So many treatment choices What to do?

There is not always a choice of treatment for a number of reasons. There are different types of cancer and different stages and the amount of cancer and where it is located can be important together with a persons age and treatment preferences. In order to give you our most relevant thoughts, we need need your full diagnosis which you can ask for if you don't have it and ask to be copied in to all your GP/Hospital correspondence. If you enter salient details into your Profile/Bio and keep this updated members can check on this and make more meaningful replies. We may express our views on certain aspects but ultimately personal decisions have to be made by you on the basis of what your Hospital team/Consultant says is suitable and your preferences. You can see what most people have written by clicking on their avatar.

As regards treatment, there are generally 4 main types which can be given in different ways. That is by removing the Prostate entirely Prostatectomy or part of it (TURP), one of several types of radiation or a form of focal therapy of which there are several types. Then there is Hormone Treatment. All of the foregoing may be administered singly or in combination.  I have not included Active Surveillance as that is monitoring rather than active treatment.

I would suggest you download or obtain a hard copy of the 'Tool Kit' which is published by this charity. It not only provides basic details about the disease but also on treatments and potential side effects. This may help you with your treatment decision and if you want a one to one, you can contact the Specialist Nurses on this Charity but remember they will not be in the same position as your Hospital Consultant. Then there is your GP who is the sort of link person and the knowledge of these varies. https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

Edited by member 28 Apr 2022 at 13:32  | Reason: to highlight link

Just to add a little to my previous reply, we don't have a lot of information about your diagnosis so can just generalize at present. There is not a great deal of difference between the successful results of the two main treatments of surgery and radiotherapy. Surgery is not likely to be offered if the cancer has broken out of the prostate and gone to bone. Other places PCa likes to go to is seminal vesicles and lymph nodes although sometimes suspect nodes are taken with Prostatectomy. Radiotherapy can treat beyond where the knife can go which is a determinate in some cases. Some men just can't wait to get their Prostate removed but in a significant number of cases it does not do the job completely and needs to be augmented by Radiotherapy and possibly Hormone treatment too, thereby adding to side effects of Prostatectomy. So some men take the view that they might just as well have RT in the first place. Some men don't mind surgery and the greater risk of incontinence (although risk of long term incontinence is quite small). Some men don't like the idea of being subject to radiation and the need to attend 20 or more sessions (called fractions). There are many pros and cons to each form of treatment and side effects that I haven't even touched on, so when you have a choice, the patient can weigh these up and make his decision. So differences in men's diagnosis and their attitude to treatment means it is best left to the patient where he has a choice. Some men opt for a Focal treatment where there is a choice so again more pros and cons. You therefore need to get a handle on this highly complex disease and the 'Tool Kit' is a good place to start. Don't be over swayed by results anybody may have had here or what men might say in the pub. You might have a similar diagnosis as any of them but have very different results.

Edited by member 28 Apr 2022 at 19:25  | Reason: Not specified

This thread rehearses all the arguments.

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

My husband “only” had two options. HT+RT or RALP. When he was diagnosed at end of Jan 22 he said from the very beginning he wanted the prostate removed - at that stage we weren’t sure if we would be offered surgery as further scans were needed. We met with the oncologist and discussed HT+RT. Incidentally, both options in my husbands case would give the same curative outcome. It really is down to personal choice, in my husbands case he felt happier knowing the tumours would be removed and if required he could have salvage RT if required, it was another string to his bow as it were. He felt the HT and RT route was quite long winded and his preference was to have the prostate removed.  It was explained to us, that to remove the prostate following RT is quite complex and not really recommended. We were grateful for one option and that the cancer could be treated with a curative intent. So for us, once surgery was an option it wasn’t too difficult a decision. Once you have all the facts, you will probably lean one way or the other. There are so many people on here who can help and this forum has been invaluable in terms of support and advice. Incidentally, he is 6 weeks post op and doing well. Good luck with your decision.

Edited by member 30 Apr 2022 at 18:54  | Reason: Not specified

Thanks John not on my own then my life has changed from a to z in last 2years wondering if I should have left it and had a couple off good years instead off all this my choice but would think again next time 

Gaz and Chevy,I know many of us share the same views i asked if it was too late to opt out of surgery when having the cannula put in for anesthetic, i wasn't having salvage RT but i did . I have dodged HT by going on a trial. 

It is bad enough wondering "what ifs" about a three year delay caused by my GP practice.

Consider the alternative, your next treatment may work and be adverse effect free. Are you mentally strong enough to ponder the what ifs in the future if you do nothing.

Thanks Chris

Edited by member 01 May 2022 at 10:32  | Reason: Not specified