate, after the pet scan my psa was 1.1, and has risen to 1.2, am due another psa test in the next month, so it’s a wait to see if has gone up 

 

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User
Posted 30 Sep 2019 at 08:51

Gary,

It would be useful to know your original diagnosis, what areas the external beam (I presume?) radiotherapy targeted, and subsequent PSA history.

You really need to know where the cancer growth is, which requires a scan of some type, and that depends what your PSA is. (Scans need a reasonable PSA to stand a chance of seeing anything.)

It's unusual to have surgery after radiotherapy. There are two reasons for this:

  • The cancer spread is less likely to be in the parts treated with radiotherapy.

  • The prostate will not be in a good state for surgery after radiotherapy - it very likely has adhesions joining it to neighbouring tissues, and most urologists would not contemplate surgery at this point.

 

User
Posted 30 Sep 2019 at 10:29

Gary

As already mentioned surgery post RT is not the norm. By coincidence the following article appeared a few days ago. Finding a surgeon to do the op may be an issue.

http://links.mkt1881.com/ctt?kn=14&ms=NjA1MjkyOTAS1&r=NDAwNTU0NjMwODE1S0&b=0&j=MTcyMzU0OTcxOQS2&mt=2&rj=MTcyMzU0OTcxOQS2&rt=0

Thanks Chris

 

User
Posted 30 Sep 2019 at 20:42

Thanks Andy, have recently had another biopsy and ct scan, it is the state of the prostate that is worrying me most. 

User
Posted 30 Sep 2019 at 20:43

Thanks for thesis article, interesting 

User
Posted 30 Sep 2019 at 22:05

Andy, your last point about the adhesions, is what worries me, the first time I spoke to my surgeon he was dead against it, but he went away to talk to a colleague and two minutes later he was all for it, I feel really confused!

User
Posted 30 Sep 2019 at 23:03

Do you have any evidence the active cancer is in the prostate? If so, how?

If you want a prostatectomy of a radiated prostate, you probably need to find a surgeon who does this procedure routinely (or at least occasionally), and will know what to expect and what the outcome is likely to be.

User
Posted 01 Oct 2019 at 14:29
Also be aware that RP after radiation is always non-nerve sparing and the risk of incontinence is also much higher.

I think if you were my dad or brother, I would want detailed scans showing that the recurrence is in the prostate before agreeing to have an operation that is going to be messy and possibly unsuccessful.

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

User
Posted 01 Oct 2019 at 14:42
Radiotherapy essentially turns the prostate to mush and makes a clean surgical separation from the surrounding tissue extremely difficult.

Best wishes,

Chris

User
Posted 03 Oct 2019 at 18:32

Thanks Andy, have recently had a biopsy and pet scan, due to see oncology next week then the surgeon week after. The surgeon in question has done many of these procedures and comes highly recommended, but I now have reservations after reading many stories on this forum,  and would now like to know what other treatments are out there 

Gary

 

ga

User
Posted 03 Oct 2019 at 20:22

If it is believed that the cancer is confined to the Prostate, 2 options may be possible apart from surgery, HIFU (perhaps TULSA - PRO version) or Cryotherapy. If the cancer is outside the prostate, neither of these 2 possibilities nor surgery will eradicate the cancer. So before taking this step I would suggest you have a 68 Gallium PSMA scan (now available on the NHS at some facilities which can help establish if/where in bone or tissue other PCa is in the body. It has to be appreciated that about 8% of men do not sufficiently express PSMA for the scan to work and that PCa cells have to be of a size or sufficiently concentrated to show up so not definitive.

Edited by member 03 Oct 2019 at 20:25  | Reason: Not specified

Barry
User
Posted 04 Oct 2019 at 11:08

Originally Posted by: Online Community Member
Thanks Andy, have recently had a biopsy and pet scan, due to see oncology next week then the surgeon week after. The surgeon in question has done many of these procedures and comes highly recommended, but I now have reservations after reading many stories on this forum,  and would now like to know what other treatments are out there 

Garyga

Hi Gary, why not print a copy of the concerns you have and the views and opinions expressed here and take this with you to your next meeting?  You can then ask specific questions about the concerns and make notes on the reply given.

You may also consider that the best "advice" is given by the qualified in response to and after due consideration of  questions posed by the subject dealing with the issue.  Bear in mind that forums may have more people who have had issues than those who sailed through? 

What ever you decide, only you will live with the consequences, so think well and choose wisely.

atb

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 10 Apr 2020 at 22:58

Sorry not posted for a while, but we all cope in different ways I guess. Last thing I posted it was to say I was considering surgery, on the 31st of October I had the surgery, all went well with no complications, but on going back to oncology on Christmas Eve, was told PSA had risen very slightly, next oncology appointment had also seen a rise in PSA, have been for a PET scan to see if they can determine where in the bone the cancer is. On the plus side much to my surprise my bladder control was very good after a few weeks, but I seem to go three steps forward and one back! On the whole I feel quite happy but with reservations? Hope all of you going through this keep positive x

User
Posted 11 Apr 2020 at 07:49

Hi Gary

sorry to hear that your psa results aren’t what you expected, I know it’s easy to say but try not to worry to much. The most important thing is you’ve had the surgery and you have had no complications, which is very positive. I think all of our problems with post or pre op surgery is the worry. I’m waiting for my surgery I had my pre op done 4 weeks ago right at the start of the covid 19 outbreak, so it’s very uncertain and worrying times. I’m trying to keep busy to stop myself from dwelling on things to much, especially being in lock down.

Good luck with the future and keep us posted

Stay strong stay safe....

Carl

User
Posted 11 Apr 2020 at 10:06

Hi Gary, what was your post op histology, for example was the cancer contained? What values of PSA are you seeing?

What type of PET scan did you have? 

Much will depend on whether the PET scan picks up anything. If you read my profile I had hormone therapy and salvage radiotherapy after surgery. After PSA rose to 0.7 I had an F18 choline PET scan, mpMRI, and a bone scan to allow decisions to be made.

I was on HT for 21 months or so.

Best wishes,

 

Ido4

User
Posted 13 Apr 2020 at 15:07

I wish you well Carl and hope you do not have to wait too long, I find the waiting very hard, it gives me too much time to think!

User
Posted 13 Apr 2020 at 15:16

Thanks for your reply, before surgery my surgeon thought there might be some cells outside the prostate, after the pet scan my psa was 1.1, and has risen to 1.2, am due another psa test in the next month, so it’s a wait to see if has gone up 

 

 
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