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How long is reasonable to consider options.

Posted 07 Jul 2021 at 10:36

Hello I'm new here. 

Last week I had confirmation of localised cancer diagnosis   (PSA of 12 ish and Gleason score of 3+4 (7)) Investigations have been ongoing since March with PSA tests, repeat PSA tests, MRI scan and template biopsy .  I have been told that I have a choice of surgery or external beam radio therapy (with preliminary hormone treatment).  I have spoken with the surgeon and he has given me a good briefing (he seemed very keen on surgery, the cancer can be "completely removed" with a short stay in hospital and some lifelong side effects which he seemed to think are better than dieing from cancer - RT is a long drawn out process with many trips to hospital and the possibility of different but equally serious side effects - his words he did seem keen on surgery - but then I suppose he would ) but said he will arrange an appointment with the oncologist to discuss the alternative.  (Still waiting for that).  Then I'm told no one will make any recommendations its up to me to decide. I am now reading as widely as I can (its all a bit daunting) and I have the prostrate cancer uk booklet (toolkit?), this website, cancer research uk website and the macmillan website. (I have found that most of the stuff on youtube seems to be very USA biased and I don't know how relevant that is over here).

The question I have is how long do I have to decide? Do I have to make a decision in a few days, a week a month? I know the short answer is the sooner the better but I want to try to make the best decision I can with as much info as I can get, and if it wont make any major difference to the outcome would like to spend at least a couple of weeks to a month on it.

Thanks for any advice. 


Posted 07 Jul 2021 at 10:55

Prostate cancer is very slow growing. You do have time to think about this a few weeks will not be a problem. You have probably already had the cancer for several years, so even several months probably won't make a difference. We have had people on here who have been on active surveillance for over a decade which shows how slow this cancer can be.

So I would definitely arrange to see an oncologist, get all the knowledge you can. Try and get the appointment soon, within the next week or two, don't let them fob you off, you want as much info as possible now, and then you want to think about it in your own time. 


Posted 07 Jul 2021 at 12:52
If you are looking at surgery locally, you could ascertain how long waiting time could be, even book a slot. Meanwhile, you could see an oncologist for his/her opinion based on your scan(s) and histology. Should you then decide on one of the forms of RT, you could remove yourself from the waiting list for surgery. Almost always HT is started before RT as this constrains the cancer and helps shrink the tumour thereby asking less of the RT to deal with. HT was not generally given before surgery but due to the longer waiting times this is now sometimes given as a prelude to surgery too.

I would also ask your Oncologist whether you would be suitable for high or low dose Brachytherapy, in need with External Beam Boost. You might have to go to another hospital for this if your present hospital doesn't offer it. You seem to have done some research on this and together with the views of your consultants as to suitability, should help you decide your treatment preference.

Posted 09 Jul 2021 at 09:22
Thanks Both for the reassurance. At least I now don't feel pressured into making a decision within a few days.
Posted 09 Jul 2021 at 10:18
I was diagnosed in November with a higher grade cancer than you, and it was only the following June when I had surgery, so take your time, no rush. Although some guys are so spooked by a cancer diagnosis they want it ripped out right away.

Do more research, get second opinions, and come back here with any questions as often as you want.

Cheers, John.

Posted 09 Jul 2021 at 12:29
My husband had the op within 4/5 weeks of diagnosis and has regretted his haste. The urologist's advice was not to rush, to take time to have a holiday or do nice things that normal couples do and, especially, to have lots of sex while we could. J didn't listen to that advice. I am not saying he would have come to any other decision but certainly, he would have had a better understanding of and been emotionally prepared for the implications and risks.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Posted 09 Jul 2021 at 18:32

Hi I can't understand why you don't have a choice of Brachytherapy from your specialist and it maybe he only does full removal as my local hospital does I had to travel to another hospital to get my Brachytherapy done.

I had PSA 2.19 and Gleason 3+4=7 with 5 out of 20 cores positive but i did feel at the meetings i was expected to go down the Robotic removal as my local hospital has the equipment and after speaking to the Brachytherapy specialist he said there was no reason the brachytherapy could not work for me but i would have to go to his Hospital the Mount Vernon that was 25 miles away. If you have more than one choices please think about it and get as much advice as you can before you commit to any of them.

I am coming up to five years since Brachytherpy with PSA 0.08 and signed off by specialist but i look at it as my cancer is in remission not cured.

Good Luck John.

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