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Meeting with the Dr

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User
Posted 21 Jun 2022 at 16:38

Hello everyone


My name is Tim and I was diagnosed with prostrate cancer last week. I had a meeting with the nurse who confirmed that I had it, that my Gleeson score was 7 (3+4), went through the treatment options that may be available and gave me a helpful booklet to read.


My conversation with the Dr is tomorrow as I had to have a bone scan beforehand. Hopefully that will come back as negative.


I have a list of questions but was wondering whether there are questions which, from experience, you would consider particularly useful or would have liked to asked? I'm conscious that I am still processing the news and may miss something obvious.


Thank you in advance.


Tim

User
Posted 21 Jun 2022 at 19:18

Has it escaped the prostate. What percentage of prostate has cancer. If it is only in the prostate how close is it to escaping? If surgery were done could nerves be spared?


Would hifu or another focal treatment be possible?


I generally think surgery is a bad idea, but if the answers to the above questions are good surgery may be the best option.

Dave

User
Posted 21 Jun 2022 at 20:28
There are factors that can swing surgery as being perceived as best solution in certain cases, although more risky in terms of more severe effects. Where MDT have suggested there are options, it's a good idea to discuss with an Oncologist as well as Urologist, also if it is an option, presenting histology with scans to Focal specialist if on balance this form of treatment appeals to patient. Another thing that should be asked is whether one of the two forms of Brachytherapy. If one of the forms of RT offered would it have to be accompanied by HT and if so for how long? The latter best addressed to Oncologist.
Barry
User
Posted 21 Jun 2022 at 20:43

OH went for surgery as all other options were with hormone therapy and that did not appeal to him at all. 


It had been recommended he list all options with side effects and sort them in order of dislike. HT side effects were his least liked.

User
Posted 22 Jun 2022 at 00:48

Every treatment you have will have side effects and they may be a tiny bit unpleasant or very unpleasant, which side effects you get and how severe they are does not seem to be easy to foresee. If you get bad side effects from surgery it will be reasonably soon and you have a long time to live with them, if you get side effects from radiotherapy they are usually not too severe and they may not appear for a decade.


Side effects of HT are pretty much immediate and are bearable for most and alleviated once HT stops (usually two years) 


Surgery fails in 30% of cases, so you then have to contend with the side effects of surgery and RT. 


Focal therapies do very little damage outside of the prostate so if you are suitable for one they are the best.

Dave

User
Posted 23 Jun 2022 at 05:04

Hi and Welcome to the club,


I understand from my experiences that it is a big shock when you are told you have prostate cancer and it is difficult to take it all in.


Try to read up on it as much as you can and check out all the options and side affects ,but of course listen to the specialists and ask to speak to the surgeon if possible on all the options.


I had PSA 2.19 Gleason 3+4=7 and was offered robotic removal by the first surgeon at my local hospital but was lucky to also speak to a Brachytherpy surgeon and he felt that with my numbers Brachytherpy was also a good option. I looked at all the options and decided to take the Brachytherapy route as i felt there where less possible side affects.


I had my Brachytherpy at Mount Vernon hospital and not my local Hospital.I am coming up to six years from my Brachytherpy with PSA @ 0.05 . If you click one my Avatar you can see my Journey so far.


There are no guarantees on any of the  procedures . I have been very lucky with my progress so far with no great side affects apart from ED but at 76 years old i think that is normal maybe but still get Viagra on prescription.


Good luck John.

User
Posted 23 Jun 2022 at 13:39

Thank you John


Do we gate a badge? 😁


Glad to hear that you are in good place.


Best wishes


Tim


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

User
Posted 23 Jun 2022 at 14:41

Hi Tim,


Great that you are getting some answers Good luck.


Still awaiting the Club badge,😇


Regards John.

User
Posted 23 Jun 2022 at 15:42

If brachytherapy can't be done and you prefer not to have a prostatectomy, external beam radiotherapy may be an option, unless you are a particularly young patient, and is less likely to impact erections than a non-nerve sparing prostatectomy.


By the way, do check out Reading Prostate Cancer Support Group, which is one of the more active local support groups.

User
Posted 23 Jun 2022 at 18:35

Wexham Park was my 'home' hospital and I had my prostatectomy at Royal Berks.


I did need salvage radiotherapy and 18 months of hormone therapy. 


But it has all worked.  There are some very good doctors in Berkshire.  

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User
Posted 21 Jun 2022 at 19:18

Has it escaped the prostate. What percentage of prostate has cancer. If it is only in the prostate how close is it to escaping? If surgery were done could nerves be spared?


Would hifu or another focal treatment be possible?


I generally think surgery is a bad idea, but if the answers to the above questions are good surgery may be the best option.

Dave

User
Posted 21 Jun 2022 at 19:54

Thank you, those are excellent questions.


Why do you think surgery is a bad option? I swing from one to the other as a preferred option.

User
Posted 21 Jun 2022 at 20:28
There are factors that can swing surgery as being perceived as best solution in certain cases, although more risky in terms of more severe effects. Where MDT have suggested there are options, it's a good idea to discuss with an Oncologist as well as Urologist, also if it is an option, presenting histology with scans to Focal specialist if on balance this form of treatment appeals to patient. Another thing that should be asked is whether one of the two forms of Brachytherapy. If one of the forms of RT offered would it have to be accompanied by HT and if so for how long? The latter best addressed to Oncologist.
Barry
User
Posted 21 Jun 2022 at 20:43

OH went for surgery as all other options were with hormone therapy and that did not appeal to him at all. 


It had been recommended he list all options with side effects and sort them in order of dislike. HT side effects were his least liked.

User
Posted 22 Jun 2022 at 00:48

Every treatment you have will have side effects and they may be a tiny bit unpleasant or very unpleasant, which side effects you get and how severe they are does not seem to be easy to foresee. If you get bad side effects from surgery it will be reasonably soon and you have a long time to live with them, if you get side effects from radiotherapy they are usually not too severe and they may not appear for a decade.


Side effects of HT are pretty much immediate and are bearable for most and alleviated once HT stops (usually two years) 


Surgery fails in 30% of cases, so you then have to contend with the side effects of surgery and RT. 


Focal therapies do very little damage outside of the prostate so if you are suitable for one they are the best.

Dave

User
Posted 23 Jun 2022 at 05:04

Hi and Welcome to the club,


I understand from my experiences that it is a big shock when you are told you have prostate cancer and it is difficult to take it all in.


Try to read up on it as much as you can and check out all the options and side affects ,but of course listen to the specialists and ask to speak to the surgeon if possible on all the options.


I had PSA 2.19 Gleason 3+4=7 and was offered robotic removal by the first surgeon at my local hospital but was lucky to also speak to a Brachytherpy surgeon and he felt that with my numbers Brachytherpy was also a good option. I looked at all the options and decided to take the Brachytherapy route as i felt there where less possible side affects.


I had my Brachytherpy at Mount Vernon hospital and not my local Hospital.I am coming up to six years from my Brachytherpy with PSA @ 0.05 . If you click one my Avatar you can see my Journey so far.


There are no guarantees on any of the  procedures . I have been very lucky with my progress so far with no great side affects apart from ED but at 76 years old i think that is normal maybe but still get Viagra on prescription.


Good luck John.

User
Posted 23 Jun 2022 at 13:38

Thank you all again for the advice.


I had the meeting yesterday and feel positive at the outcome. The consultant suggested that brachytherapy was the best option given my circumstances (Gleason score 7, cancer only on the prostrate) however there was a question mark over whether my prostrate is big enough (its 17 cm3) so I am going to have a discussion with the oncologist as to how they see it.


Give the distribution of the cancer around the prostrate, the prostatectomy will take all the nerves so I am anxious to avoid that at this stage. However, I may find myself in that position if the prostrate is deemed to small. So no immediate resolution but the consultant is confident that it can be cured.

User
Posted 23 Jun 2022 at 13:39

Thank you John


Do we gate a badge? 😁


Glad to hear that you are in good place.


Best wishes


Tim


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

User
Posted 23 Jun 2022 at 14:41

Hi Tim,


Great that you are getting some answers Good luck.


Still awaiting the Club badge,😇


Regards John.

User
Posted 23 Jun 2022 at 15:42

If brachytherapy can't be done and you prefer not to have a prostatectomy, external beam radiotherapy may be an option, unless you are a particularly young patient, and is less likely to impact erections than a non-nerve sparing prostatectomy.


By the way, do check out Reading Prostate Cancer Support Group, which is one of the more active local support groups.

User
Posted 23 Jun 2022 at 18:35

Wexham Park was my 'home' hospital and I had my prostatectomy at Royal Berks.


I did need salvage radiotherapy and 18 months of hormone therapy. 


But it has all worked.  There are some very good doctors in Berkshire.  

 
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