Just been informed.

Good afternoon, Lee.  Sorry to see you here, especially at the young age of 50.

I'm not as expert as some of the members of the forum, but it seems to me that you will have some level of choice in your treatment.  However, I was diagnosed at the age of 46 and, partly because I was young and partly because I had a T3a at diagnosis, they said surgery was my best option.   Several younger men have made the comment that they are advised to 'have it out'.  Talk to the specialist nurses at PCUK and I'm sure other members will come along to explain your options.  I've been on the forum for three years now and still rely on the knowledge of members to help me make my decisions.  

Ulsterman 

+1 as here :- https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880

Edited by member 27 Nov 2019 at 15:33  | Reason: to highlight link

Hi,  This is a common question and I think there was one a couple of days ago. The general options for a low risk patient are (without checking the spelling):

Active Surveillance with perhaps more tests.

Surgery:  Robotic or Laporoscopic Prostatectomy.  Rezius Sparing Prostatectomy.  Open Prostatectomy.

Hormones and Radiotherapy, followed by more hormones.

Hormones and Brachytherapy followed by more Hormones

There's a general view that Surgery and RT have very similar outcomes although RT might get stray cells.  Also less fit patients will only be offered RT.  Surgery gives you a quick answer on your condition, RT doesn't.

My own thoughts were I wanted it cut out immediately, in fact the day before.  Many take a more measured view and look around as many hospitals don't offer a complete range or options.

I'm sure others will expand on the above. It's a lot to take in.  Thinking about side effects and personal preferences and emotions.

All the Best
Peter

Sorry to see you here Baggers

I was 52 when diagnosed. Gleason 7 , like you, localised.

The decision  was somewhat straightforward in my case as I had obstructive symptoms and was going to have to have surgery of some sort in a year or two and therefore decided to go for surgery.

Recovery from surgery generally straightforward, but think hard about incontinence issues and erectile dysfunction (ED). Incontinence is a real nuisance although this improves over time in most. ED may not improve in a proportion, although there are other means to keep your sex life active. As its localised you will have nerve sparing that increases the chances of ED improving over time. You will obviously be sterile.

I havent concentrated on RT or HT, but reading through he forum looks like the treatment takes a long time and has its own downside/complications which others will explain better.

Time is on your side 

One thing to have it in your head, you are not going to die because of this.

Thala

Baggers,

Your diagnosis, as far as you've given (PSA 4.22, G 7, and probably T2a or T2b) is quite favourable for a prostatectomy. Two bits of information are missing though - how near the edge it is, and if you are likely to be able to have nerve sparing so there's a chance erections will recover afterwards. If it's near the edge, that reduces the chance of the prostatectomy working, and you might then also have to have RT, in which case you should consider having just RT in the first place. If nerves won't be spared and sex is important, again, consider RT as that has a better chance of preserving erections.

If you decide on RT as a primary treatment, there are a number of choices. EBRT (external beam) is what most people will think of first, but you may be suitable for a more closely targeted radiotherapy such brachytherapy (internal radiotherapy) or stereotactic radiotherapy (SBRT, or by a trade name Cyberknife), which are more precision treatments and come with fewer side effects. The downside of RT is that as a younger person, you have a long period of life ahead, and as RT treatments have a small risk of creating cancers decades ahead, that risk will be higher for you than for an 80 year old, where they aren't going to live long enough for that to happen.

As a T2a or T2b, you might also be a suitable candidate for HIFU where the areas of cancer are destroyed by High Intensity Focused Ultrasound. This is focal treatment (targets just the cancer), but is much less proven by data than the other treatments, due to far fewer treatments.

You will probably only be offered treatments which your cancer centre provides (or other centres linked to it). If you want to investigate something like HIFU, you would have to be asked to be referred to one of the hospitals currently trialing it on the NHS.