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Diagnosis i didn't see coming

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User
Posted 17 Sep 2021 at 22:09

Hi 


I've just got the news I'm 3+4 Gleason 7. So much to take in and each treatment seems good and bad in equal measure.


The operation seems the best option I think. I've been offered radiotherapy as well.


My PSA was low at 3.5 and after a first biopsy I was told it was Gleason 6 but they found it was worse after a pinpoint second biopsy.


It's come as a shock as I don't seem to have obvious symptoms.


 

User
Posted 18 Sep 2021 at 19:01

Sorry to read that. With a PSA of 3.5 I'd have been thinking it's unlikely to be significant.


With this illness little is certain so thinking in terms of probability can be helpful.


I was flat out and fully blinkered to get the op and I still think it right.  Although I now know there are times when RT is very probably better. Such as when it might be locally outside the prostate.


Mine was upgraded when they got it in the lab.  That's an advantage with the op. They examine the prostate and can also say if it's got negative margins, which is good. Knowing this information gives you a bit more re-assurance as long as it's good news.


With RT, hormones may start right away which makes it seem like treatment is happening but the lesion is still there.   You may not need a fast operation but if it's going to happen better get it done in my opinion especially with the delays they speak of.


There's a lot to take in.


All the best, Peter


 

User
Posted 18 Sep 2021 at 23:54

 


"Sorry to read that. With a PSA of 3.5 I'd have been thinking it's unlikely to be significant." 


Unlikely, yes , but it can be the case as has been found on this forum before.  Once diagnosed it makes sense to learn as much as you can about your cancer and then consider whether to monitor it or opt for one of the treatments that are open to you.  Unfortunately, cancer can disperse in a way that can't always be seen on scans and opinions can differ as to when is the best time to start radical treatment.  It is important that a man understands as much as he can about his situation/treatment which could lead to a life changing experience.  Much may depend on how he views the risks of waiting or early treatment and which treatment to opt for.  


 


 

Barry
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User
Posted 18 Sep 2021 at 01:07

It would help if you have the fuller details of your biopsy, such as the TNR values and the core numbers. Also your age and general level of fitness.


In general people seem to make choices based on which side effects they feel better able to deal with. The general long term survival rates are similar for all treatments.


It might also help if you can say what area of the country you live in and whether you have looked at alternatives such as Brachytherapy and HIFU.

User
Posted 18 Sep 2021 at 11:25

About 60% of men your age have prostate cancer, and a complete lack of symptoms is extremely common. My cancer was only found because my GP said one day when I went to see him about something completely different, "I see you're over 55 so we'd better do a PSA test"!


I went down the RT route personally and found it entirely tolerable. As said, it basically depends which set of side-effects you find less objectionable. One factor to consider is that about a third of men who have surgery go on to require salvage RT, and so end up with both side-effects!


Best wishes,


Chris

Edited by member 18 Sep 2021 at 13:38  | Reason: Not specified

User
Posted 18 Sep 2021 at 12:49

A lot of the arguments for different treatments were expressed in this thread.


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


I know the title is rather specific, but I think all treatments were covered and the original poster changed his mind so he went in to this with an open mind, which is a good idea.


Go to the publications section of this website and download all the information you can as pdfs. Read the above thread and any others you find, and post here with your questions. 

Dave

User
Posted 18 Sep 2021 at 19:01

Sorry to read that. With a PSA of 3.5 I'd have been thinking it's unlikely to be significant.


With this illness little is certain so thinking in terms of probability can be helpful.


I was flat out and fully blinkered to get the op and I still think it right.  Although I now know there are times when RT is very probably better. Such as when it might be locally outside the prostate.


Mine was upgraded when they got it in the lab.  That's an advantage with the op. They examine the prostate and can also say if it's got negative margins, which is good. Knowing this information gives you a bit more re-assurance as long as it's good news.


With RT, hormones may start right away which makes it seem like treatment is happening but the lesion is still there.   You may not need a fast operation but if it's going to happen better get it done in my opinion especially with the delays they speak of.


There's a lot to take in.


All the best, Peter


 

User
Posted 18 Sep 2021 at 23:54

 


"Sorry to read that. With a PSA of 3.5 I'd have been thinking it's unlikely to be significant." 


Unlikely, yes , but it can be the case as has been found on this forum before.  Once diagnosed it makes sense to learn as much as you can about your cancer and then consider whether to monitor it or opt for one of the treatments that are open to you.  Unfortunately, cancer can disperse in a way that can't always be seen on scans and opinions can differ as to when is the best time to start radical treatment.  It is important that a man understands as much as he can about his situation/treatment which could lead to a life changing experience.  Much may depend on how he views the risks of waiting or early treatment and which treatment to opt for.  


 


 

Barry
User
Posted 19 Sep 2021 at 00:46

Originally Posted by: Online Community Member
One factor to consider is that about a third of men who have surgery go on to require salvage RT


But a similar proportion of men who have RT also need further treatment - and they may not be able to have either  surgery or more RT.

 
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