I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

removal or radiotheraphy+hormone?

User
Posted 16 Apr 2021 at 14:42

Hi everyone. New to the site. I have just been advised I need active treatment. My biopsy showed a gleason 4+4 on the right side and a gleason 3+3 on the right anterior  (2/10 cores). Nothing on left.  Bone scan clear.

Joint meeting with excellent oncologist and surgeon advised either radical prostatectomy or radiotherapy +hormone treatment as options with both likely to achieve an excellent outcome. PACE trial available.

I have looked at both options - there are clearly short and long term risks to both and short and long term potential side effects to both. 

I would very much welcome any thoughts and advice on how to decide which option to go for. Many men will have struggled with this question and personal experiences are worth so much more than words on a page.

many thanks

Keith 

User
Posted 16 Apr 2021 at 21:52

Hi Keith,

This thread was active recently.

https://community.prostatecanceruk.org/posts/t26986-Can-t-understand-why-anyone-would-choose-surgery-over-Brachytherapy--I-must-be-missing-something

It discusses many of the choices and reasons for and against them. The amount of cancer you have will effect your choice and so will the risks you are prepared to take with side effects. 

Edited by member 16 Apr 2021 at 21:53  | Reason: Not specified

Dave

User
Posted 16 Apr 2021 at 23:18

Hi,  I haven't heard of one with two Gleasons on one side, and it only has 2 pins with samples.  It sounds like your choices are open.   I just looked up the PACE trial and it sounds like they'll decide for you from 3 treatments.

Some people might be happy with that but I'd be asking where it will occur and if it means I get quicker or slower treatment.  Also presumably the RT options in the trial both include a period of hormone treatment before and after.

People say outcomes are similar and as no two cases are identical precise evaluation at an individual level is difficult.

My reasons for choosing surgery are on my profile along with a link to a website I did with quite a bit of detail.   I'm sure I'd still choose surgery although some others say the opposite.   Most are happy with their choices.

RT has benefits for elderly and unfit people and for more complex cases where reaching cells outside the prostate is beneficial.   Less advanced cases can use Brachytherapy instead of standard RT.   Some places may not offer Brachytherapy because they don't do it although that might be less prevalent now and it might be you aren't a good candidate.

For me having surgery was largely because I was told it was near the edge and the RT would need a few months of hormones maintaining the risk in my opinion.   Having it cut out seemed to be the lowest risk of it spreading.   I also liked that it's done while I'm asleep.  With luck when you wake up it's gone.   A few weeks healing and a few months getting continent, plus risks with ED which has never properly recovered.   I read that with RT ED comes on after a longer term, if it comes on.    I was never keen on having hormones because it lessens the time your body will stand if you need later treatment.  I wasn't keen on hormones anyway as I'm not keen on tablets and drugs if I don't need them (tomorrow I have my 2nd Covid jab, I need that).   

Also you can have RT after surgery but are very unlikely to have surgery after RT.  Although some say you shouldn't factor that in as it's not good to need salvage treatment, but I did and still would.   Drowning men and all that.

As you've been pointed to other discussions by Dave I won't go on too much.

It might not be the best to put your real name on here unless you're very open about who knows your problems.  There is some personal discussion on here.

All the best, Peter

 

 

  

User
Posted 17 Apr 2021 at 07:22
I went down the HT/RT road and have no regrets about doing so. It was all very tolerable. Happy to answer any questions you may have about it.

Best wishes,

Chris

User
Posted 17 Apr 2021 at 10:48

Very personal choice.

For me I didn't like the idea of hormone treatment and its potential effects on libido etc and after talking to a number of people felt surgery was the best option for me. Main reasons were

The surgeon had a very good reputation

It was planned (and was) fully nerve sparing

It seemed that the chances of long term significant incontinence were low

That ED was a more significant risk but on balance I thought I'd find a way to overcome this.

 

User
Posted 17 Apr 2021 at 12:57

Many thanks for your comprehensive comments Peter.

I have read your other posts- your experience is very reassuring. I must speak for many in thanking you for providing all this detail as we can see exactly what you experienced.

I have been told Brachy is not an option due to the location of the gleason 8. 

I am 65, fairly fit, walk 5+miles a day with the dog.  BMI is low at 22. No other medical problems and not on any medication. 

Thanks for comment re name - I have amended.

Kind regards

Keith

  

User
Posted 17 Apr 2021 at 13:07

Thanks Dave

Very useful article although Brachy not an option for me it does give information on the other choices.

I am led to believe I have a fairly small amount of cancer - 2 biopsies (one in 2019 -2 gleason 6s. 12 cores) one in 2021 with 1 gleason 8 and one gleason 6 . 10 cores) 

I must admit that the possible short and long term side effects from Radiation plus hormone treatment (9 months worth) are worrying but it is difficult to quantify how many of these will affect me and to what degree of seriousness.

Cheers

Keith 

 
Forum Jump  
©2024 Prostate Cancer UK