Treatment choice

Treatment choice

User

Posted 08 Dec 2022 at 23:39

I have been diagnosed and have had biopsies , 7 out of 9 have cancer. my PSA went from 30 t0 35in a month.

I'm now being offered Prostate removal surgery or Radiotherapy and have to make that decision. I have also heard of another treatment called Nanoknife or irreversible electroporation. I don't know if this is available on the NHS. I think basically the cancer is burnt out electrically. There are few side affects, but I don.t know about reoccurrence. Know that the cancer is contained in the prostate.

Basically has anyone got any advice?

User

Posted 09 Dec 2022 at 00:12

You can ask your consultant to refer you to a Nanoknife specialist for a view although I suspect with 7/9 positive cores and a PSA over 10, you will not be suitable. Nanoknife may be a reasonable option for someone with a very small tumour which has been diagnosed , early and the emotional resilience not to be devastated if the cancer comes back. It also helps if you can afford to pay for it doing more than once. There are two hospitals in England that offer Nanoknife on the NHS although I am not sure either are accepting referrals for prostate cancer at the moment.

If not already done so, do make sure you have an appointment with an oncologist who offers brachytherapy before you make a decision between RP and external beam RT

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

User

Posted 09 Dec 2022 at 07:48

I would look into brachytherapy, however I was under the impression that your PSA had to be less than 20 to be considered.

I could be wrong.

Rgds

Dave

User

Posted 09 Dec 2022 at 12:39

Your Gleason score and staging will also help guide you. If your Gleason is say 3+3=6 then an alternative might be a possibility. If it's a lot higher then a more radical approach will likely be needed. If your staging is T2 that also points at a lower risk with an alternative treatment. A psa of 35 could indicate radiotherapy will be the best option as it will cover a wider area. Although I don't want to make a judgement as your psa might be caused by inflamation and there are a number of other things to consider. Personally I'd consider the alternative treatments, except Brachytherapy, only for low risk small cases. All the best, Peter

User

Posted 09 Dec 2022 at 14:00

Originally Posted by: Online Community Member

This was my situation: a PSA (32 at diagnosis) that was considered anomalously high for the biopsy results (G3+4). The conclusion was that there was a high probability of undetectable micro-mets in the lymph nodes outside the prostate hence a recommendation for whole-pelvis RT to zap everything.

Cheers,

Chris

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