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Surgery or not.

User
Posted 25 Oct 2019 at 06:14

With a psa 28 - Gleeson score 7 -aged 59 - bone scan negative would radical prostectomy be best option? My partner reluctant for me to undergo surgery and wants me to try lifestyle changes diet and supplements but I am feeling this may just prolong treatment and cancer could spread if left untreated. 


I am sure others have faced this dilemma and wondered what their decision was. Especially how to get their partners on board and how partners can get support. 


 

User
Posted 25 Oct 2019 at 20:31

It would seem your partner is not well informed about treating PCa. I would suggest you obtain a copy of the 'Tool Kit' as here https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880 and together consider more about the disease and recognised treatments.


 

Edited by member 25 Oct 2019 at 20:32  | Reason: Not specified

Barry
User
Posted 26 Oct 2019 at 03:23

Andy,


You are right, and your partner is very wrong.


You haven't given enough of your diagnosis (such as staging), but you may be offered prostatectomy, and will almost certainly be offered some form(s) of radiotherapy. PSA 28 makes you a high risk patient, and if your staging is T3, that would also be a second high risk factor, and should be making you consider radiotherapy, maybe HDR boost if they offer it (shortened course of external beam RT, plus high dose rate (HDR) brachytherapy). Position of cancer inside the prostate is also a factor, as well as any node spread.

User
Posted 26 Oct 2019 at 03:37
Dietary and lifestyle changes and supplements will do you no harm, but they will not cure you of prostate cancer.

Discuss the matter with a surgeon and an oncologist, and if you like, get second opinions from two more. Take your partner along.

Best of luck.

Cheers, John.
User
Posted 26 Oct 2019 at 14:19
You should speak to people who have been there and made thier choice (via Prostate UK or Macmillan, or local support groups). I had a surgeon and an oncologist explain in detail both options available to me (prostatectomy and hormone / radiotherapy) and was then told to take some time, think carefully, talk it over with my wife and let them know (in due course!) what I wanted to do. In the end I chose hormone / radiotherapy, because I could not face the idea of surgery and incontinence. But it was my decision. Each man's prostate cancer is to some extent unique, and lifestyles differ. Your choice will be just that - yours. But don't do nothing. Lifestyle changes and diet supplements will not cure your cancer. It is scary, but for the most part, prostate cancer is treatable, and curable. Best wishes, whatever you choose to do.
User
Posted 26 Oct 2019 at 14:45

Gleason 7 sounds lowish but is it 3+4 or 4+3.  Mine was 4+3 upgraded to 4+4 after the operation when they gave it a real look.  4+4 isn't so good.  PSA 28 isn't low, but isn't a true measure.


Considering where it is located and how big it is could be a factor.   The urologist told me if was near the edge but they couldn't be certain how big it was.    Although the surgeon said it was 13mm near the apex and drew a diagram.   From that I felt surgery was a good option as it looked away from other organs.   If it was close to the bladder then RT can give a wider treatment.  Also RT could cover lymph nodes, I believe.   Although the surgeon will make a judgement whether to take lymph nodes.  He didn't take mine.   


I was very prejudiced towards getting it out whatever side effects, and having a proper pathology analysis.  Also I knew after 7 weeks that if my psa goes above almost zero then it doesn't look too good.


We all need to make our own decisions.


I found that two days in hospital was no issue and a few weeks later I was back to normal except I leaked, but less and less for another 4 months. I still haven't got a proper erection, in fact it's very temperamental, and that might be partly mental.   My wife is more interested in me being here longer, sex hasn't been a major factor for either of us, so it wasn't an issue.


As for changing diet, depending what your diet is now, that can be a good thing.  Like the Macmillan advert says Cancer doesn't give a hoot about you.  Being healthier in general must be of some benefit to perhaps last longer and put up with more but is unlikely to stop it, unless it's a single cell that tried to be lucky perhaps.


Unless the doctor recommends Active Surveillance I'd go for treatment.  I was offered AS with a template biopsy and I'm glad I didn't take it.


All the best.


 

Edited by member 26 Oct 2019 at 14:48  | Reason: Not specified

User
Posted 26 Oct 2019 at 18:01

I think this highlights the difference between complimentary treatments and alternative treatments. In my view there is NO alternative to proper medical intervention whatever form that takes. The complimentary side of things - dietary modifications etc -may help and certainly adopting a healthier diet and more exercise is all to the good. Once under treatment I would want to discuss any supplements with my treatment team to ensure they wouldn't negatively affect any treatment.

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User
Posted 25 Oct 2019 at 20:31

It would seem your partner is not well informed about treating PCa. I would suggest you obtain a copy of the 'Tool Kit' as here https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880 and together consider more about the disease and recognised treatments.


 

Edited by member 25 Oct 2019 at 20:32  | Reason: Not specified

Barry
User
Posted 26 Oct 2019 at 03:23

Andy,


You are right, and your partner is very wrong.


You haven't given enough of your diagnosis (such as staging), but you may be offered prostatectomy, and will almost certainly be offered some form(s) of radiotherapy. PSA 28 makes you a high risk patient, and if your staging is T3, that would also be a second high risk factor, and should be making you consider radiotherapy, maybe HDR boost if they offer it (shortened course of external beam RT, plus high dose rate (HDR) brachytherapy). Position of cancer inside the prostate is also a factor, as well as any node spread.

User
Posted 26 Oct 2019 at 03:37
Dietary and lifestyle changes and supplements will do you no harm, but they will not cure you of prostate cancer.

Discuss the matter with a surgeon and an oncologist, and if you like, get second opinions from two more. Take your partner along.

Best of luck.

Cheers, John.
User
Posted 26 Oct 2019 at 14:19
You should speak to people who have been there and made thier choice (via Prostate UK or Macmillan, or local support groups). I had a surgeon and an oncologist explain in detail both options available to me (prostatectomy and hormone / radiotherapy) and was then told to take some time, think carefully, talk it over with my wife and let them know (in due course!) what I wanted to do. In the end I chose hormone / radiotherapy, because I could not face the idea of surgery and incontinence. But it was my decision. Each man's prostate cancer is to some extent unique, and lifestyles differ. Your choice will be just that - yours. But don't do nothing. Lifestyle changes and diet supplements will not cure your cancer. It is scary, but for the most part, prostate cancer is treatable, and curable. Best wishes, whatever you choose to do.
User
Posted 26 Oct 2019 at 14:45

Gleason 7 sounds lowish but is it 3+4 or 4+3.  Mine was 4+3 upgraded to 4+4 after the operation when they gave it a real look.  4+4 isn't so good.  PSA 28 isn't low, but isn't a true measure.


Considering where it is located and how big it is could be a factor.   The urologist told me if was near the edge but they couldn't be certain how big it was.    Although the surgeon said it was 13mm near the apex and drew a diagram.   From that I felt surgery was a good option as it looked away from other organs.   If it was close to the bladder then RT can give a wider treatment.  Also RT could cover lymph nodes, I believe.   Although the surgeon will make a judgement whether to take lymph nodes.  He didn't take mine.   


I was very prejudiced towards getting it out whatever side effects, and having a proper pathology analysis.  Also I knew after 7 weeks that if my psa goes above almost zero then it doesn't look too good.


We all need to make our own decisions.


I found that two days in hospital was no issue and a few weeks later I was back to normal except I leaked, but less and less for another 4 months. I still haven't got a proper erection, in fact it's very temperamental, and that might be partly mental.   My wife is more interested in me being here longer, sex hasn't been a major factor for either of us, so it wasn't an issue.


As for changing diet, depending what your diet is now, that can be a good thing.  Like the Macmillan advert says Cancer doesn't give a hoot about you.  Being healthier in general must be of some benefit to perhaps last longer and put up with more but is unlikely to stop it, unless it's a single cell that tried to be lucky perhaps.


Unless the doctor recommends Active Surveillance I'd go for treatment.  I was offered AS with a template biopsy and I'm glad I didn't take it.


All the best.


 

Edited by member 26 Oct 2019 at 14:48  | Reason: Not specified

User
Posted 26 Oct 2019 at 18:01

I think this highlights the difference between complimentary treatments and alternative treatments. In my view there is NO alternative to proper medical intervention whatever form that takes. The complimentary side of things - dietary modifications etc -may help and certainly adopting a healthier diet and more exercise is all to the good. Once under treatment I would want to discuss any supplements with my treatment team to ensure they wouldn't negatively affect any treatment.

 
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