My Decision Time approaches

Hi everyone -  I have just joined and been reading up .This is my first post . I find it so helpful as well as informative. Ian now 68 , fit healthy and active. Northampton area. 

After an initial psa test in Nov18 (4.8) and biopsy 1/14 active , Gleason 3/3 TNoMo then 12 months of surveillance with psa hovering up / down 6.3 - 7.3 

recent second more extensive biopsy 12/40 cancer cells Gleason 4/3 still TNoMo. Clear MRI. 
Given 3 options - continue surveillance, RP orHT andEBRT.

I have requested appts with oncology and surgery to discuss details to make an informed decision . Reading posts on the treatment options has given me so much more background information and v usual prep for the meeting 
So it’s then decision time . 😩
I think I prefer to take action now rather than continue surveillance so that it is treated before it deteriorates further. 

I agree that I found it a huge relief to share the news with family and close friends - once the first biopsy results came back. It actually helps talking about it and perhaps explained my mood swings to my nearest and dearest😂. 
I too find nights the worse when I can’t sleep the demons appear and so far haven’t been able to stop this . 

thank you everyone for sharing your thoughts and cases. 

Edited by member 20 Jan 2020 at 00:00  | Reason: Error on 1st post - sorry just realised my mistake on my current Gleeson -it is now 3/4 not 4/3 . Ap

Hi Sorry you find yourself here.

I would agree that now is the time for treatment with a 4+3. They would be doing you a disservice offering further surveillance I think. Active surveillance is only normally advised up to 3+4 ( and regarded as favourable i.e low volume and looks to be well contained away from the edges.

The decision on treatment is not easy as differing treatments seem to have similar outcomes but of course side effects need to be taken into account. We chose surgery as we wanted to know exactly how much of the prostate was involved and whether the Gleason score was confirmed. 

We live in Northamptonshire so feel free to read  Tony's profile. If you opt for surgery you will have it at Leicester General unless you opt for somewhere else. I think Radiotherapy is done at Northampton.

Tony had a very capable surgeon although he is not one of the big names and we are happy enough with the outcome as he  had negative margins and PSA undetectable so far after 2 years. We were given the difficult choice whether to spare the nerves or not as some of the tumour was close to the edge. (Hindsight is a marvellous thing but we have no regrets as some men still have permanent Erectile dysfunction even when they are spared)

Everyone is different though and some are lucky with very little or no side effects after a time.

Good luck with whatever treatment option you go for.

Ann

Edited by member 19 Jan 2020 at 00:14  | Reason: Not specified

You say you have sleepless nights over this, but in your condition you statistically have more than a 98% chance of surviving for fifteen years, by which time you might have died of something else.

I concur that the time is right now for radical treatment, and if you elect for surgery, find yourself a good high volume surgeon with excellent outcomes. My own surgeon (who does 300-400 ops a year, worldwide), said he wouldn’t send a friend or family member to any surgeon who does less than 100 prostatectomies a year.

You can check on prognostications here:

https://www.mskcc.org/nomograms/prostate/pre_op

And on surgeons’ outcomes here:

https://www.baus.org.uk/default.aspx

Best of luck.

Cheers, John

Edited by member 19 Jan 2020 at 03:09  | Reason: Not specified

It’s up to you of course, I had virtually pain-free surgery. Click on my profile to read the gory details if you wish.

Cheers, John.

Best wishes,

Chris