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Which procedure ?

Posted 15 Sep 2021 at 21:32


  I'm new here and still coming to terms with my situation having just being diagnosed with intermediate prostate cancer.  A PSA of 6.3 and Gleason of 7 (3+4) and localised, I have been offered either the Op or RT & HT.  HIFU was not offered but seems like this is not available on the NHS everywhere, though the side affects seem lower.

 I'm drawn the the RT + HT as this seems to have fewer or shorter side affects than the Op.  Could I ask those who took the same option, what their side affects were please and how long did some last... if they had any?    The thought of dypers and leakage for a period of time .............enough said.

Any comments would be greatly appreciated.



Posted 15 Sep 2021 at 23:14


Just diagnosed is never an easy time.  There is a lot to take in and accept in your mind.  Although most men are cured for their lifetime except for the worry of having to be checked regularly and any side effects, if there are any.

I had the operation so can't really answer your question.  Although I saw RT and hormones as a long treatment, perhaps six months to a year.  Also needing a long time to know if it worked, perhaps another year.  Then to have the potential of longer term side effects, perhaps 5-10 years, possibly affecting the colon and erectile function.  That is looking on the downside.

Each case and each person is different but I was never worried by my leakage problems and always felt they'd go away quickly.   Diapers sounds like nappies but they're small pads and I never had a problem wearing them.  No-one knew as far I know and they were warm in winter.  I always felt fortunate to be offered the operation.

Good luck,


Edited by member 15 Sep 2021 at 23:18  | Reason: Not specified

Posted 15 Sep 2021 at 23:46

Hi AWJ, i had slightly more agressive cancer than you and mine was T3, the view of the medics was that the Op would not have got all the cancer so HDR Brachy, EBRT and HT were the only sensible option for me. Sorry about all the initials, look them up on Google if you don't know them already. Anyway I'm very happy with my treatment. Two years of HT is a long time so it isn't a quick treatment. I haven't had any bad side effects, with RT they may come years later but hopefully I will have died in a freak Morris dancing accident before then. A slight problem with RT is that you will have natural psa from the healthy prostate cells remaining, so you will never know if all the cancer was removed, but statistically RT is just as successful as surgery.

I believe it may be possible to be referred out of your local NHS area if you want a treatment which isn't offered locally. I don't know how easy that process is? 


Posted 16 Sep 2021 at 06:55

I went down the HT/RT route (strongly recommended, in my case) and found it all very tolerable. 6 months HT prior to RT, seven weeks of RT, and another year of HT after that. No dramatic side-effects.

Everyone reacts differently to HT; in my case, when I first started taking it, I had difficulty in concentrating on things for a couple of months, but that cleared up, the expected complete loss of libido, some weight gain, and the HT made me sleep like a log (a benefit!).

In terms of the RT, really nothing for the first month of treatment, then an increasing urgency to pee and passing mucus from the rear end as the radiation irritated the bowel and bladder. Side-effects generally peak about two weeks after RT ends. For me, the bladder issues returned to normal about a month after RT ended. Bowel issues took longer to settle down, but mainly ok within 3 months and entirely so within a year.

The only permanent side-effect is that the radiation makes the prostate swell up, which commonly restricts urine flow. A prescription for Tamsulosin entirely sorts that out, though. I'll be on that for the rest of my life.

It wasn't too awful at all. Certainly nothing to worry about. Finished RT in March 2019 (ie two and a half years ago) and everything is absolutely fine now.

Best wishes,


Edited by member 16 Sep 2021 at 06:57  | Reason: Not specified

Posted 16 Sep 2021 at 07:17

Thanks for the replies guys.  Still coming to terms with this but then I have to.  I suppose it's horses for courses and what suits some, may not suit all.  With the cure rate being the same as the op, I'm still drawn to RT but will have the conversation  in a couple of weeks with the hospital.

thanks again


Posted 16 Sep 2021 at 11:38
Have you had a recommendation for treatment from the Multi-Disciplinary Team (MDT) at your hospital who should have looked at your results and suggested a treatment path?

I and three of my mates all had PCa at the same time, followed by surgery. Three of them had post-operative recurrence of cancer and had to have RT/HT subsequently.

We are all doing fine now, 3 1/2 years later.

Best of luck.

Cheers, John.

Posted 16 Sep 2021 at 11:56

Yes had the option of Op or the RT/HT. Advised that it's purely my decision which I need to be happy with. With the cure rate between both choices being the same, I'm looking at the RT/HT route.

Great you're all doing well. I'm pushing for 10 - 20 yrs but see what he offers. :) ;) :)

Have to be a bit optimistic....



Posted 16 Sep 2021 at 13:24
A fifth friend opted for just HT/RT, and he’s doing fine too.

I always wonder if the three that had to have adjuvant treatments following prostatectomy sometimes wonder if they should have gone for HT/RT in the first place?

Some say in years to come, there will be no more surgery for this cancer.

Don’t let anything I write in this regard influence your decision, as it’s anything but a scientific survey, just a statement of facts about four men and myself.

Cheers, John.

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