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What treatment road should I go down?

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User
Posted 22 Aug 2022 at 16:02

Hello everyone.Sorry for the silly username(blame my other half!)but I can't seem to change it.

Had MRI July 11th,nurse said looked very suspicious,had transperineal biopsy done same day.

"Peripheral zone-2.1 cm diameter focus of abnormal signal posteriorly  within the left peripheral zone towards

the gland base in the 4-6 o'clock position.It shows significant restriction of diffusion & marked contrast enhancement consistent with PIRADS 5/Likert 5 change."

Transition zone-no convincing tumour focus identified.Probable extracapsular extension.

Radiological staging T3a,No, Mo. Gleason 7 .

Saw radiologist today.(22nd August)He told me bone scan clear,lymph nodes clear and no evidence of spread(phew!).Also that the cancer was curable.

We went on to discuss treatment options:-he advised against surgery in view of my age-75-although gym fit and in otherwise  good health. Suited me as I was set against prostatectomy anyhow as I did not want to run the 

incontinence risk,however small. He thought I might be suitable for HIFU until I said a previous consultant had told me at my initial interview I wouldn't be suitable as there was another tumour in the right lobe .

I'm seeing a HIFU specialist on 7th Sept to rule me in/out for HIFU. 

Radiologist ruled me out for Nanoknife as he said radiation level used would be too strong for my bowel-I have

a long-standing Ulcerative Colitis condition which has been quiescent for the last 25 years or so, but nevertheless

he would be nervous of recommending that treatment for me.

Which brought us down to ADT/radiation therapy. Again, I asked about OAR gel treatment to protect the bowel -he agreed that was a possibility but that that was only available privately in the UK. Would that mean I would have to have the whole treatment privately then? He recommended ADT/radiation therapy.

I ideally want a treatment with the least side effects if I am suitable  .

Hope I haven't gone on for too long! Will keep my future posts briefer. 

Has anyone got any thoughts on what I've said? Thanks for listening.

 

 

User
Posted 23 Aug 2022 at 03:49
I took the opportunity of asking whether Space Oar might be used with HIFU. I was told that it had been tried but HIFU holed it so not an option with this form of treatment. Best results with HIFU are dealing with a significant tumour on one side of the Prostate, although full gland ablation is still done but less so now. I am surprised the Radiologist ruled out Nanoknife because of radiation. This is another name for Irreversible Electroporation which relies on short bursts of electricity administered via probes placed in the prostate not using radiation. I wonder whether the Radiologist was thinking of Cyberknife which does use radiation.
Barry
User
Posted 22 Aug 2022 at 20:08
I think if HIFU is available and you are fairly pragmatic about doing it again in the future if the first time doesn't get it all, go for it.

Paying privately for SpaceOar should not prevent you from having RT on the NHS. You may have to travel for the SpaceOar though.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Aug 2022 at 21:22

SpaceOar is useful in some situations but not all. I'm your age and I was treated with RT [followed by HT] without SpaceOar. I asked about it but my oncologist suggested it would not be necessary. Turned out to be correct, absolutely no issues with stray RT

Jules

User
Posted 23 Aug 2022 at 08:00
Hi Cosybedrabbit

To change your username use the "Update Profile" button at the top of the page. First option is " username to show". Change that to what you want.

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User
Posted 22 Aug 2022 at 20:08
I think if HIFU is available and you are fairly pragmatic about doing it again in the future if the first time doesn't get it all, go for it.

Paying privately for SpaceOar should not prevent you from having RT on the NHS. You may have to travel for the SpaceOar though.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Aug 2022 at 21:22

SpaceOar is useful in some situations but not all. I'm your age and I was treated with RT [followed by HT] without SpaceOar. I asked about it but my oncologist suggested it would not be necessary. Turned out to be correct, absolutely no issues with stray RT

Jules

User
Posted 23 Aug 2022 at 03:49
I took the opportunity of asking whether Space Oar might be used with HIFU. I was told that it had been tried but HIFU holed it so not an option with this form of treatment. Best results with HIFU are dealing with a significant tumour on one side of the Prostate, although full gland ablation is still done but less so now. I am surprised the Radiologist ruled out Nanoknife because of radiation. This is another name for Irreversible Electroporation which relies on short bursts of electricity administered via probes placed in the prostate not using radiation. I wonder whether the Radiologist was thinking of Cyberknife which does use radiation.
Barry
User
Posted 23 Aug 2022 at 08:00
Hi Cosybedrabbit

To change your username use the "Update Profile" button at the top of the page. First option is " username to show". Change that to what you want.

 
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