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Radiotherapy or Prostatectomy?

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User
Posted 06 Aug 2022 at 13:40

I was diagnosed with prostate cancer on 1/8/22. I had a PSA score of 6.2, followed by an MRI and then a transperineal ultrasound guided biopsy. My Gleason score is 3+4 and I have been given 2 options. Radiotherapy or Radical Prostatectomy. I'm an active fit and otherwise healthy 63 year old. Running and plenty of golf keep me fit. 


I have read all of the paperwork passed to me by NHS but prepared by Prostate Cancer UK, and I just can't make a decision. I was told that when I see the consultant on 9/8/22 I must tell him of my decision. I'm meeting a friend on Monday who has had the Prostatectomy to understand his experience, but I don't know anyone who took the radiotherapy route.


I would very much appreciate anyone sharing their thoughts with me from a more experienced and knowledgable position regarding Radiotherapy experience and generally anyone who might guide me as to which treatment to take. 


 


 


 

User
Posted 06 Aug 2022 at 16:39

Hi Tony,


I think you need to read up as much as possible before your meeting and also what to expect from side affect that can be different with each procedures .


I had PSA 2.19 and Gleason 3+4=7 that was picked up by a private medical that i needed to renew my 7.5 ton driving licence that you need at the age of 70 and as microscopic blood was found in my urine sample the doctor sent me for a PSA test.


I spoke to a specialist at my local hospital and he offered me Robotic surgery but i asked if i could have a second opinion  from the brachytherapy specialist that was at the hospital at the same time and he felt from my notes that brachytherapy was also a good option but if i choose it i would have to go to his hospital at Mount Vernon.


I used this site for help and read up as much as possible, but i was already leaning towards brachytherapy as it seemed less intrusive and i had a friend that had had it two years earlier .


I am coming up to six years from my operation with PSA 0.05 and was signed off by my specialist in 2021.


There are no guarantees on what every route you take  so i wish you luck with your choice.


You can click on my Avatar and see journey so far.


John.

Edited by member 06 Aug 2022 at 16:42  | Reason: Not specified

User
Posted 06 Aug 2022 at 16:51

Agreed, it seems a bit rushed. So you need to read up on side effects, outcomes etc etc regarding 3+4. Both have side effects. However the main side effect hopefully is that you will be free of cancer with either option

User
Posted 06 Aug 2022 at 23:30

RT/Brachytherapy/HT for me. Don't even think of making a decision this week you need a month to consider all the options, and don't worry that cancer ain't in a hurry. Look at my profile to see how I got on.

Dave

User
Posted 07 Aug 2022 at 23:40
"one of my concerns with the RT/HT route is the suggestion that if it doesn't work, that you cannot later have the RP surgery, whereas I'm told that the other way round is possible. It feels like a two bites at the cherry option."

This is slightly flawed thinking - if the first treatment fails, the chances of achieving full remission with a second treatment are much lower, regardless of which radical treatment you choose. A better way of thinking about it is to determine which treatment is most likely to get you to remission and then decide whether the certain and potential side effects of that treatment are acceptable to you. If not, which is the next best treatment with side effects that you are comfortable with.

As stated above, most men experience some loss of length and / or girth after RP but the testicles usually remain unchanged. HT also leads to loss of length / girth but also (usually) the testicles shrink as well.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Aug 2022 at 15:24

hi tony I went down the rt/ht route diagnosed psa 24.9 gleeson 9 now 14 months on psa remaining at 0.01 found whole experience very tolerable good luck with your choice gaz 👍

User
Posted 06 Aug 2022 at 16:24

That seems very rushed. Although I made up my mind quickly I was under no pressure to do so.


Prostate Cancer tool kit might help 


https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100


It's free

User
Posted 06 Aug 2022 at 18:09
I went down the RT/HT route (recommended in my case). I found it all pretty tolerable. Happy to answer any questions you might have about it.

Cheers,

Chris
User
Posted 06 Aug 2022 at 22:43
I would suggest you need to meet with the oncology team and discuss the ht/rt route too. At least then you will have the opportunity to ask questions rather than reading a leaflet. Can you meet with the surgeon too? I’m assuming both options will have the same outcome and are curative? My OH is 4.5 months post rp and has made a great recovery. It’s not an easy decision. From dx he wanted “it out” and if further treatment was required, rt would then be an option following surgery. It’s difficult to remove the prostate if you have rt/ht as primary treatment. Just had his second PSA test and its undetectable (phew) Happy to answer any questions.
User
Posted 07 Aug 2022 at 02:14
I agree with Dave that you decline being pressured into making a treatment decision for a few weeks until you feel more comfortable in doing so.

The experience of a man you know or any individual who responds to your request may be quite different to yours so I suggest you bear this in mind.

In your situation, I would want to know more about whether in as far as seems to be the location of the cancer, whether the surgeon feels how confident s/he is that your nerve bundles on both or one side can be preserved as this will greatly influence ED. With RT how many fractions (sessions) would you have and would this be with HT and if so for how long? Would one of the types of Brachytherapy be suitable, even if you had to go to a different hospital for it? It may be that you might be suitable for focal therapy as another option, so would you like to investigate this?

You will have read the pros and cons of the various treatments and it really comes down to how adverse you are to any aspect because the outcome for each in terms of dealing with cancer is pretty similar, although a repeat focal treatment might be required if you were able to have this form of treatment.
Barry
User
Posted 07 Aug 2022 at 19:52
I would speak to oncologie first and also check out other treatment options. Have you asked if HIFU, cryotherapy or nanoknife ( all available on the NHS at UCLH on the NHS) are potential options?
User
Posted 07 Aug 2022 at 21:32
Hi, i chose to go down the RT route (all details to date in my bio), its been mostly tolerable and ive been able to get on with life generally... this was for a T2 'contained' diagnosis, if the diagnosis had been worse then i may well have gone the op route. I spoke to my specialist nurse a lot before confirming that path, and also took some further advice from a couple of forum members who were all very helpful. Its obviously a big decision to make so you need to take the route your most comfortable with and, like others have indicated, don't rush it if you need more time to decide. Good Luck!
User
Posted 07 Aug 2022 at 21:43

Originally Posted by: Online Community Member


I appreciate that both treatments cause ED problems, but the RP surgery has the issue of shortening/almost losing your penis. Did you have anything like that from R/T.



From someone who is 5 months down the RP route, I don't think the shortening is such a big issue. Certainly my flacid penis looks no different from before RP. I'm yet to achieve a full "self propelled" erection so I can only compare what can be achieved with a vacuum pump. Yes, it's a bit shorter than previously but probably slightly fatter. That might more to do with the mechanics of a vacuum induced erection compared with blood pressure from the inside. Other people on here have claimed no change in length but the cut and shut process on the urethra must have some sort of impact on length in the short term at least. Rest assured there are plenty of tools in the box to address ED issues, so either way, your sex life shouldn't come to an abrupt end.


There is certainly a lot to take and it's quite wrong to be put under pressure to make a decision. Sometimes the MDT recommends one route over another (as in my case) which helps with the decision making.

User
Posted 07 Aug 2022 at 21:51

I went the RT/HT route. I initially said I wanted a prostatectomy which they said they'd do, but didn't think it would be curative, so I'd probably need RT afterwards. Also, I found it probably wouldn't be nerve sparing. This caused me to choose RT/HT, and avoid having both sets of side effects.


I'm now 3 years since the RT and 18 months since finishing the HT. A month or two back, I was able to tell my oncologist I now almost wouldn't know anything had been done, which is not at all what I was imagining from the outset.


It's still too soon to know how well the treatment worked and I'm well aware I'm a high risk patient, so recurrence is a possibility.

The HT will cause penile shortening, both through lack of Testosterone and lack of frequent erections. Regular erections, using the pump if necessary, may reduce or prevent that.

User
Posted 07 Aug 2022 at 22:08

Although the decision is left to you I found that the clinical staff, in at least my case, did have leanings towards one treatment path. They were in fact unanimous in that leaning. Has a clinical nurse been assigned, they have in my experience been very helpful? Alternatively speak to the prostatecanceruk.org specialist nurse. Again excellent and knowledgeable. 


 


 


 


 


 

Edited by member 07 Aug 2022 at 22:08  | Reason: Not specified

User
Posted 08 Aug 2022 at 00:47

Hi Tony,


We found this video really interesting just to give you an idea of what to expect from all treatment options.


My husband had RP Dec 2021. His recovery has gone far better than we expected especially in terms of continence. ED is an ongoing issue but he did have 6 months of HT aswell. 


Best of luck with whatever you decide. 


https://youtube.com/watch?v=4ELsojPFNV8&feature=share

User
Posted 08 Aug 2022 at 13:23
To answer your questions, Tony, RT side-effects are cumulative and usually peak about 10-14 days after treatment ends. I had 32 sessions of RT, so six and a half weeks, Monday-Friday.

The first three weeks or so I was absolutely fine. I then started to have difficulty peeing, which is very common - the radiation makes the prostate swell. I was prescribed Tamsulosin which completely sorted that out.

Towards the end of treatment I started passing large amounts of green slime from the rear end. This again is common: radiation irritates the bowel and makes it produce more of the mucus which lubricates things. Frequent and loose bowel motions in general. Also an increased urgency to pee (again, radiation irritates the bladder) until I was having to "go" every 40m or so, 24h a day, which was exhausting. I bought a urine bottle (Amazon) which was a big help. You get back to sleep much faster if you don't have to get out of bed.

Finished treatment. Side-effects reached their worst about 10 days later. Peeing frequently rapidly subsided. Back to normal within a few weeks. Bowel issues took much longer. At least three months to start stabilising and probably a year to return to any sort of normality. If I went out for the day I took at Imodium tablet. It didn't disrupt my life.

I'm probably making it sound worse than it was! It really wasn't too disruptive and I managed fine. I'm now three and a half years after RT. I'm still on Tamsulosin and will be for life, but no issues. Bowel is different to before, but not troublesome.

Hope that's of some help to you,

Chris


User
Posted 08 Aug 2022 at 16:41

I was high risk, so they chucked everything they could at me. HDR brachy, EBRT,  2 years HT. Brachy is almost certainly a good idea. You may be suitable for LDR brachy. If they start talking about HT find out how long they want you on it. I think, you being a low risk patient, 6 months of HT will probably be sufficient. 

Dave

User
Posted 09 Aug 2022 at 11:34

On the face of it your diagnosis seems similar to mine. However i was given the choice of active survillance as well- which I did for a couple of years or so. I can only assume the PCa is close to the edge of the prostate but I'm not a doctor. I elected in the end for open surgery and was happy with my decision. Good luck with your choice 

User
Posted 09 Aug 2022 at 20:33
I went down the HT/RT route. The "RP is better because you can have RT if it fails " line was put to me by the specialist nurse. But as the surgeon only did open surgery, wouldn't give a commitment to save nerves & suggested I may have to have RT later as my PSA was high (40).

I'm now 9 days post trestment. I had the same side effects as Cheshire Chris during treatment and for first week post treatment. My bowels now seem mostly settled and bladder seems to have started to improve. Worst side effect is poor sleep.

're your fitness levels. I've maintained mine by upping my exercise (Nordic Walking) right from the start of HT. Before RT, through it and since my treatment ended. You have to resist the temptation to feel sorry for yourself and not get out and do what ever exercise you normally do, but more. I know everyone is different but I really do believe if you don't use it you'll lose it. Good luck which ever treatment you choose. There is no such thing as an easy option but for me RT was the best.
User
Posted 10 Aug 2022 at 13:11

Hi Tony,


I was diagnosed February 2022


I went down the  HDR Brachytherapy route which went well and was tolerable, you are in hospital all day for the procedure + an overnight stay. The procedure is pain free and I didn`t have any side effects. I am halfway through my 15 radiotherapy sessions which has also been ok. 


I urinate more in the night and have ED, but a small price to pay  if it all works in the end, and I am cancer free.


I am also on HRT injections for 2 years.


Happy to answer any questions


best of luck with your choices


Pete

User
Posted 10 Aug 2022 at 15:10

Prostectomy everytime prostate cancer can return to other parts of the prostate I had a hidden one too gleason 9 had it our 7 months on all clear everything returned to normal recommend

User
Posted 10 Aug 2022 at 18:20

If you opt for surgery make sure your surgeon is high volume and has got good stats on the BAUS website. Also make sure you ask about nerve sparing and ask the surgeon how confident he is and how far he is willing to go to spare nerves.

User
Posted 13 Aug 2022 at 15:31

Hi Pete,


Thanks for that. I noted your point about HRT injections for 2 years. When I spoke to the PCUK advice line the nurse was quite surprised that I would only have HT for 4 months. She thought it ought to be 18/36 months. I spoke to my nurse about it and she was adamant that 4 months months was more appropriate. 


Has anyone else been through this conversation?


 


 

Show Most Thanked Posts
User
Posted 06 Aug 2022 at 16:24

That seems very rushed. Although I made up my mind quickly I was under no pressure to do so.


Prostate Cancer tool kit might help 


https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100


It's free

User
Posted 06 Aug 2022 at 16:39

Hi Tony,


I think you need to read up as much as possible before your meeting and also what to expect from side affect that can be different with each procedures .


I had PSA 2.19 and Gleason 3+4=7 that was picked up by a private medical that i needed to renew my 7.5 ton driving licence that you need at the age of 70 and as microscopic blood was found in my urine sample the doctor sent me for a PSA test.


I spoke to a specialist at my local hospital and he offered me Robotic surgery but i asked if i could have a second opinion  from the brachytherapy specialist that was at the hospital at the same time and he felt from my notes that brachytherapy was also a good option but if i choose it i would have to go to his hospital at Mount Vernon.


I used this site for help and read up as much as possible, but i was already leaning towards brachytherapy as it seemed less intrusive and i had a friend that had had it two years earlier .


I am coming up to six years from my operation with PSA 0.05 and was signed off by my specialist in 2021.


There are no guarantees on what every route you take  so i wish you luck with your choice.


You can click on my Avatar and see journey so far.


John.

Edited by member 06 Aug 2022 at 16:42  | Reason: Not specified

User
Posted 06 Aug 2022 at 16:51

Agreed, it seems a bit rushed. So you need to read up on side effects, outcomes etc etc regarding 3+4. Both have side effects. However the main side effect hopefully is that you will be free of cancer with either option

User
Posted 06 Aug 2022 at 18:09
I went down the RT/HT route (recommended in my case). I found it all pretty tolerable. Happy to answer any questions you might have about it.

Cheers,

Chris
User
Posted 06 Aug 2022 at 22:43
I would suggest you need to meet with the oncology team and discuss the ht/rt route too. At least then you will have the opportunity to ask questions rather than reading a leaflet. Can you meet with the surgeon too? I’m assuming both options will have the same outcome and are curative? My OH is 4.5 months post rp and has made a great recovery. It’s not an easy decision. From dx he wanted “it out” and if further treatment was required, rt would then be an option following surgery. It’s difficult to remove the prostate if you have rt/ht as primary treatment. Just had his second PSA test and its undetectable (phew) Happy to answer any questions.
User
Posted 06 Aug 2022 at 23:30

RT/Brachytherapy/HT for me. Don't even think of making a decision this week you need a month to consider all the options, and don't worry that cancer ain't in a hurry. Look at my profile to see how I got on.

Dave

User
Posted 07 Aug 2022 at 02:14
I agree with Dave that you decline being pressured into making a treatment decision for a few weeks until you feel more comfortable in doing so.

The experience of a man you know or any individual who responds to your request may be quite different to yours so I suggest you bear this in mind.

In your situation, I would want to know more about whether in as far as seems to be the location of the cancer, whether the surgeon feels how confident s/he is that your nerve bundles on both or one side can be preserved as this will greatly influence ED. With RT how many fractions (sessions) would you have and would this be with HT and if so for how long? Would one of the types of Brachytherapy be suitable, even if you had to go to a different hospital for it? It may be that you might be suitable for focal therapy as another option, so would you like to investigate this?

You will have read the pros and cons of the various treatments and it really comes down to how adverse you are to any aspect because the outcome for each in terms of dealing with cancer is pretty similar, although a repeat focal treatment might be required if you were able to have this form of treatment.
Barry
User
Posted 07 Aug 2022 at 10:52

Thanks Jim. I have ordered the toolkit.

User
Posted 07 Aug 2022 at 11:19

Hi Chris - one of my concerns with the RT/HT route is the suggestion that if it doesn't work, that you cannot later have the RP surgery, whereas I'm told that the other way round is possible. It feels like a two bites at the cherry option. The other worries are the bowel incontinence and other urinary problems. Did you suffer much with these? I think I'd suffer from not wanting to leave the house if I thought I might suddenly need to go to the loo. My wife has a similar issue (for different reasons) and I've seen how badly that has impacted her life. I appreciate that both treatments cause ED problems, but the RP surgery has the issue of shortening/almost losing your penis. Did you have anything like that from R/T.


At the end of the day, the most important factor is the success rate of both options and my consultant said that both treatments should provide a recovery for me with "one treatment". If R/T can really do that then it feels like the "less invasive" route to achieve the successful outcome. But I'd like to see the actual stats. 


The more I read, the more confused I get, and as per Old Barry, I don't think 8 days is enough time to make such an important decision. I shall make the point to the consultant on Tuesday. I shall also insist on talking to the Oncology radiotherapy consultant. 


Do you have a view on the rectal spacer option? Did you have one? It reads as though it can help to reduce side effects, although a procedure is required for it to be inserted. That sounds as though it would be worth the effort. 


If you don't mind, any other issues, pointers, tips, concerns that you might share would be very helpful.


Thanks.


 


 


 

User
Posted 07 Aug 2022 at 19:52
I would speak to oncologie first and also check out other treatment options. Have you asked if HIFU, cryotherapy or nanoknife ( all available on the NHS at UCLH on the NHS) are potential options?
User
Posted 07 Aug 2022 at 21:32
Hi, i chose to go down the RT route (all details to date in my bio), its been mostly tolerable and ive been able to get on with life generally... this was for a T2 'contained' diagnosis, if the diagnosis had been worse then i may well have gone the op route. I spoke to my specialist nurse a lot before confirming that path, and also took some further advice from a couple of forum members who were all very helpful. Its obviously a big decision to make so you need to take the route your most comfortable with and, like others have indicated, don't rush it if you need more time to decide. Good Luck!
User
Posted 07 Aug 2022 at 21:43

Originally Posted by: Online Community Member


I appreciate that both treatments cause ED problems, but the RP surgery has the issue of shortening/almost losing your penis. Did you have anything like that from R/T.



From someone who is 5 months down the RP route, I don't think the shortening is such a big issue. Certainly my flacid penis looks no different from before RP. I'm yet to achieve a full "self propelled" erection so I can only compare what can be achieved with a vacuum pump. Yes, it's a bit shorter than previously but probably slightly fatter. That might more to do with the mechanics of a vacuum induced erection compared with blood pressure from the inside. Other people on here have claimed no change in length but the cut and shut process on the urethra must have some sort of impact on length in the short term at least. Rest assured there are plenty of tools in the box to address ED issues, so either way, your sex life shouldn't come to an abrupt end.


There is certainly a lot to take and it's quite wrong to be put under pressure to make a decision. Sometimes the MDT recommends one route over another (as in my case) which helps with the decision making.

User
Posted 07 Aug 2022 at 21:51

I went the RT/HT route. I initially said I wanted a prostatectomy which they said they'd do, but didn't think it would be curative, so I'd probably need RT afterwards. Also, I found it probably wouldn't be nerve sparing. This caused me to choose RT/HT, and avoid having both sets of side effects.


I'm now 3 years since the RT and 18 months since finishing the HT. A month or two back, I was able to tell my oncologist I now almost wouldn't know anything had been done, which is not at all what I was imagining from the outset.


It's still too soon to know how well the treatment worked and I'm well aware I'm a high risk patient, so recurrence is a possibility.

The HT will cause penile shortening, both through lack of Testosterone and lack of frequent erections. Regular erections, using the pump if necessary, may reduce or prevent that.

User
Posted 07 Aug 2022 at 22:08

Although the decision is left to you I found that the clinical staff, in at least my case, did have leanings towards one treatment path. They were in fact unanimous in that leaning. Has a clinical nurse been assigned, they have in my experience been very helpful? Alternatively speak to the prostatecanceruk.org specialist nurse. Again excellent and knowledgeable. 


 


 


 


 


 

Edited by member 07 Aug 2022 at 22:08  | Reason: Not specified

User
Posted 07 Aug 2022 at 23:40
"one of my concerns with the RT/HT route is the suggestion that if it doesn't work, that you cannot later have the RP surgery, whereas I'm told that the other way round is possible. It feels like a two bites at the cherry option."

This is slightly flawed thinking - if the first treatment fails, the chances of achieving full remission with a second treatment are much lower, regardless of which radical treatment you choose. A better way of thinking about it is to determine which treatment is most likely to get you to remission and then decide whether the certain and potential side effects of that treatment are acceptable to you. If not, which is the next best treatment with side effects that you are comfortable with.

As stated above, most men experience some loss of length and / or girth after RP but the testicles usually remain unchanged. HT also leads to loss of length / girth but also (usually) the testicles shrink as well.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Aug 2022 at 00:47

Hi Tony,


We found this video really interesting just to give you an idea of what to expect from all treatment options.


My husband had RP Dec 2021. His recovery has gone far better than we expected especially in terms of continence. ED is an ongoing issue but he did have 6 months of HT aswell. 


Best of luck with whatever you decide. 


https://youtube.com/watch?v=4ELsojPFNV8&feature=share

User
Posted 08 Aug 2022 at 13:23
To answer your questions, Tony, RT side-effects are cumulative and usually peak about 10-14 days after treatment ends. I had 32 sessions of RT, so six and a half weeks, Monday-Friday.

The first three weeks or so I was absolutely fine. I then started to have difficulty peeing, which is very common - the radiation makes the prostate swell. I was prescribed Tamsulosin which completely sorted that out.

Towards the end of treatment I started passing large amounts of green slime from the rear end. This again is common: radiation irritates the bowel and makes it produce more of the mucus which lubricates things. Frequent and loose bowel motions in general. Also an increased urgency to pee (again, radiation irritates the bladder) until I was having to "go" every 40m or so, 24h a day, which was exhausting. I bought a urine bottle (Amazon) which was a big help. You get back to sleep much faster if you don't have to get out of bed.

Finished treatment. Side-effects reached their worst about 10 days later. Peeing frequently rapidly subsided. Back to normal within a few weeks. Bowel issues took much longer. At least three months to start stabilising and probably a year to return to any sort of normality. If I went out for the day I took at Imodium tablet. It didn't disrupt my life.

I'm probably making it sound worse than it was! It really wasn't too disruptive and I managed fine. I'm now three and a half years after RT. I'm still on Tamsulosin and will be for life, but no issues. Bowel is different to before, but not troublesome.

Hope that's of some help to you,

Chris


User
Posted 08 Aug 2022 at 14:12
Hi Chris.

Many thanks. After all of this reading/help and talking to Prostate Cancer UK, I'm heading towards Brachytherapy if I am allowed, or normal EBR if I can't. It sounds so much more straightforward and less invasive the RP.
User
Posted 08 Aug 2022 at 15:24

hi tony I went down the rt/ht route diagnosed psa 24.9 gleeson 9 now 14 months on psa remaining at 0.01 found whole experience very tolerable good luck with your choice gaz 👍

User
Posted 08 Aug 2022 at 16:41

I was high risk, so they chucked everything they could at me. HDR brachy, EBRT,  2 years HT. Brachy is almost certainly a good idea. You may be suitable for LDR brachy. If they start talking about HT find out how long they want you on it. I think, you being a low risk patient, 6 months of HT will probably be sufficient. 

Dave

User
Posted 09 Aug 2022 at 11:34

On the face of it your diagnosis seems similar to mine. However i was given the choice of active survillance as well- which I did for a couple of years or so. I can only assume the PCa is close to the edge of the prostate but I'm not a doctor. I elected in the end for open surgery and was happy with my decision. Good luck with your choice 

User
Posted 09 Aug 2022 at 20:33
I went down the HT/RT route. The "RP is better because you can have RT if it fails " line was put to me by the specialist nurse. But as the surgeon only did open surgery, wouldn't give a commitment to save nerves & suggested I may have to have RT later as my PSA was high (40).

I'm now 9 days post trestment. I had the same side effects as Cheshire Chris during treatment and for first week post treatment. My bowels now seem mostly settled and bladder seems to have started to improve. Worst side effect is poor sleep.

're your fitness levels. I've maintained mine by upping my exercise (Nordic Walking) right from the start of HT. Before RT, through it and since my treatment ended. You have to resist the temptation to feel sorry for yourself and not get out and do what ever exercise you normally do, but more. I know everyone is different but I really do believe if you don't use it you'll lose it. Good luck which ever treatment you choose. There is no such thing as an easy option but for me RT was the best.
User
Posted 10 Aug 2022 at 13:11

Hi Tony,


I was diagnosed February 2022


I went down the  HDR Brachytherapy route which went well and was tolerable, you are in hospital all day for the procedure + an overnight stay. The procedure is pain free and I didn`t have any side effects. I am halfway through my 15 radiotherapy sessions which has also been ok. 


I urinate more in the night and have ED, but a small price to pay  if it all works in the end, and I am cancer free.


I am also on HRT injections for 2 years.


Happy to answer any questions


best of luck with your choices


Pete

User
Posted 10 Aug 2022 at 15:10

Prostectomy everytime prostate cancer can return to other parts of the prostate I had a hidden one too gleason 9 had it our 7 months on all clear everything returned to normal recommend

User
Posted 10 Aug 2022 at 18:20

If you opt for surgery make sure your surgeon is high volume and has got good stats on the BAUS website. Also make sure you ask about nerve sparing and ask the surgeon how confident he is and how far he is willing to go to spare nerves.

User
Posted 13 Aug 2022 at 15:27
It turns out I wasn't quite as T2 as I was originally told. As the tumour was close to the edge of the prostate and 'is bulging" its very near to a T3. I was told that on that basis brachytherapy was not an option. My nurse has been great and we discussed the options at great length. She insists that the prospects of curative success are the same for both Op and HT/RT routes.

The concern that I've always had with the HT/RT route is keep being told that with the Op you can later have RT if things fail, but not the other way round. However both the Oncologist and the nurse have talked about Salvage treatments. I was told that I could keep taking HT which would keep it under control "forever", but she made a good point about ongoing advancements in treatments, which happen all the time. I was comforted by her comments and if things do go wrong I feel that I have further HT as option (1), with the back up of whatever next comes down the line could be more curative. Has anyone else had this sort of message?

In the end I have chosen HT/RT based on the treatment and side effects being more tolerable to me and the success rates being the same. But I have not yet started the treatment..... tablets are due next week.

But I still lie in bed every night wondering if I've made the right decision. I'm so scared.
User
Posted 13 Aug 2022 at 15:31

Hi Pete,


Thanks for that. I noted your point about HRT injections for 2 years. When I spoke to the PCUK advice line the nurse was quite surprised that I would only have HT for 4 months. She thought it ought to be 18/36 months. I spoke to my nurse about it and she was adamant that 4 months months was more appropriate. 


Has anyone else been through this conversation?


 


 

 
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