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Is having RP just delaying HT/RT

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User
Posted 20 Jan 2023 at 15:56
Looking for some advice/input

Age 69 G8 T3a NO MO psa 9.191 (CT scan next week)

advised can have RP(robotic) in approx 6wks

or HT 3 months then RT 

I have only seen the surgeon so far, waiting to speak to the oncologist

my initial gut reaction is to have the surgery

I have asked if they don't get everything with the surgery

what is the time secondary treatment re the HT and RT times, they said 

that would be referred to the oncologist

Is taking surgery just kicking the can down the road (as I am T3a)

and that I might need HT and RT anyway, if so what benefit would the operation be
User
Posted 20 Jan 2023 at 22:57

It's a good point about kicking the can down the road.   I went for surgery wanting it out even if it didn't do the long term fix but thinking it would.   Since then I've read several accounts where they say modern RT is much better than it was focussing more precisely and with better doses, and with a T3 it can radiate areas around the prostate that an op wouldn't clear.  I'd expect that depends where your T3 lesion is and whether they scan to get a more precise location if needed.


I note you're a Gleason 8, presumably 4+4.  From what I've read RT and hormones could also restrict that more than an op.


With a Gleason 8 I've also read that hormones before and after RT are better.


You might watch YouTube oncologist Dr Scholz, although I would say be careful as some doctors can frighten you to death and might suggest things that aren't easy to get or are very rare.  I'll link one video below but he's done a few on that channel related to treating Gleason 8 with RT and different hormones and chemo.   He also says PCa chemo isn't as toxic as chemo for other cancers.    https://youtu.be/q2bTlh7MwsE


My health warning is not to take the word of one person as correct.


All the best.

Edited by member 20 Jan 2023 at 23:14  | Reason: Not specified

User
Posted 20 Jan 2023 at 16:47

Traveler, apparently 70 percent of surgery cases are successful as are approximately 70 percent of RT treatments. You will ideally choose the treatment that gives you the best chance of success at the first attempt.


 


Thanks Chris 

User
Posted 20 Jan 2023 at 17:09

It’s a difficult one. My husband was T3a N1 PSA 8.3 and G7.


He had surgery knowing he would need RT afterwards, he just wanted the bulk of it out and they also removed the infected lymph node.


His stats changed after the op T2 N1 and G9. They get the chance to look at the whole prostate then of course. 


He is over 12 months post op and had his last 3 monthly HT injection Nov 2021 (only ever had 6 month HT in total) He has so far had an undetectable PSA so hasn’t commenced RT. We’re hoping it will stay that way but we know it could change anytime.


I think many will say why put yourself through 2 lots of side effects. (You’re in a better position than us though with no spread to lymph nodes) Luckily for us my husband has recovered really well from the op and will be 75 in April. He does have ED but improving. We seem to cope better with that than his loss of libido from HT.


Everyone is different though and have different things that matter more for them. Hopefully when you have spoken to oncology aswell you will have all the information you need to make the best decision for you.


All the very best


Elaine

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User
Posted 20 Jan 2023 at 16:47

Traveler, apparently 70 percent of surgery cases are successful as are approximately 70 percent of RT treatments. You will ideally choose the treatment that gives you the best chance of success at the first attempt.


 


Thanks Chris 

User
Posted 20 Jan 2023 at 17:09

It’s a difficult one. My husband was T3a N1 PSA 8.3 and G7.


He had surgery knowing he would need RT afterwards, he just wanted the bulk of it out and they also removed the infected lymph node.


His stats changed after the op T2 N1 and G9. They get the chance to look at the whole prostate then of course. 


He is over 12 months post op and had his last 3 monthly HT injection Nov 2021 (only ever had 6 month HT in total) He has so far had an undetectable PSA so hasn’t commenced RT. We’re hoping it will stay that way but we know it could change anytime.


I think many will say why put yourself through 2 lots of side effects. (You’re in a better position than us though with no spread to lymph nodes) Luckily for us my husband has recovered really well from the op and will be 75 in April. He does have ED but improving. We seem to cope better with that than his loss of libido from HT.


Everyone is different though and have different things that matter more for them. Hopefully when you have spoken to oncology aswell you will have all the information you need to make the best decision for you.


All the very best


Elaine

User
Posted 20 Jan 2023 at 22:57

It's a good point about kicking the can down the road.   I went for surgery wanting it out even if it didn't do the long term fix but thinking it would.   Since then I've read several accounts where they say modern RT is much better than it was focussing more precisely and with better doses, and with a T3 it can radiate areas around the prostate that an op wouldn't clear.  I'd expect that depends where your T3 lesion is and whether they scan to get a more precise location if needed.


I note you're a Gleason 8, presumably 4+4.  From what I've read RT and hormones could also restrict that more than an op.


With a Gleason 8 I've also read that hormones before and after RT are better.


You might watch YouTube oncologist Dr Scholz, although I would say be careful as some doctors can frighten you to death and might suggest things that aren't easy to get or are very rare.  I'll link one video below but he's done a few on that channel related to treating Gleason 8 with RT and different hormones and chemo.   He also says PCa chemo isn't as toxic as chemo for other cancers.    https://youtu.be/q2bTlh7MwsE


My health warning is not to take the word of one person as correct.


All the best.

Edited by member 20 Jan 2023 at 23:14  | Reason: Not specified

 
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