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Treatment advice - surgery/RT/Brachytherapy

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User
Posted 27 Jul 2023 at 21:58

Hi,

I am 54 and this week had Biopsy results confirming cancer.

May - I had MRI following Dr visit concerned about pee flow etc, PSA 6.5.

MRI showed a 10mm lesion on the right side of my Prostate. PIRADS 4 . Prostate 16 cc. Susoected to be contained.

Biopsy 2 weeks ago - transperineal. 14 cores taken.

 

Results of Biopsy - 2 cores show cancer. They were from area on right where MRI showed the lesion. Cores have 5% and 60% cancer.

T-2 N-0 

Gleason - 7 (3 + 4)

I am to get a bone scan in 2/3 weeks. The clinical nurse has mentioned likely options of surgery, RT or Brachytherapy ( pending a flow test ).

I appreciate the bone scan results will influence options, however if it is clear then I am looking for advice/ thought to help me pick the best option for me ?

Any advice is greatly appreciated.

thanks 

Craig 

User
Posted 26 Sep 2023 at 18:19

Following appointments with surgeon and then the consultant oncologist I made my decision to have surgery.

Just had it confirmed that operation will be next week Wednesday 4th October .

Fingers crossed .

 

User
Posted 27 Jul 2023 at 23:46

Interesting that you are getting a bone scan, nothing in your scoring suggests that you should need one. Although it's good of course that they are checking for peace of mind.

As for treatment it's can be tricky. My clinicians gave me a gentle nudge towards surgery and were very good at discussing why the other options carried more risk. Age being pretty much the deciding factor.

Edited by member 28 Jul 2023 at 00:20  | Reason: Not specified

User
Posted 27 Jul 2023 at 23:56

Originally Posted by: Online Community Member
Interesting that you are getting a bone scan, nothing in your scoring suggests that you should need one.

Bone scans are a standard precautionary move. Certainly no reason for concern because it's been recommended.

Jules

User
Posted 28 Jul 2023 at 07:35
Hello C Mac, click on my avatar to see my diagnostic and treatment journey.

Hope it helps.

Rgds

Dave

User
Posted 28 Jul 2023 at 08:20

Hi Craig,

RT with a brachytherapy boost might also be an option as well. It was ruled out for me because of poor flow rate. Also bear in mind that the criteria for surgery in Scotland is slightly different from England  in that if there is any sign of spread they won’t offer surgery…however that doesn’t appear to be the case for you, so you are lucky to have that choice given that you are a youngster😊 Again it wasn’t offered to me because I am T3B.

it’s a difficult decision to make, what I would suggest is that you go along to your local Maggies centre which will likely have a Prostate Cancer Support Group. There you will find men who have had various treatments and can share their experiences with you. Maggies [Fife) has completely changed the way I deal with this disease and I am eternally grateful to them and the men in the groups I attend.

all the best with your decision.

Derek

User
Posted 26 Sep 2023 at 19:09

Hi Craig,

Glad you’ve made your decision and it’s good that you don’t have to wait long for the surgery.

Good luck next week and keep us posted n your progress.

all the best

Derek

User
Posted 27 Sep 2023 at 18:12

Well done. I certainly felt better once I had made the decision. After surgery the recovery wasn't as bad as I feared. Hope all goes well.

User
Posted 04 Mar 2024 at 19:32

Dear C Mac,

I am new to this forum. I had a PIRADS 4 diagnosis of a 2mm lesion following an MRI. My PSA was 8.8 and 7.9 after it was taken again a month later. I am awaiting a transpereneal biopsy.

It seems to me I might be following the path you have trodden. What surgery did you have and could you give me any advice? 

Thank you so much for any information and best wishes.

Keith 

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User
Posted 27 Jul 2023 at 22:12
User
Posted 27 Jul 2023 at 23:46

Interesting that you are getting a bone scan, nothing in your scoring suggests that you should need one. Although it's good of course that they are checking for peace of mind.

As for treatment it's can be tricky. My clinicians gave me a gentle nudge towards surgery and were very good at discussing why the other options carried more risk. Age being pretty much the deciding factor.

Edited by member 28 Jul 2023 at 00:20  | Reason: Not specified

User
Posted 27 Jul 2023 at 23:56

Originally Posted by: Online Community Member
Interesting that you are getting a bone scan, nothing in your scoring suggests that you should need one.

Bone scans are a standard precautionary move. Certainly no reason for concern because it's been recommended.

Jules

User
Posted 28 Jul 2023 at 06:58

Thanks Jim. I live in Tayside, Scotland. The clinical  nurse advised that if the Gleason score has a 4 in it they do a bone scan. As you say good to get that information 

User
Posted 28 Jul 2023 at 07:35
Hello C Mac, click on my avatar to see my diagnostic and treatment journey.

Hope it helps.

Rgds

Dave

User
Posted 28 Jul 2023 at 07:52

Originally Posted by: Online Community Member

Thanks Jim. I live in Tayside, Scotland. The clinical  nurse advised that if the Gleason score has a 4 in it they do a bone scan. As you say good to get that information 

It definitely is because you can put every ache and pain down to cancer when in reality it's not.

User
Posted 28 Jul 2023 at 07:56

Thanks Dave, very informative treatment journey that is helpful in my process of making a decision. Thanks Craig 

User
Posted 28 Jul 2023 at 08:20

Hi Craig,

RT with a brachytherapy boost might also be an option as well. It was ruled out for me because of poor flow rate. Also bear in mind that the criteria for surgery in Scotland is slightly different from England  in that if there is any sign of spread they won’t offer surgery…however that doesn’t appear to be the case for you, so you are lucky to have that choice given that you are a youngster😊 Again it wasn’t offered to me because I am T3B.

it’s a difficult decision to make, what I would suggest is that you go along to your local Maggies centre which will likely have a Prostate Cancer Support Group. There you will find men who have had various treatments and can share their experiences with you. Maggies [Fife) has completely changed the way I deal with this disease and I am eternally grateful to them and the men in the groups I attend.

all the best with your decision.

Derek

User
Posted 28 Jul 2023 at 09:28

Thanks Derek,

Appreciate the response and advice, very helpful.

thanks

Craig

User
Posted 26 Sep 2023 at 18:19

Following appointments with surgeon and then the consultant oncologist I made my decision to have surgery.

Just had it confirmed that operation will be next week Wednesday 4th October .

Fingers crossed .

 

User
Posted 26 Sep 2023 at 19:09

Hi Craig,

Glad you’ve made your decision and it’s good that you don’t have to wait long for the surgery.

Good luck next week and keep us posted n your progress.

all the best

Derek

User
Posted 26 Sep 2023 at 19:49

Thanks Decho,
Tough making the decision but feel content with it now it’s made.

Will update how it all goes.

thanks

Craig

User
Posted 27 Sep 2023 at 18:12

Well done. I certainly felt better once I had made the decision. After surgery the recovery wasn't as bad as I feared. Hope all goes well.

User
Posted 04 Mar 2024 at 19:32

Dear C Mac,

I am new to this forum. I had a PIRADS 4 diagnosis of a 2mm lesion following an MRI. My PSA was 8.8 and 7.9 after it was taken again a month later. I am awaiting a transpereneal biopsy.

It seems to me I might be following the path you have trodden. What surgery did you have and could you give me any advice? 

Thank you so much for any information and best wishes.

Keith 

User
Posted 04 Mar 2024 at 20:11

Hi Keith,

Looks like similar paths indeed.

I had a bone scan that was clear. With the it looking like the cancer was contained I opted for surgery. I was considering option 2 which was Radiotherapy.

Surgery 4/10/23 and was a success. Post operation confirmed the Gleason score was correct and also that the cancer was contained in the prostate.

First blood checks post op are showing PSaA undetectable . Next check are in March.

all I would say is do your research as you have your results etc. Read peoples updates on the forum for both surgery and also the radiotherapy journeys and hopefully you will get to a decision you feel is right for you .

 

My surgery was a success and was the right decision for me.

I do have the side effects of incontinence and ED just now but hopefully that will improve.

All the best.

C Mac

User
Posted 04 Mar 2024 at 20:19

C Mac

Many thanks for your reply. I greatly appreciate it.

You say you choose the radiotherapy option, what other options were you offered? Also could you send me a link to some information on radiotherapy?

Many thanks,

Keitj

User
Posted 04 Mar 2024 at 20:29

Hi Keith,

I had surgery, radiotherapy was the alternative initial choice.

First place to read up for info about diagnosis, process and procedures and probable answer to questions is

https://prostatecanceruk.org/

 Also try this forum using the search feature.

 

thanks

Craig

 

User
Posted 04 Mar 2024 at 20:46

C Mac,

Many thanks,

Keith 

 
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