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Choices for the newly diagnosed ?

User
Posted 05 Jan 2022 at 19:34

I had my telephone consultation with the urologist today. This was the follow up from my appointment with the oncologist just before Christmas. It is decision time for me and I have opted to go for radical prostatectomy (open surgery). It will include local lymph node removal and salvage RT further down the line. I must admit the one night in hospital with a laparoscopic procedure is more appealing than the five nights with open surgery. The surgeon is in his mid-fifties with a long experience of prostatectomies. He says with advanced local PCa he can get improved (reduced) positive margins (apparently by feeling the prostate) compared to laparoscopy. I’m going to need mop up RT whatever, but I guess the less dodgy cells left in there the better. I forgot to ask what the time period is between surgery and salvage RT but I’m sure many of you will be able to enlighten me. The only bad news coming from the appointment is when I asked what the timescale to surgery would be, he said with the NHS on its knees at the moment (his words) he had no idea.

Edited by member 06 Jan 2022 at 08:00  | Reason: Not specified

User
Posted 06 Jan 2022 at 01:14

Some might throw their hands up in horror but I am with you in spirit. J also chose to have open RP on the advice of his very laparascopic-experienced surgeon for more or less the same reason (he could get his hands in and feel to maximise the nerve sparing) but also because J had previously had abdominal surgery and there was a concern that the old scarring would be in the way. 


If there is going to be a significant delay before the op, you could ask about hormone therapy to keep it under control in the meantime?


By the way, there is a typo in your post ... you want negative margins, not positive ones!

Edited by member 06 Jan 2022 at 01:16  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 06 Jan 2022 at 12:10

Thanks Lyn. I know what I meant to say about positive margins but didn't make it particularly clear, did I. I'm hoping I made the right decision. The oncologist said my PCa was quite treatable with the HT/RT route but wouldn't be drawn on what was the better option for me. He did indicate the extent of the cancer growth would entail a fair old dose of radiation. It also seems from what he said that targeting the lymph nodes is a bit hit and miss and they are quite close to vital organs. I am not yet on any HT but I will certainly need to be if I'm waiting for surgery on NHS. A friend of mine has a similar diagnosis to me and is being treated by the same consultant. He had his prostatectomy earlier this week with the same surgeon but privately. He emailed yesterday me to say everything went well. This is not an option that is available to everyone but I am giving it some serious thought. It's not like you can spend your money on exotic holidays at the moment. Chris

 
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