Been diagnosed oct 2020

One factor to consider is how likely surgery is to cleanly remove all the cancer. If there is evidence of spread, unfortunately a high proportion of surgical cases do require follow-up RT and then you're stuck with both sets of side-effects of course, so it might be better to have gone with the RT in the first place?

No easy answers, unfortunately.

Very best wishes,

Chris

Sorry you are here Paul.

Do you know whether the surgery would be nerve sparing?

As Chris posted if there is any spread you may have to have salvage RT after and that would be a big factor (for me) in deciding which route to take.

Good luck

Thank you gents,

I am researching both options in great detail today with my wife and there are side effects with both that I was unaware of. I had a callback to begin the hormone treatment on Monday to aid in limiting the spread of the cancer. Whilst I decide which route to take. 

I had a medical bowel condition a few yrs back that might complicate things should I choose RT? I'll discuss this with the consultant on Monday.

Thanks for your posts 👍

Thanks Peter,

You have given me a lot to think about there which is very helpful information

Appreciated 

Paul

If I may add to what Lyn has written, as Lyn's opinion is highly regarded.   I too was thinking it's taken a long time but thought it better to push it forward rather than put any delay into it.   It's correct that a full picture is better taken by speaking to both a surgeon and an oncologist.   

My own opinion is it depends how long it takes.  In my case with a 4+3 near the edge I was keen on getting in and before Christmas.   Covid could add to your delays.  With a Gleason 9 outside the prostate I wouldn't want to be waiting.  I knew what I wanted though as they gave no impression it was outside the prostate.  I'd have had RT only if they said surgery wasn't on the table.  In your case it's a bit more complicated but if it was me I believe I'd go with RT especially that they'll give you the injection quickly.  Obviously I'm only another patient and don't really know.

You can theoretically have RT after surgery but not usually the other way round.  

I don't know who you've been speaking to during diagnosis although it's not usually an oncologist.  In general both surgeons and oncologists prefer their own treatments but might express some reservations you aren't keen on.  I'd be wanting to know how confident the surgeon is of taking it all if I was seriously thinking of going that way.  RT can hit wide areas but it puts a limit on future RT if you needed it.   There's nothing straightforward.

Best wishes,

Chris

Hi Gordon 

I got sent for blood tests early in Oct due to some problems that I had been having for some time but being the idiot I am, I ignored the symptoms & my PSA score came back at 19.8, I then had to wait a few weeks for a telephone consultation before being sent for an MRi scan.

After another few weeks I got my results from the scan & then a fortnight later went to hospital for a perennial biopsy. 

The results then came back for that approx 10 days after.

This was when the aggressive cancer was confirmed & I was given my gleason score.  The consultant explained that it was on both sides of my prostate & possibly spread slightly but I needed to get a bone scan & pelvic CT scan.

The results of which were told to me this morning along with both treatment options.

I'm pleased to say that both the bone & pelvis scan came back clear.  I also think under the current covid pandemic that things have been quite quick all things considered. However, had I not been so stupid early on & ignored my symptoms then things may have been different.

Thanks for your post Gordon

Paul

Hi Paul

I had a RP over a year ago ,since than my life f....up for a Good Time...big time!!

I'm not a well educated guy,can't give you technical advice like others 

But my case wasn't as dangerous as yours. From the Moment until I had the Surgery operation everyone from the nurses to the ordinary medical people they suggested me to have a RP surgery operation. 

As Lyn says please take your time do your study (I did not, because of I have been taking medicines for my mental illness those medicines did not help me to think logical ways)

As Lyn says do not let them force you to do anything take your time.

Before my operation I did not know about symptoms apart erection dysfunction 

That's all the info I was given and was told that after the operation I wasn't able to lift anything as heavy as even a pint of milk for one week.

Anyway here is the side effects of RP surgery operation. (Some)

Sex? For a decent sex life forget it for a long long time.maybe you will never have one.depends if they saved both nervous 

Because of use of catheter at least about a week you might catch infections that might even cause very serious problems to your kidney

After the operation you will inject stuff into your arm,lap,shoulder for one month so plenty pains though of it.

Belly aches,abdomen pains  groin pains you name it.

Some people says on here ohhh after 2 weeks of RP surgery I started running marathon, or cycling etc.

Do not believe any of them PLEASE!!they just wants to satisfy their ego and physically its impossible to do such exercises. 

You feel like you will be a half man not full man.hope you know what I mean.

Before my RP surgery operation I never stepped into any hospital for internal pains. Now I do every week.last week in 24 hours I admitted twice to A&E

Before my surgery operation 

I was able to go out and not to use bathrooms 4-5 hours easly 

Had no pains at all 100%

Wasnt getting up night times for toilets. 

Sex life was Good.

HERNIA!! most people whom had RP operation they had Hernia symptoms and surgery as well.

You will be a very angry person impatient man too for a while.

Anyway I dont wish to discourage you for anything but as Lynn says take your time and dont let them force you for anything. 

Please read my other comments if you wish to from my posts etc.

Take care mate and hope you won't be treated the way I was .

Edited by member 30 Jan 2021 at 01:36  | Reason: I added more info

There are horror stories, as above, but if you click my profile you will see my experience has been far from it.

Your own case will have been reviewed by the Multi Disciplinary Team (MDT) of up to fifteen clinicians of various disciplines, who will make a suggestion as to your future treatment. Ultimately the choice of the way to go will be down to you.

When you see the oncologist, you will no doubt discuss how your previous bowel problem might impinge on the efficacy of RT, which has bowel trouble as a potential side effect.

I and two friends had surgery the same time as me around three years ago, and two of them had to have HT and RT afterwards, as the surgery didn’t remove all the cancer. They could have had RT in the first place. Not a scientific survey, with a cohort of three, but just sayin’. We are all fine now.

They say that medicine is advancing so fast that in years to come people will laugh at the idea of excising cancers, rather than other therapies. That day is not here yet, so best of luck with your choice of pathway.

Cheers, John.

Chris

Plus not all men have to do these self-injections - some hospitals require them for everyone post-surgery, some only for those they think are at particular risk of DVT

Some hospitals require them for all inpatients, even if there's no operation taking place.

Sorry you find yourself in this situation. Your diagnosis sounds very similar to mine, although of course everyone's experience of surgery or radiotherapy will be different.

Pre-op PSA of 20 and G9 with spread into SV I personally wanted the reassurance of having the prostrate completely removed, and the confirmation that comes from the post-surgery pathology to confirm the grade and spread. But I'm sure there are equally valid reasons for opting for RT.

The surgeon made no promises about nerve sparing, other than he'd do what he could. I think being relatively fit and otherwise healthy helped with recovery from the surgery. And, personally speaking, I was not bothered about the daily injections. Best advice I received was to walk a bit each day, and each day walk a bit further.

In my case, although surgery was done on the basis that the intention was curative, I was told afterwards to expect further treatment at some point. Nearly two years later I'm still <0.1 on the quarterly tests - so far so good!

I wasn't offered hormone therapy (which comes as a surprise to some people) but point of mentioning it is that you'll encounter lots of views about different treatment options, and not everyone is offered exactly the same choices.