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Buyers remorse

User
Posted 23 May 2022 at 23:37

Hi all

I was diagnosed in 2014 with Gleason 3+4 in 20% of 1 core and was considered low risk. I choose active surveillance as it seemed to me that the risks involved with treatment seemed higher than leaving it. I had around 8 MRIs over the years that all showed TxM0N0, no measurable tumour and no spread. My PSA tended to wander around, but was 4.9 at its highest.

At the start of the year my PSA hit 6, which kind of freaked me out as this was at the same time as another MRI that showed nothing much. I asked for another biopsy and the result was 3+4 in 80% of 3 cores. Now considered low to intermediate risk, the advice was to undergo treatment.

I spoke to radiotherapy folks and surgery folks and decided on robotic assisted RP, which I had done last Monday at the Churchill in Oxford. The surgery went as planned and based on my MRIs, the surgeon said he had saved both nerve clusters. He also said that he could feel no tumour in the extracted tumour, which is consistent with my MRIs.

Since having the op I am plagued by the question, have I used a sledgehammer to crack a nut? Should I have opted for radiotherapy or HIFU? I was never going to leave it to surveillance again, but I find myself consumed by doubt about my choice, watching countless videos on YouTube of doctors extolling the virtues of radiotherapy over RP. I now it’s too late to change anything, but wondered if everyone has these feelings?

In terms of recovery, I am doing OK. I never had any real pain, it just felt like I’d done a ton of sit-ups. The catheter is driving me nuts though and that is coming out on Friday. Then I have the incontinence and ED to deal with, but all in time. Time does seem to be the key here.

 

Anyway, I’m just starting my journey and I wish everyone well on theirs 

 

 

 

User
Posted 24 May 2022 at 08:40

Originally Posted by: Online Community Member
Since having the op I am plagued by the question, have I used a sledgehammer to crack a nut? Should I have opted for radiotherapy or HIFU?

I don't think you've got any reason to regret your choice. There's always options but the way you went is as likely to achieve long term success as RT of some form would have. If you're unlucky enough to have any form of recurrence in the future RT would be an option to deal with that. The worst thing you can do in these situations is to underestimate the seriousness of the issue and under-treat it [sorry for making up a term there].

Once you've recovered from surgery you will probably feel much better about your choice!

Jules

User
Posted 24 May 2022 at 08:53

Hi Anthony 

The first thing I’d say is, don’t over think it. I had a PSA of 4.7 with a Gleason score of 4 + 4 and was headed for RP until a PSMA scan showed contact with the capsule. After that I was only offered RT with HT for three years and ongoing active monitoring.

So, whereas I feel good and healthy I have serous ongoing fitness issues as the HT rips into my muscles. I also have the recurrent issue if the next PSA result.

But once it’s gone, it’s gone.  You’ll recover from the RP, regain your fitness and there are ways and means for the ED too. 

User
Posted 24 May 2022 at 13:38

I was diagnosed T2b, Gleason 3+4 and had RALP last November. I suffered the same doubts as you. However, my post op pathology revised the staging to T3a and all my doubts disappeared. Had I not had the op, I would never have known the true situation and whilst I still do have a risk of reoccurrence, even with clear margins, I believe the risk would have been greater with other procedures. 

User
Posted 24 May 2022 at 08:29

Soon they will give you the true results following the examination of the whole prostate following removal. 

User
Posted 24 May 2022 at 08:49
You've done exactly the right thing. Your cancer is now (hopefully) sorted, so get on with the rest of your life!

Best wishes,

Chris

User
Posted 24 May 2022 at 20:59

So now you think you used a sledgehammer to crack a nut, but if you had chosen RT you would be worried you had tried using a toffee hammer when a ball-pain hammer was the correct tool.

There is no wrong answer because you only get one go at a first treatment. So you can never compare the outcomes.

If things go wrong now would they have gone right with the other treatment? Would they have gone wrong even faster with the other treatment. If things go right now, would they have gone just as right with the other treatment, or wrong with the other treatment? As you will never know the answer it is pointless speculating. Just get on with your life and regret nothing.

Dave

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User
Posted 24 May 2022 at 08:29

Soon they will give you the true results following the examination of the whole prostate following removal. 

User
Posted 24 May 2022 at 08:40

Originally Posted by: Online Community Member
Since having the op I am plagued by the question, have I used a sledgehammer to crack a nut? Should I have opted for radiotherapy or HIFU?

I don't think you've got any reason to regret your choice. There's always options but the way you went is as likely to achieve long term success as RT of some form would have. If you're unlucky enough to have any form of recurrence in the future RT would be an option to deal with that. The worst thing you can do in these situations is to underestimate the seriousness of the issue and under-treat it [sorry for making up a term there].

Once you've recovered from surgery you will probably feel much better about your choice!

Jules

User
Posted 24 May 2022 at 08:49
You've done exactly the right thing. Your cancer is now (hopefully) sorted, so get on with the rest of your life!

Best wishes,

Chris

User
Posted 24 May 2022 at 08:53

Hi Anthony 

The first thing I’d say is, don’t over think it. I had a PSA of 4.7 with a Gleason score of 4 + 4 and was headed for RP until a PSMA scan showed contact with the capsule. After that I was only offered RT with HT for three years and ongoing active monitoring.

So, whereas I feel good and healthy I have serous ongoing fitness issues as the HT rips into my muscles. I also have the recurrent issue if the next PSA result.

But once it’s gone, it’s gone.  You’ll recover from the RP, regain your fitness and there are ways and means for the ED too. 

User
Posted 24 May 2022 at 13:38

I was diagnosed T2b, Gleason 3+4 and had RALP last November. I suffered the same doubts as you. However, my post op pathology revised the staging to T3a and all my doubts disappeared. Had I not had the op, I would never have known the true situation and whilst I still do have a risk of reoccurrence, even with clear margins, I believe the risk would have been greater with other procedures. 

User
Posted 24 May 2022 at 20:59

So now you think you used a sledgehammer to crack a nut, but if you had chosen RT you would be worried you had tried using a toffee hammer when a ball-pain hammer was the correct tool.

There is no wrong answer because you only get one go at a first treatment. So you can never compare the outcomes.

If things go wrong now would they have gone right with the other treatment? Would they have gone wrong even faster with the other treatment. If things go right now, would they have gone just as right with the other treatment, or wrong with the other treatment? As you will never know the answer it is pointless speculating. Just get on with your life and regret nothing.

Dave

 
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