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Another Cancer Diagnosis

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User

Posted 17 Dec 2020 at 14:51

Wife to Chris who was diagnosed with rectal cancer September 2016. After lots of radiotherapy, major surgery, permanent stoma and 3 months chemo, life was good again. He’s back on the golf course, cycling, painting and looking after grand children. He was diagnosed with an enlarged prostate 6 years ago and after surgery going for a wee has been slow. Anyhow shockingly after an MRI scan and biopsy we got the news yesterday that he now has prostate cancer. This is all new to us but Gleason score is 3+4 which the consultant said is low grade. He has put him on surveillance which sounds good he inferred that no treatment is necessary for now. The issue we have is that Chris is unable to have more radiotherapy he has hit his limit and because of his rectal surgery further surgery would be difficult with a poor outcome. I am so worried about the future holds for us. We have been through so much already. Any words of encouragement or advice would be greatfully received.

User

Posted 17 Dec 2020 at 16:06

Hi Ellie,

Sorry to read your message. Gleason 3+4 is the second level out of 7 which are classed as Prostate Cancer and if the 4 is a very small bit it's better. Knowing his psa test results would be useful. If psa is low and hardly changing then it might be years before you need to consider treatment. That coupled with what the MRI showed about it's size and location.

Have you been told that further surgery would have a poor outcome. I'm not at all an expert but I wonder why, as I'd have thought if you had other things removed it would be easier.

One thought could be that if he can't have radiotherapy he's better being treated before it gets to a stage where surgery isn't possible. Although some people like to preserve their quality of life and put off surgery or any other treatment as long as possible.

Prostate Cancer doesn't usually effect the playing of golf except for just after an operation or if it gets very bad.

Prostate Cancer is usually slow growing and they say some men have low levels all the time. There is a lot to learn and everyone is different it seems. All the best, Peter

Edited by member 17 Dec 2020 at 16:08 | Reason: Not specified

User

Posted 17 Dec 2020 at 20:23

Thank you Peter for your response. It’s great to hear you say it’s good to have 4 as small. His last PSA score was 1.5. The doctor will retake it in 3 months time, hopefully it’ll be still low. I realise we have much to learn on this new journey. I’ve learned so much from the forum and it’s members at bowel cancer uk. I believe that contact with others going through the same cancer is invaluable.

I’m sure I’ll be here asking lots more questions before long.

User

Posted 17 Dec 2020 at 20:55

Hi,

I wonder if he might be a candidate for brachytherapy? This only delivers radiation to the prostate, so it wouldn't be a matter of redosing areas already treated. It may be that his prostate has already had enough of the max lifetime dose there's not enough headroom for further treatment, but I think I would ask for referral to a one of the main cancer centres that does Brachytherapy so one of their oncologists can review the previous treatment and comment.

Another thought might be Cyberknife, if a treatment plan can be designed that avoids recooking any tissues above max dose.

Another possibility might be proton beam, but that would be privately, and probably around £30k, and still same issue with not exceeding max dose to prostate.

User

Posted 17 Dec 2020 at 21:48

Thanks Andy - my husband did ask about brachytherapy but the doctor didn’t seem to think that would be an option either. We do have private health insurance but not sure that would cover proton therapy. We will take time to research and seek help and advice from The Christie. There is an awful lot to think about.

User

Posted 18 Dec 2020 at 00:41

If not already done so, download the toolkit from this website or call the number at top of the page to order a hard copy.

Hopefully he will be suitable for active surveillance for many years and then, if it progresses, intermittent hormone treatment may be a good option.

Edited by member 18 Dec 2020 at 00:42 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 18 Dec 2020 at 01:30

I am all for active surveillance if recommended, and a friend has been on it for five years whilst enjoying life to the full.

If you have private health insurance it might be worth having a consultation with one of these ‘top’ prostate surgeons, as recommended by their peers, to see if a prostatectomy is possible subsequent to the previous surgery.

https://www.dailymail.co.uk/health/article-5808997/Meet-best-urologists-Britain.html

My own surgeon, who we call Professor ‘Whocannotbenamedhere’, for he cannot be named here, is a world-renowned prostate surgeon, and you could find out about him if you Google ‘Santis prostate’.

Best of luck.

Cheers, John.

User

Posted 18 Dec 2020 at 11:24

Hi Ellie,

I had Gleason 3+4=7 and Psa 2.19 with 5 cores out of 20 Positive ,had Brachytherapy in September 2016 and 4 years on i was signed off December 2020.

If you click on my avatar you can see my Journey so far.I am not suggesting you go to Brachytherapy but it was one of the options i was given.If you need any more information just ask.

Good Luck John.

User

Posted 19 Dec 2020 at 01:13

Thank you all so much for taking time to respond and your helpful advice. I wonder what percentage of 3+4 Gleason score have treatment immediately compared to the number that are put on surveillance.

User

Posted 19 Dec 2020 at 07:54

Ellie,

I don't know the percentage, but it's going to depend on other things. I was 3+4, but bulging against the front of the prostate, so wouldn't have been eligible for Active Surveillance.

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