Surgery OR Hormone + Radiotherapy

User

Posted 29 Sep 2022 at 14:03

Elaine4878 - the painful urinating turned out to be caused by a UTI, not unusual after a catheter apparently. After the full 7 days of antibiotics it settled down.
Tony

User

Posted 29 Sep 2022 at 15:44

Originally Posted by: Online Community Member

Elaine4878 - the painful urinating turned out to be caused by a UTI, not unusual after a catheter apparently. After the full 7 days of antibiotics it settled down.
Tony

Great news it was easily sorted for you 👍

User

Posted 03 Nov 2022 at 21:32

Hello good people I need you advice and help concerning my father's treatment. He is 69 years old but he is an active person. He was diagnosed with prostate prostate cancer about two months ago. His PSA level is 7.46 and according to the hospital's report he is stage 2a. We made a biopsy and we have two different Gleason. The first one is 4+4 in 12 of 20 point and the second one is 3+4 in 9 of 20. Yesterday he made a PET Scan and we are waiting for the result. He doesn't have any problems. We were offered to choose between robotic surgery and radiation therapy together with hormonal therapy. The doctors don't want to tell us which option is better for him. They only tell us the advantages and the disadvantages for the both of them and that according to them he will be cured with both. I will be grateful if you can help me and share your opinion and personal experience. Thank you in advance!!!

User

Posted 03 Nov 2022 at 23:39

Hi Georgana,

Slightly odd to have two sets of biopsy results. I guess they may be from left and right side reported separately.

Anyway all those figures and PSA and staging are consistent with a disease which needs treating. I had Radiotherapy but my disease was more advanced than yours. With stage 2a an operation would probably be successful in removing all the cancer. I myself would not want to risk the side effects of surgery.

Dave

User

Posted 04 Nov 2022 at 09:26

Hi Gergana, it was me who started this thread earlier in the year. I was aged 71, fit and active. My diagnosis was similar to your father’s: PSA 10.83, after MRI scan and biopsies: Gleason 7 (3+4), T2c (c meaning the cancer cells were in both sides of the prostate). I was given the same 2 options as your father. I chose surgery, robotically assisted, as the indications were that the cancer was contained within the prostate and not near the edge, so I thought let’s hopefully get it all out while it’s contained. Also hormone & radiotherapy was going to take 5 or 6 months and surgery would not be possible afterwards if needed. I was in hospital for 1 night only after surgery which went well and was nerve sparing. After histology my post-surgery diagnosis was increased to 4+3, the surgeon confirmed that there were no cancer cells near the edge and that surgery had been a good choice. My 3 month PSA test result was under 0.03 which means undetectable, so it appears that all the cancer has gone, another test in 3 months time. Apart from the inconvenience of a catheter for a week after surgery, I was lucky that I had no side effects and was fully continent. If I had to do it again I would choose surgery, but of course everyone and there diagnosis is different. Best wishes for your father’s treatment, whichever it is,
Tony

User

Posted 09 Nov 2022 at 11:32

Hello thank you for your responses. Today we get the results from PET Scan with 68 GA PSMA and the result is T2aN0M0. There is something written which I can't understand. Do you know what SUVmax-10.7 means?

User

Posted 09 Nov 2022 at 14:34

That looks not too bad a result. Localised with no spread. Curative pathway I would think.

User

Posted 09 Nov 2022 at 16:55

Well I googled it and SUV means Standardised Uptake Value.

Roughly this means that they inject the psma or other tracer and a little bit is uptaken in to all the tissue, but the tumour uptakes the most.

Now different doses of psma and different weight of patient and time to image mean the measured figure needs adjusting, so they factor in all these to find what the uptake would be if they had delivered the standard dose to a standard weight patient and waited the standard time to image.

So SUVmax is the maximum uptake of tracer in the tumour.

How significant the number is I can't say. I read some suggestion that healthy tissue has an SUV of 5.0 and I found one post on here where the SUVmax was 19.5 (that was Old Barry in May 2018). Anyway Old Barry is still alive four years later, so hopefully 10.7 isn't much to worry about.

Edited by member 13 Nov 2022 at 15:17 | Reason: Not specified

Dave

User

Posted 10 Nov 2022 at 02:49

Can't remember the 19.5 statistic but what. is really important is that men exhibit sufficient PSMA for the tracer to work with it. In about 8% of men it doesn't. The result in the case being considered here indicates that no Prostate Cancer can be seen outside the Prostate, so there is a very good chance that either surgery or a form of radiation will end the cancer, although it can never be 100% ruled out because a few unseen cancer cells may have avoided the surgery or radiation so men should still be monitored after treatment even on a less frequent basis as time goes by.

Where there is no perceived advantage of offering one treatment over the other, doctors will usually leave it to the patient to decide because a case can be made for and against surgery and radiation. (Apparently, this has been explained to Dad and he will decide). In the UK, a majority of younger men tend to have surgery and older men RT. Unfortunately, the extent and severity of after effects of a treatment cannot be known until after the treatment and some men need salvage treatment with either option. Any treatment experiences posted here may not necessarily be the same for your Dad.

Hope whatever Dad decides works well for him.
.

Barry

User

Posted 13 Nov 2022 at 15:14

Thank you a lot may be we will choose HR+RT therapy. I will write what is happening and hope to help other people.

User

Posted 17 Nov 2022 at 05:04

Such an informative thread, I'm 69 with choice of RARP or RT.

Gleason 3+4, tumour II A, 49 mm and PSA 9. The urology dept is advising RARP, got a second opinion meeting next week.

Any thoughts on questions I should ask would be gratefully received, thanks and best wishes to all, Tony

User

Posted 18 Nov 2022 at 23:38

I did originally want RP. I am 58 years old and I am Gleason 9 (4+5) PSA was 12 - given staging as Tc2 M0 N0 and scans indicate no spread and contained within the prostate. No evidence of it breaking out. Found by pure accident as went to practice nurse with an insect bite and mentioned I was peeing more at night. I cannot have surgery due to DVT after a trauma injury so on HT for 4 months with 20 sessions of RT at the end of January. Told no signs of spread of cancer in the seminal vesicle, bladder or bowel or pelvic area from MRI, bone and CT scans. Prostrate is 20cc so cannot have brachytherapy as small. I know it’s a high risk cancer with Gleason 9 but hoping that the RT kills the cancer. They have told me it’s a curative intent. Onco said I was one “lucky boy” it as not broke out the capsule. Must admit though I can’t help thinking as it managed to sneak out whilst I am on HT and waiting for RT. The onco said the chance of that is “nil” as no tetrostone to feed it!

Andy

Edited by member 18 Nov 2022 at 23:42 | Reason: Forgot to add

User

Posted 19 Nov 2022 at 09:46

Really good news that the cancer has not gone outside the prostate.

Always remain positive.

Sid.

What matters is not the years in your life, but the life in your years!

User

Posted 20 Nov 2022 at 00:03

Andy (SLF), it sounds as if you are in a good situation with a treatment likely to work well. Good luck!

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