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Whats best

User
Posted 10 Sep 2021 at 11:13

Just being diagnosed with cancer not given much info about treatments and unsure of what is best.

not getting much help from the hospital im under I think its confined but not sure.

User
Posted 14 Sep 2021 at 15:40
As I asked you before, what did your MDT team recommend? I would go with their suggestion.

Like Barry said, my surgeon or his pet robot nicked about two inches off my previously adequate penis during surgery, but as it’s only any use now for pissing through, it’s not a problem. In fact Her Loveliness is quite relieved that there is no longer any threat of all that sex malarkey, so it’s worked out fine in the end for both of us.😉

Best of luck, whatever you choose.

Cheers, John.

User
Posted 12 Sep 2021 at 14:33

Hi Terry

 

I think my diagnosis was similar to yours. T2bN0M0 Gleason 3+4.  I opted for surgery which I dont regret. You may want to read my thread and also the thread by TechGuy to understand what you might decide to put yourself through. We both had surgery at LBH with high volume surgeons using nerve sparing and neurosafe. Whilst unpleasant you will get through it.

Wishing you the very best of luck with your decision. 

User
Posted 12 Sep 2021 at 15:36
Surgery and radiotherapy have very similar long-term success rates, so it really does depend which set of side-effects you find less objectionable. It's all right for the wife to say "whip it out" - she doesn't have a prostate 🙂.

All the best,

Chris

User
Posted 12 Sep 2021 at 16:02

Hi Terry,

As a generalisation there is not a great deal between the success of Prostatectomy and radiation in dealing with PCa but if you opt for the former it is sometimes necessary to have RT to supplement it. The incidence of this increases if the cancer is on the edge of the Prostate. Rarely, a Prostatectomy is done after RT but it is much more difficult to do and only a few surgeons will attempt it. The biggest difference between these two procedures is in the side effects and the fact that with RT, Hormone therapy is given usually before, during and after RT. HT potentially introduces the possibility of other side effects. As an alternative to External Beam Radiation, some men have Brachytherapy, either a High Dose version or low Dose with seeds. You could ask the consultant about this at your next meeting.

Good advice to read the 'Tool Kit' as John suggested. PCa is a complex disease which does not necessarily end with surgery or radiation and it makes sense to learn the basics and pros and cons of the two treatment options given to you. There are other treatment possibilities which largely come under the heading of 'Focal' treatment. The side effects of these are milder but long term results not so well defined and there is a possibility that in some cases further Focal Therapy of one sort or another may need to be repeated or in some severe cases a Prostatectomy or RT may be required. For Focal Therapy it would mean discussing your suitability with an expert in this field. It rather depends on how much time and effort you are prepared to make to look at other possibilities, some of which might be alternatives for you.

Edited by member 12 Sep 2021 at 16:06  | Reason: Not specified

Barry
User
Posted 12 Sep 2021 at 17:22

I'm in agreement with all the previous posts. I particularly like Barry's suggestions about focal therapies like HIFU. 

Dave

User
Posted 13 Sep 2021 at 11:16

My diagnosis was pretty similar. Spent quite a while on AS then opted for surgery. Have a look on my profile if you would like to know more. 

Good luck

User
Posted 17 Sep 2021 at 06:39

Hi Terry, my husband had similar diagnosis. He opted for surgery and histology showed a few surprises once the prostate was removed in that it had in fact been a higher grade than originally thought. 10 weeks post robotic surgery virtually dry and no further treatment needed.

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User
Posted 10 Sep 2021 at 13:58
Tez,

Order the free, fully comprehensive ‘Tool Kit’ information folder from the publications section of this website, right away.

We need loads more information from you about your age, condition and grade / staging of your cancer diagnosis, before we can offer you any constructive advice.

Best of luck.

Cheers, John.

User
Posted 12 Sep 2021 at 09:43

I have just being given results

Gleason is 3+4=7

Psa 6.4  0.2

And it T2 NX

I think it is still contained in prostate and not spread 

I'm 66 and not sure wich treatment to go for wife says just get it removed so it doesn't spread Not sure whats best in long run 

User
Posted 12 Sep 2021 at 09:53
You should have had a Multi-Disciplinary Team (MDT) comprising of various medics of different disciplines look at your test results. What was their recommendation as to a treatment programme, ‘with curative intent’, as they say?

Best of luck.

Cheers, John.

User
Posted 12 Sep 2021 at 10:08

I asked the consultant and he said he would go for robotic  surgery but said if I ask a radiologist they would probably say that was best still not sure 

User
Posted 12 Sep 2021 at 12:24

Hi Terry,

We’ve been in a very similar situation trying to make a decision on what treatment will be best for my husband. His diagnosis is different to yours T3a Gleason 4+3=7 PSA 8.3 and also has node involvement. 

Finally made the decision to go for robotic surgery, even knowing he will almost certainly need radiotherapy aswell after it. We feel better having now made the decision too. It seems there is no right or wrong decision it’s just working out what is best for you. 

Good luck with making your decision 

User
Posted 12 Sep 2021 at 12:32

Thanks Im thinking I'll probably go for the robotic surgery aswell it seems the best option long term.But a radiologist is going to call me tomorrow so I'll make my mind up then 

User
Posted 12 Sep 2021 at 14:33

Hi Terry

 

I think my diagnosis was similar to yours. T2bN0M0 Gleason 3+4.  I opted for surgery which I dont regret. You may want to read my thread and also the thread by TechGuy to understand what you might decide to put yourself through. We both had surgery at LBH with high volume surgeons using nerve sparing and neurosafe. Whilst unpleasant you will get through it.

Wishing you the very best of luck with your decision. 

User
Posted 12 Sep 2021 at 15:36
Surgery and radiotherapy have very similar long-term success rates, so it really does depend which set of side-effects you find less objectionable. It's all right for the wife to say "whip it out" - she doesn't have a prostate 🙂.

All the best,

Chris

User
Posted 12 Sep 2021 at 16:02

Hi Terry,

As a generalisation there is not a great deal between the success of Prostatectomy and radiation in dealing with PCa but if you opt for the former it is sometimes necessary to have RT to supplement it. The incidence of this increases if the cancer is on the edge of the Prostate. Rarely, a Prostatectomy is done after RT but it is much more difficult to do and only a few surgeons will attempt it. The biggest difference between these two procedures is in the side effects and the fact that with RT, Hormone therapy is given usually before, during and after RT. HT potentially introduces the possibility of other side effects. As an alternative to External Beam Radiation, some men have Brachytherapy, either a High Dose version or low Dose with seeds. You could ask the consultant about this at your next meeting.

Good advice to read the 'Tool Kit' as John suggested. PCa is a complex disease which does not necessarily end with surgery or radiation and it makes sense to learn the basics and pros and cons of the two treatment options given to you. There are other treatment possibilities which largely come under the heading of 'Focal' treatment. The side effects of these are milder but long term results not so well defined and there is a possibility that in some cases further Focal Therapy of one sort or another may need to be repeated or in some severe cases a Prostatectomy or RT may be required. For Focal Therapy it would mean discussing your suitability with an expert in this field. It rather depends on how much time and effort you are prepared to make to look at other possibilities, some of which might be alternatives for you.

Edited by member 12 Sep 2021 at 16:06  | Reason: Not specified

Barry
User
Posted 12 Sep 2021 at 17:22

I'm in agreement with all the previous posts. I particularly like Barry's suggestions about focal therapies like HIFU. 

Dave

User
Posted 13 Sep 2021 at 11:16

My diagnosis was pretty similar. Spent quite a while on AS then opted for surgery. Have a look on my profile if you would like to know more. 

Good luck

User
Posted 13 Sep 2021 at 18:39
No intention to cause you concern but we do sometimes have men join us who say after treatment that they were not told of potential side effects. Men are often unaware for instance that for a period of time men can suffer varying levels of incontinence and for a few this becomes a permanent situation. Also erectile disfunction can likewise take a long time to overcome even with mechanical and chemical aides for some men and intercourse as pre treatment may never again be the same as pretreatment. Something that is less frequently mentioned is that surgery and radiation can cause men to find their penis is shorter and more flaccid so penal rehabilitation may be needed. These are just some of the downsides of which men undergoing should be aware. So as previously suggested, a man should learn more about the disease and be aware of potential risks that can vary with treatments and happen at different times with different treatments
Barry
User
Posted 13 Sep 2021 at 19:20

Thanks Barry I am looking at all the side effects each treatment seams to have them its difficult making a decision 

User
Posted 14 Sep 2021 at 15:40
As I asked you before, what did your MDT team recommend? I would go with their suggestion.

Like Barry said, my surgeon or his pet robot nicked about two inches off my previously adequate penis during surgery, but as it’s only any use now for pissing through, it’s not a problem. In fact Her Loveliness is quite relieved that there is no longer any threat of all that sex malarkey, so it’s worked out fine in the end for both of us.😉

Best of luck, whatever you choose.

Cheers, John.

User
Posted 14 Sep 2021 at 16:26

I asked the consultant what he recommended he said im a surgeon I would recommend surgery but if you ask a radiologist they would probably recommend radiation your chose 

Not much help really 

User
Posted 17 Sep 2021 at 06:39

Hi Terry, my husband had similar diagnosis. He opted for surgery and histology showed a few surprises once the prostate was removed in that it had in fact been a higher grade than originally thought. 10 weeks post robotic surgery virtually dry and no further treatment needed.

User
Posted 17 Sep 2021 at 07:43

Hello Terry, I opted for robotic surgery in the end and you can read about my experience on my profile.

Flexi

User
Posted 17 Sep 2021 at 23:26

Hi Terry,

Your diagnosis isn't that bad from what you wrote.  Gleason 3+4=7,   Psa 6.4  0.2,   T2 NX.  I'm not sure what the 0.2 is.   Although there are other factors such as where it's located and we're all different.

When you've made up your mind you will feel more relaxed but might have occasional doubts.  I'd resist the doubts.

I've written so many times about my urgent need to have surgery that it feels like a worn record.  It's in my profile with a deeper explanation if you click on the link in it to my website.  If you're still reading into it.

I'd still choose surgery.   Do you like the surgeon, have you seen his figures in the BAUS website (British Association of Urological Surgeons).   How many ops has he done and how many successful.   I wouldn't get too carried away but it is re-assuring to know he's done a good number of recent ops.

I'm loathe to recommend for someone but it needs to satisfy your biggest worries.    I think my biggest worry was it ws near the edge but I'd been told away from the bladder.  So I felt surgery would get it out and not involve the bladder.  There was a worry how long it would take before treatment.

Anyway all the best.
Peter

Edited by member 17 Sep 2021 at 23:29  | Reason: Not specified

User
Posted 18 Sep 2021 at 07:45

I've been told it is contained inside the left side of the prostate with non on the outer edges showing in biopsies, not sure what this means.  The 0.2 is psa Density what ever that is.

Just trying to make up my mind radiologist or surgeon 

 

User
Posted 18 Sep 2021 at 09:29

Hi Terry.

As most of the posts are about Robotic surgery maybe you could ask your team about Brachytherpy and it's side affects.At my first meeting at the hospital the first surgeon was pushing Robotic Surgery for his hospital and i believe if i hadn't looked into all the procedures before hand i may have gone for his sales pitch but i asked if i could speak to the Brachytherapy specialist that was in the hospital at the same time.

On speaking to the Brachytherapy specialist he said with my numbers there was no reason why Brachytherpy would not be a good option but would have to go to his Hospital Mount Vernon about 20 miles away.

My PSA was 2.19 and Gleason 3+4=7 with 5 cores of 20 positive.I am 5 years on with PSA 0.05 and was signed off in December 2020.ED is still a problem but i get by with Viagra.I had no real problems with water works or bowl movements apart from getting up two to three times a night but that unproved over time 

If you click on my Avatar you can see my journey so far.But remember there are no guarantees on any of the options.

Good Luck John.

 
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