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Active Surveillance or Treatment

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User

Posted 25 Oct 2021 at 20:24

New to this I was diagnosed with pc t2a no nodal involvement Gleason 3+3 graded 1 MDT suggested active surveillance but could consider RP or RT with HR and I was 58 on diagnosis now 59 my PSA was 4.06 on diagnosis in June my latest PSA 5 months after is 4.15 .I don't have any urinary symptoms .Am I delaying the inevitable if opting for AS? Alternatives all have side effects

User

Posted 25 Oct 2021 at 23:28

You may be delaying the inevitable but that has benefits! Important question is whether you are missing an opportunity for a cure.

You need to have confidence in the diagnostics and if you opt for AS make sure you emphasize the "Active" part.

User

Posted 26 Oct 2021 at 06:20

My friend, who is in his seventies, is G 3+4=7, has been on AS for five years. He has regular PSA tests, annual MRI scans and appointments with his consultant.

I suggest you do the same, at least for a year, then review the situation. In the meantime have as many orgasms as possible, as they might not be achievable once any kind of radical treatment starts.

Best of luck.

Cheers, John.

User

Posted 26 Oct 2021 at 07:39

Given the fact that you're only in your 50s, radical treatment will almost certainly required at some point. We're all different, but if it were me, knowing that fact would make me want to get it over and done with so I could get on with my life.

Best wishes,

Chris

User

Posted 26 Oct 2021 at 08:06

Thanks so very much to all .You have given me much food is for thought.If I were to go for treatment and a better chance of cure would probably opt for RT with HR but as I am in my 50s worried about secondary cancer caused by the treatment.RP is pretty severe surgery with possible lasting side-effects such a difficult one to call.But I feel as if I need to make one as you said I maybe missing an opportunity for cure

KEPP

User

Posted 26 Oct 2021 at 08:24

I had HT/RT at a younger age than you are now (I was 56) and have no regrets about doing so. The treatment was very tolerable and two and a half years later I'm living a happy life and am (fingers crossed) cancer free. In my case RT was the recommended treatment, but I have no regrets about having it and would make the same choice again. I asked my oncologist about the risk of secondary cancers and he assured me that it's a small risk.

Best wishes,

Chris

User

Posted 26 Oct 2021 at 08:31

Thanks Chris. Can I ask are you still having regular PSAs as presumably your prostate is still making this ?

No lasting side effects from the treatment?

User

Posted 26 Oct 2021 at 08:46

Finally, if you had a critical illness insurance policy with many insurers, they would not pay out on a G 3+3=6 cancer diagnosis, as it is not classed as ‘life threatening’!

There is a school of thought that G 3+3=6 should not even be called ‘cancer’, and my lighthearted suggestion for it would be a ‘little trouble down below’.

Don’t rush into any decision. You have been offered AS as the medics think it’s appropriate for you.

Cheers, John.

User

Posted 26 Oct 2021 at 10:02

The risk of cancer caused by the RT is about 4% I think, so it increases your risk of getting bowel cancer from 1 in 15 to just less than 2 in 29. The risk of untreated prostate cancer becoming advanced and incurable is much greater than the risk of RT induced cancer.

Bollinge's advice is good - have loads of sex while you still can. You are on an AS route which gives you time to have some normality and as long as the AS is done correctly, your medics will know when it is time to get radical.

Change your name though - by using your email address you are opening yourself up to spammers and weirdos. If you can't work out how to change it, contact the moderators.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Oct 2021 at 10:19

Thanks John wise words indeed I am using this time in between PSA Tests to look at my options if there is disease progression I had an interesting discussion with someone who paid for proton beam therapy having been on AS for 6 years and still had a 3+3 as he couldn't live with the notion of spread in-between his investigations I am constantly turning over in my mind

Kepp

User

Posted 26 Oct 2021 at 10:21

Thanks sorry didn't know you could see my name

User

Posted 26 Oct 2021 at 16:18

Originally Posted by: Online Community Member

Thanks Chris. Can I ask are you still having regular PSAs as presumably your prostate is still making this ?

No lasting side effects from the treatment?

Yes, I'll have 6-monthly PSA tests for the rest of my life. Had one last week for 2.5 years after finishing RT and my PSA is stable at 1.2.

Lasting effects? Change in orgasms, obviously. Still feel just as intense, but just a few drops of liquid come out. Radiation makes the prostate swell up, so I'll be on Tamsulosin tablets again for life, to sort out "flow" issues (zero problems as long as I take the tablets). Change in bowel behaviour but again nothing troublesome.
All in all, as I said before, a relatively trouble-free treatment.

Best wishes,

Chris

User

Posted 26 Oct 2021 at 17:52

I was T1 and Gleeson 3+4 on diagnosis. Was on AS for a couple of years as didn't feel I needed to rush and was only recently in a new relationship. When I was restaged at T2a I felt it was time to act and opted for surgery. Turned out it was T2c so glad I made the choice to act. Glad I didn't rush though.

User

Posted 16 Nov 2021 at 08:59

Thanks for that I have been asked to have flaxseed pomegranate juice and a cup of soya a day any comments?

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