HT versus HT/RT

Hi Mike,

Some men do well on HT for a number of years whilst for some it only works for a very short time. In the latter situation it can be replaced or augmented by other treatments of which chemotherapy is one. RT does not necessarily bring severe side effects but these can vary from man to man in range and intensity. I think it is more likely for most men that HT will have a greater impact with side effects than RT. The RT dose is shaped so as to minimise damage to other organs. The comment about the tumour being in an awkward place may have been in regard to the focal therapy you considered (if HIFU), because there is an area within the Prostate on which the probe is unable to focus.

PCa is a very complex disease where even clinicians can struggle sometimes to predict outcomes and not wish to advise men what of several treatments to opt for, because ultimately is is down to an affected man to consider depending how risk adverse they are. Yet consultants have the benefit of seeing scans and biopsies and using their experience to help evaluate an individual case, so any queries you have are best addressed to them. Your individual experience may not be the same as others even with a similar diagnosis.

As regards Space Oar, this has been credited with being helpful in some cases but has not been widely rolled out and some hospitals have stopped giving it I read.

If you have not yet done so, you may find it useful to download or obtain a copy of the 'Tool Kit' as here :- https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880https://prostatecanceruk.org/prostate-information/our-publications/publications/tool-kit?_ga=2.206109653.795867346.1564408880-1013787081.1564408880

Edited by member 22 Mar 2021 at 19:30  | Reason: Correction HT for RT in first sentence

I think I would start with putting your diagnosis in this website.

https://prostate.predict.nhs.uk/

I have taken some guesses as to all your diagnosis numbers. Roughly speaking it says if you hadn't been diagnosed with pc you have about a 50% chance of reaching 90 years old. As you have been diagnosed you only have a 40% chance of getting to 90. If you have radical treatment your chances are about 45%.

So there isn't much to choose between doing nothing and getting treated, personally I had some RT, less than will be planned for you, and I had hardly any side effects. HT is not much fun, and may lead to osteoporosis so I wouldn't want to be on it for too long at your age.

I don't think dieing of prostate cancer would be much fun, not too sure what I would prefer die of though, anyway if I were in your position I would probably choose RT. But obviously it's your choice. 

Thanks to all who have replied so quickly. Still trying to absorb all the information I've received recently and to try to work out the best options. Thanks Barry for the Tool Kit suggestion - it's been ordered.

Comforting to to know from Chris, Lyn and Dave that RT did not cause too many problems. I've been told that HT would continue for two years after RT. Is this what happened in your experience and once stopped, did side effects from the HT cease? Does anyone know what would happen if I stopped HT immediately after RT? Information on SpaceOar very useful and fits in with my consultant's view.

Reassuring that all seem positive of the benefits of RT. 

Thanks again, everyone.

I was on HT for 18 months in total: 6 months before RT and a year after. My oncologist reckons that there's no real difference in benefit between 18 months and 2 years of HT. The side-effects of HT do go away, but it takes a while (many months).

Chris

Does anyone know what would happen if I stopped HT immediately after RT?  

Well rather unusually, by present treatment plans, I stopped HT (Zoladex in my case), immediately after RT in 2008.  I found HT made me very tired with a few other minor side effects and as nobody suggested I continue with it, I didn't ask for more of the same.  In fact I have since been offered HT but have declined it.  Whether it might have benefitted me I can't say and neither can the clinicians who advised me.  My PSA stayed around 0.05 - 0.6 for a couple or so years post RT before beginning to increase slowly.  By 2014, The Royal Marsden referred me to UCLH for HIFU as a salvage treatment for failed RT.  I subsequently had HIFU in 2015 which knocked back the PSA but again it began to increase albeit very slowly.  By late 2020 my PSA was just above the figure which denoted biochemical failure.  I had an mpMRI in late February this year and have a telephone appointment next month to discuss whether I will be offered repeat HIFU, which I would be OK with, or HT which I don't really want.

I don't know if the foregoing is of any help to you other than to show you are not compelled to continue with HT after RT if you so decide although it is now generally regarded as helping RT do the job if continued for between 18 months  and 3 years post RT.  There is also the possibility that you stop HT and only restart when your PSA reaches a certain figure.  This intermittant treatment gives what is called a Hormone Holiday during which debilitating effects of HT can reduce for a time.

Hi Mike, I was recently diagnosed with PC at 53, one of the first things I was told was to ensure my 3 brothers got tested asap... 2 were fine but the eldest, who is 61, has been diagnosed with PC and they also found a lump on his kidney which needs dealing with... All this with no clear symptoms beforehand as far as I am aware! .. So definitely recommend your eldest son gets tested to be on the safe side.

Cheers, 

Nick