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choosing surgery

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User
Posted 16 Nov 2019 at 07:54

Hello everyone


Well, this is a club I never thought I'd be joining. (Not quite true - I have been on medication for BPH for about 7 years.)


Here are my stats:


Age 64 (how did that happen?)


Diagnosis: Prostate Adenocarcinoma T2 N0 M0 Gleason 4+5 PSA 6.6


Proposed treatment: I was offered a choice between robotic assisted radical prostatectomy with lymph node dissection, or hormone treatment and radiotherapy.


I discussed my treatment options with doctors and surgeons, with a specialist nurse, with my family, and with a family friend who had robotic surgery some time ago. I've read lots of literature from the hospital and from the prostate cancer charity. I was particularly concerned about the side effects of hormone treatment, and the fact that the hormone therapy would last 3 years, whereas with surgery the timeline for recovery should be much shorter. The consultant urologist who did my biopsy said surgery was a good option for me as I was "young and healthy", which I found flattering!


I have decided to go ahead with the surgery, and I have a pre-assessment appointment today and a date for surgery in 2 weeks time. On the one hand, I don't feel unwell at all, I am putting a brave face on things, and agreeing with people when they say "good that they found it early" and "good that they can treat it with surgery" and so on. In my immediate family I think some people's reactions are influenced by the fact that my brother-in-law died last year from bowel cancer, which had already spread to his liver before he was diagnosed.


On the other hand, this is going to be a life-changing experience. It's going to be painful, uncomfortable, embarassing, and upsetting for me and my family for many months. It's not something I want to do. I had other plans. I am fearful at times, and have waves of near panic when I want to run away and hide (though I wouldn't be running very far or very fast!)


that's all from me today. Your comments are welcome. Be kind!


 

User
Posted 17 Nov 2019 at 12:21
It is often said that a patient is being treated with 'Curative intent' which better describes it. Cautious optimism is a good way for the patient to look at it.
Barry
User
Posted 18 Nov 2019 at 03:17
I am happy to be cured!

Until the result of my next PSA test...

Cheers, John.
User
Posted 18 Nov 2019 at 07:01

Hi David,


I take the view that we're all up the same creek but that there's a plentiful supply of paddles. I'm 10 days post-op and have no regrets.


Roll with the punches.


Best of luck, Kev.


 

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User
Posted 16 Nov 2019 at 09:06
Hello David. I had to make the same decision some months ago - prostatectomy within 6 weeks, or hormone therapy followed by radiotherapy. It was made clear that whichever route I chose, the outcome would be the same - I would be cured. Weighing up the pros and cons, reading up on side-effects, duration, comfort - I chose the hormone / radiotherapy route. I don't like operations, and could not stand the thought of being incontinent, even for a few months. My point is, if you have the choice, then it really is up to you. Your choice is what you think will be best for you, and nobody should try to second guess you. My route has been a longer haul - 7-8 months - and the 20 daily trips to the hospital a real drag! The side effects of the hormones then the x-rays are not pleasant, but they are (in my case) very manageable. Your end point is to be cured. Whichever way anyone chooses, they have to keep that in mind. Best of luck with the surgery.
User
Posted 16 Nov 2019 at 19:27

Hi Hermit (may I call you Hermit?),


Thanks for your kind comments, I think you're right, everyone has to make their own decision.


I have spoken to a couple of people who have had similar surgery (one even in the same hospital) and they have told me how they manged their side effects. They are each a few years post-surgery, and are doing well. So I am hoping for the best.


Best wishes for a successful outcome for your treatment,


David

User
Posted 16 Nov 2019 at 21:14
It very much boils down to personal preference at the end of the day. I was fortunate in that my urologist and oncologist both strongly recommended that I went down the HT/RT route, and that coincided exactly with my preferred treatment, so it was an easy decision to make. It’s now 18 months since my diagnosis; I had RT in Feb/Mar, and the test results are looking great, so I’m very happy!

I think the important thing is to be comfortable with your choice and not to start thinking “what if...”. It sounds very much as if you are comfortable with your decision, and I wish you the very best for your treatment.

Chris
User
Posted 17 Nov 2019 at 12:21
It is often said that a patient is being treated with 'Curative intent' which better describes it. Cautious optimism is a good way for the patient to look at it.
Barry
User
Posted 17 Nov 2019 at 15:51
There is no such thing as a cure for cancer and while oncos and surgeons may dumb it down a bit for patients sometimes by referring to being 'cured' the correct terminology and what we all hope for is 'full remission'
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 17 Nov 2019 at 19:00
Not according to the experts Heenan although many cancer patients go into full remission (for example, a significant % of childhood leukemias) and many more will do so in the future as treatments emerge and improve.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 17 Nov 2019 at 20:19
Isn't that essentially saying that there's a chance the disease may come back, Lyn? But surely that's true for any disease, isn't it? There's a chance that anything may come back at some point.

Chris
User
Posted 17 Nov 2019 at 22:01
'Full remission' is used to describe the point at which a person has been disease free for long enough for the medics to believe it won't come back. Yes, I suppose almost any cancer can come back but if you look at it technically, the cancer cells are more likely to have been left behind than to reappear out of nowhere. Some cancers are less likely to produce micromets and / or can be killed by chemotherapy and so radical treatment is much more likely to eradicate all cancerous cells - testicular cancer, lymphoma and leukemia are good examples.

Dad received a letter from the NHS 10 years after his RP, informing him that he was now in 'full remission' - they could have saved themselves the postage as it came back 3 years later.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 Nov 2019 at 03:17
I am happy to be cured!

Until the result of my next PSA test...

Cheers, John.
User
Posted 18 Nov 2019 at 07:01

Hi David,


I take the view that we're all up the same creek but that there's a plentiful supply of paddles. I'm 10 days post-op and have no regrets.


Roll with the punches.


Best of luck, Kev.


 

User
Posted 18 Nov 2019 at 09:00
Love it
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 11 Dec 2020 at 13:39

I have been signed off 4 years after Brachytherapy  my Specialist did not say i was in remission or Cured, and i never expected it .


I will still have my Psa tested next year just in case he was pulling my plonker🤣🤠


Good with your treatment.


John.

 
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