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User
Posted 30 May 2020 at 16:22

Hi,

I have locally Advanced P.C the cancer is not contained in the prostate but not reached any where else.

G of 4+3   T3a.

I have had 37 sessions of Radiotherapy & been having Zoladex injections for 14 months.

I don't understand why it is not possible to operate on me.(probably silly question )

Thanks in advance

User
Posted 30 May 2020 at 21:11

Hi Rikky,

I was 4+3  possibly T3a and had an operation.  The tumour was said to be at the apex which is away from the bladder.  Perhaps yours is nearer another organ and RT can get a wider range.

Perhaps if they decided yours is a definite T3a and 4+3, which is a higher risk, then that's a risk too far.

Mine turned out to be 4+4 and T2a after they removed it.  I wondered if he'd have operated if he'd known, although it being negative margin as well lowers the risk presumably.

On your profile you said you were quite fit and low BMI so I can't think of another reason except perhaps the surgeon sets limits on what he's willing to do and overall the MDT decided your best option is RT.

As you're well down stream it's probably better not to ponder too much on these matters really.  You are where you are and looking forward is enough for anyone to worry about.  Although no harm in asking if it's not causing you more worry.

Hope things are well,
Peter

User
Posted 30 May 2020 at 21:32
It’s not normally possible to operate after RT. It makes the prostate all mushy with in distinct lines.

I was operated on in good hope only to find that 5 of the 18 lymph nodes removed were cancerous. If they had known that prior then they wouldn’t have offered surgery in the first place. Your treatment plan sounds hopeful. I’m now incurable

User
Posted 30 May 2020 at 22:07
ricky, are you asking why it’s not possible to operate now, having had your RT, or why it wasn’t possible to operate instead of having RT?

The answer to the first question is that RT turns your prostate into mush, which sticks to the surrounding tissue. Very few surgeons will attempt a prostatectomy after RT, because it’s extremely difficult to cleanly separate the prostate from its surroundings.

The answer to the second question depends on your individual situation. In my own case, both my oncologist and urologist recommended RT over surgery for me because my PSA of 31 at diagnosis was anomalously high for the G3+4 cancer found in the biopsy, leading to a suspicion of undetectable spread to the lymph nodes. I had “wide beam” RT to zap the lymph nodes as well as the prostate.

Best wishes,

Chris

User
Posted 31 May 2020 at 14:17
Thank you for all your replies,my PSA was 75 so maybe that is the reason they wouldn't operate.

Now i know that they can't operate after RT i can move on and put it out of my mind.

Cheers

Richard

User
Posted 31 May 2020 at 14:42

Hi Richard,

Yes, that would certainly have been the reason why. You presumably had the whole pelvic region irradiated, as I did, to zap any cancer cells in the lymph nodes.

Is your current PSA still low?

Best wishes,

Chris

Edited by member 31 May 2020 at 14:43  | Reason: Not specified

User
Posted 31 May 2020 at 15:42

Hi Chris,

The last PSA was 5 months ago,next one due in a month when i see the Oncologist.

Then it was 2.2. so big improvement .

Cheers

Richard

User
Posted 31 May 2020 at 18:08
That’s excellent. Mine was 1.4 last month (14 months after finishing RT), which is also encouraging.

Best wishes,

Chris

User
Posted 01 Jun 2020 at 11:24

Originally Posted by: Online Community Member
Thank you for all your replies,my PSA was 75 so maybe that is the reason they wouldn't operate.

Now i know that they can't operate after RT i can move on and put it out of my mind.

Cheers

Richard

I'm in the same boat, but thankfully don't need it removed - I did not know it went "Mushy" !!

User
Posted 01 Jun 2020 at 12:05
Yes, it is like the difference between removing a small fresh tomato and trying to remove a fried tomato; bits might break off & it is hard to pick up anything that has spilt.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 Jun 2020 at 20:59

Originally Posted by: Online Community Member
Yes, it is like the difference between removing a small fresh tomato and trying to remove a fried tomato; bits might break off & it is hard to pick up anything that has spilt.

I would have thought, all they need to do, is stick a Surgical Hoover in there, & suck the lot out!!!!
No I'm not medically qualified.💂

User
Posted 01 Jun 2020 at 21:53

Going into surgery I was seen as a simple T2, surgeon advised me post RP surgery for whatever reason the cancer was more extensive then initial data presented and I was a T3B with the cancer busting out of capsule and spread to seminal vescile - Cancer did not get into lymph nodes (18 were tested). That was almost 2 years ago. All tests subsequently have shown PSA is ‘undetectable’. My Gleason was 4+3+5 a high grade cancer with a higher risk of reoccurrence.

Whilst it’s not common to operate at T3 I am proof it’s possible. Select your surgeon with care. A High volume surgeon is a must. My surgeon (NHS) is based at the Marsden. They were fantastic. I took surgery over other treatments as I wanted backstops if the cancer came back. I didn’t fancy 2 years of HT. I have had no incontinence and now seeing promising signs of getting an erection capable of penetrative sex. I will be 64 this year and in good health.

I found all the medical staff excellent, and keen to offer advice - don’t be afraid to ask any question no matter how trivial you think it is. Your question is one I assume they get regularly. Very possibly there is a clinical reason why they didn’t mention surgery but it doesn’t hurt to ask the question and potentially seek a second opinion if your still uncertain - the hospitals are use to it.

 

WHOOPS HAVING JUST RE READ YOUR POST I SEE YOU HAVE HAD RT. MY SURGEON SAID PICKING UP THE PEICES AFTER RT HAS RISK AND REQUIRES A LOT OF SKILL/EXPERIENCE.

Edited by member 01 Jun 2020 at 22:01  | Reason: Not specified

 
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