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Questions to ask specialists

User
Posted 22 Nov 2021 at 18:06

PSA of 10.2.  Gone through all the tests now MRI, biopsy and PET bone scan. Gleason score of 7 (3+4) which is grade 2.

Biopsy confirmed small suspicious area from MRI- 3 cores from this area were cancerous.  The other 6 from left and right of prostrate were clear.

70 years old, healthy and fit.

Been advised I have a choice of treatment - radiotherapy or radical prostratectomy and will shortly meet the surgeon and oncologist to get the pros and cons of each treatment.  And then I have to decide.

Any advice on questions to ask or general advice

 

User
Posted 22 Nov 2021 at 18:49
If you are considering RARP then how many of these procedures has the surgeon done? You can check the stats out @ buas.org

Much of it will be down to personal choice. Many men, myself included, take the view that they just want the cancer gone and surgery seems to fit the bill. Others may value sexual function or urinary continence more and may view radiotherapy as being the way to go. We are all different and with the same facts in front of us we will all make different decisions and will have differing outcomes.

User
Posted 23 Nov 2021 at 01:06

When considering RT, ask what RT options are open to you and whether HT will be required and if so for how long as this generally producers more side effects than RT. Also, ask how many fractions (sessions) of RT you will have. As we usually recommend to new members, suggest you download or obtain a free copy of the Tool Kit which gives a lot of useful information about PCa and treatment. I have found consultants appreciate it if a patient has a grasp of the essentials so they don't have to spent so much time on every detail and it will help you understand options, (not all of which may be open to you for various reasons). https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

Edited by member 23 Nov 2021 at 01:11  | Reason: Not specified

Barry
User
Posted 23 Nov 2021 at 10:49

Hi ,

Maybe look up all the procedures  and the side affects. You could ask about Brachytherapy also.

I had Brachytherpy in September 2016 with Gleason 3+4=7 and PSA 2.19. I had 5 out of 20 samples positive.

There is a lot of information on this site and lots of stories from members.

Good Luck John.

User
Posted 23 Nov 2021 at 11:44

For surgery, if sexual function is important to you, ask what the chances are of the procedure being nerve sparing (i.e. saving the nerves that generate erections). Ask if Neurosafe will be performed, whereby histology checks during the operation if it's safe to spare nerves. (I'm only aware of one hospital which does this on the NHS, although the NHS was doing a randomised blind trial in other areas too, where you have a 50% chance of having Neurosafe, but you won't be told before or afterwards.)

You might also ask if the surgeon does Retzius Sparing technique, which tends to lead to faster (and often immediate) recovery of continence. There are only perhaps 5-10 surgeons in the UK who do Retzius Sparing, and they tend to be top surgeons anyway. A year after surgery, the figures for continence are the same Retzius Sparing or not, but it gives you faster initial recovery. Doesn't make any difference to erectile function, except that top surgeons may be better at preserving it whichever technique they use.

 
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