Recent Diagnosis of Prostate Cancer and Treatment path advice

User

Posted 13 Jan 2021 at 15:20

Hello,

We’re newbies here, my Father has been diagnosed with Prostate Cancer a week before Christmas 2020.

Age 78 ( but a very fit and active one at that)

PSA 7.8

T2 N0 M0

Gleason scale of 7 3+4 in 5/6 areas with evidence of extraprostatic extension in tissue sample.

Right anterior 3+3 in 15%

Right Mid 3+3 in 50%

Right Posterior 3+3 in 40%

Left anterior 3+4 in 40%

Left Mid 3+4 in 20%

My Father unfortunately had bowel cancer in 2016 he underwent a successful operation with chemo. He has mild diverticulitis as his stools are a bit loose.

The oncology advised route of treatment seems to be HT+RT our concerns with this is the RT- (external beam) which will probably effect his bowel as we’ve heard some alarming reports of people suffering with bowel urgency etc. We have since heard of a rectal spacer but I believe this is quite difficult to obtain through the NHS has anyone had any experience with this?

Also he has been offered the Pace C trial any comments on this please? We do know that on this trial a rectal spacer is not possible.

My dad was leaning more towards a Prostatectomy (only open surgery possible because of his previous surgery) but recently he spoke with the surgeon who advised him because of his age and previous bowel surgery that this probably wouldn’t be his best option.

Penny for your thoughts people.

Much appreciated

User

Posted 13 Jan 2021 at 20:51

Re radical treatment you need to decide they all have significant if different risks.

I would add another option watchful waiting - basically do nothing and enjoy life free of the side effects from radical therapy. Obviously you will face a higher risk of dying of PC and any PC symptoms you have will continue but even advanced PC can take a long time to give you life changing symptoms.

User

Posted 13 Jan 2021 at 22:45

The rectal spacer (SpaceOAR) is available on the NHS, rationed to most deserving cases only, and I would have thought with previous bowel cancer treatment and diverticulitis, he would stand a good chance. It's only available in hospitals which have a surgeon trained in inserting the spacer.

Has oncology suggested brachytherapy to your father? That's internal radiotherapy and has a faster fall-off in radiation dose outside the prostate in the direction of the rectum (but can be higher to the bladder). Again, that will probably only be offered if your hospital has the facilities. This can be used with SpaceOAR too, to provide higher protection to the rectum.

If your hospital can't do treatments you might want, then you can ask to be referred somewhere that does, although that might cheese off your current clinicians.

User

Posted 14 Jan 2021 at 01:46

Originally Posted by: Online Community Member

The oncology advised route of treatment seems to be HT RT our concerns with this is the RT- (external beam) which will probably effect his bowel as we’ve heard some alarming reports of people suffering with bowel urgency etc. We have since heard of a rectal spacer but I believe this is quite difficult to obtain through the NHS has anyone had any experience with this?

I would imagine that the oncologist took this into account before saying that he would be suitable for RT. There are horror stories out there for any and all treatment options but the vast majority of people don't actually experience the worst possible outcomes. As it happens my husband had RT without any side effects at all apart from feeling a bit tired in the afternoons towards the end. But he was 52 and working full time so a bit different to your situation.

If there is an issue with your dad getting the rectal spacer, that may be more to do with a) his previous bowel surgery or b) his prostate cancer is in an area that the spacer would impede or c) they use a general anaesthetic in your area to place the spacer and are reluctant to give your dad a GA or d) your NHS trust is not one of the ones that has applied to the innovation fund for money for rectal spacers.

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

User

Posted 14 Jan 2021 at 08:59

I went down the HT/RT route. Nearly two years on my the end of treatment my bowel behaviour is somewhat different to what it was pre-treatment, but not in a way that's problematic. The number of men who suffer major side-effects is very small.

Best wishes,

Chris

User

Posted 27 Apr 2021 at 09:15

Thank you for all your responses peeps.

Here is an update with how my Dad is doing, he's now on Hormone therapy and doing quite well I've been keeping him fit with strength training and cardio he's bench pressing 20kg 15reps x3 not bad for nearly an 80 year old!

He starts his Radiotherapy in early June .

What he's struggling with is his sleep his bladder keeps waking him up at night at least 3 times - seems to be roughly every 2 hours. Are there any Herbal remedies anyone has tried that helps with this?

Cheers

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