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Another Englishman in France

User
Posted 18 Mar 2023 at 23:01

I live in the South of France near Montpellier. I had a urine infection last August and a PSA test showed a high level of 32. I had a full workup of physical examination by the urologist, ultrasound, CT scan and PET scan all which showed no metatases. Biopsy gave Gleason 3+4 with cancer in all samples with nerve infiltration and the cancer appeared to be outside the capsule. MRI confirmed this is the case. So I am T3N0M0 probably and CPG 5. Option of wait and see is out of course, I need treatment. I am a retired nurse who used to work on a cancer wing in a London hospital so I am realistic.

I have started HT (February) and will be having radiotherapy. I see a oncological radiologist next week and I will be having a second opinion while I am in England over Easter so I can speak in my own language. My French is OK but not fluent.

I have no questions at the moment but may ask some after seeing the radiologist. It might be useful to compare the treatments here with England. I suspect they are pretty much the same.

There is a cancer support charity for Anglophones in France called Cancer Support France. I had just started volunteering for them when I found I too had cancer. Weird eh?

User
Posted 19 Mar 2023 at 00:51

Your diagnosis is almost exactly the same as mine five years ago. Only difference is I was G4+5 and PSA was about 25. I had HT, HDR, EBRT. All my PSAs since treatment have been either 0.1 or 0.2 . I'm happy with that.

Dave

User
Posted 19 Mar 2023 at 12:36
That's great to hear. I have a couple of questions if you don't mind answering

Are you on any treatments now?

How long were you on HT? My urologist wants me on it for 3 years.

What was the rationale for the HDR as well as EBRT? Were you on three-dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) or its image guided version or something else?

It would be useful to know to prepare questions for my meeting with the oncologist (in French).

Thanks

User
Posted 19 Mar 2023 at 13:45

I am not on any treatment now. I was diagnosed in March 2018. On to HT (zoladex) for 24 months. HDR in September 2018. Followed by 15 fractions EBRT. I was treated at Christie hospital Manchester. LINAC was an Elektra Versa HD, it can be used in different modes. I think image guided was the mode used on me.

The HDR allows a high dose of radiation to be given with no damage to nearby organs. As I had extra capsular extension and perineural invasion EBRT allowed for a slightly wider area to be treated, but as the HDR did most of the work the EBRT which puts other organs at risk was about half strength.

I guess a question to ask is, Is HDR suitable for you?

Do you need 3 years HT? Latest evidence is that 18 months is probably sufficient.

Last HT injection was January 2020 it wasn't until Jan 2021that my testosterone was fully recovered. All PSAs whilst on HT were <0.1 and since then have been 0.1 or 0.2 often alternating.

Allowing for the time it took to recover testosterone I would say I am two years post treatment and all is well. I am fully aware that cancer could return but I will worry about that bridge when I get there.

Dave

User
Posted 19 Mar 2023 at 22:49
Thanks, that is really useful. We have been looking at other centres of excellence in the USA and your treatment of HDR EBRT and HT seems the preferred option for our profile of locally advanced cancer. Quite how useful HT is and for how long is under researched but I am happy to take it and will probably discontinue it at 18 months unless someone can give me a really good reason to continue.

Glad you are in remission and hope it stays that way.

Denis

 
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