Best and cheapest Prostatectomy

He charges twenty grand in his private clinic, but operated on me for ‘free’ on the NHS. You will be on a NHS fast track now anyway. The standard stay for my surgeon is one overnight, but I stayed a second because of a long drive home.

You say you have ‘high risk’ cancer. Did they give you a Gleason score: G- X+Y=Z, or a staging figure of 1-4? If you are Gleason 9 or 10 that is high risk, and the advice above to take the hormone Bicalutamide to buy some time is wise.

Even if you have a high grade cancer, they are usually slow growing, so I suspect your sense of urgency to splash out £20,000 is misplaced.

Give us more details of your diagnosis, and others here will pitch in.

Best of luck.

Cheers, John.

You would get the HT straight away and at 67 you are unlikely to see any of the side effects of RT which take 20+ years to appear IF they are going to.

I know waiting is difficult, but a two month delay is very unlikely to effect the outcome. It might be worth asking, though, if you could start HT as a holding measure to suppress the cancer while you do wait.

Best wishes,

Chris

You would be paying for so much more than just that - the nurses, the anaesthetist, the anaesthetic, the oxygen, every member of the theatre team, the blood matching prior to surgery, the cost of sterilising the surgical equipment, any blood transfusion needed, every member of the recovery room team, the cost of transporting the removed prostate to a local lab, the pathologist's time, equipment needed to wax & process the gland for sampling, the writing of a report & producing images for the surgeon to review, pain relief post op, the catheter & spare bags, the wound dressings, the physio who comes to see you on the ward before you go home, pain meds to take home with you, time for the surgeon to read pathology report & draw conclusions, the follow up appointment .... 

I know much of this from the itemised bill we received after John's RP - including the cost of the catheter, the length of tubing and 1 day & 1 night bag :-/ 

My Gleason scores were 4+5 RHS 3+3 LHS

Staging was T2a NO MO

However I need to check the T2a - because if a they wouldn't have given me RHS and LHS gleason scores??

Was the T2a N0 M0 based on an mpMRI by any chance? My initial stage from mpMRI was T2a/c which I took as "could be a, could be c". The biopsy that followed showed it was most certainly c. I'm wondering if only your 4+5 showed up on imaging (hence a) but the biopsy also found the "only just about cancer" 3+3. That's just me guessing of course! I had a PIRADS 4 on one side and PIRADS 3 on the other side - hence the radiologist hedging their bets...

Just an observation, to make of what you will.

Whenever someone posts about a sense of urgency following a diagnosis, the advice is consistently to take your time, and very often people will point to the slow growing nature of prostate cancer cells and some may even say months & longer delays will assuredly make no difference.

But to my knowledge the process of mestastasis is imprefectly understood. Is it a process or an event? Does someone go from a local lesion to stage 4 overnight? If not how long does it take? I understand recent thinking is that distant seeding of metastatic tumours happens over a period of time and can be interrupted, such that the distant tumour becomes 'unviable' if the source is removed, but not always. 

I guess I'm saying that nobody really knows how long you have between gleason 9 cells emerging and their escaping, so your sense of urgency makes sense to at least one observer. 

Good luck with what you choose.

Ever seen that powerful film, 'The Deer Hunter' ?

Yes I agree Lyn, I was thinking of adding that he had already been playing that game for a couple of years but just didn't know it, so yes already spun the magazine 700 times another 90 is no big deal, especially if he can get HT and improve the odds about ten fold. My post was getting a little long though.

Barry, I have only seen bits of the film, but it was very much at the top of my mind as I wrote the post. I must watch it all the way through now. 

that’s pretty much the state of play. My ex is an immunologist and works in cancer drug trials and told me almost the same. When mets break off they establish themselves in a new location effectively as a stem cell inducing angiogenesis etc We get mutations all our lives and these increase with age. Usually the immune system recognises these and mops them up but our immune system also tends to degrade with age.....