Does this ever get easier?

Thank you for your reply , I'm trying.... He started HT three weeks ago, told they would re scan in three months , now other department want to change it...  Question is who do you put your faith in ?

Hi Jules, all we know is that they want to discuss radical treatment..... They won't do a telephone consultation it's got to be face to face so have had to ask to reschedule appointment as they only gave us 48hours notice and my hubby just couldn't get the time off.

Tp3a, it's very close to the outer edge so not 100%sure if it's escaped the prostate. Bone scan clear  no sign of spread to other organs or surrounding tissue, but multiple lung nodules found . Was waiting three months to see if the nodules shrink with treatment , gleeson 7

Well with T3 near the edge, I wouldn't be wanting a prostatectomy, quite a high chance of leaving some behind, and clearly if he wants to keep the nerves prostatectomy is out.

They could be thinking of HDR brachytherapy as well as EBRT.

The nodules in lungs I would think are unlikely to be prostate cancer, but they are going to know a lot better than me. If the lung nodules are prostate cancer the treatment plan will be complicated.

Yes rescanning after HT does make sense as a way of testing the nodules. 

Yes HDR brachytherapy combined with EBRT would work with cancer in both sides. The merger of departments may be opening up other treatment options, and as his final plan can't be decided until the lungs question has been resolved I guess you have to have another meeting.

Update.....

Had consultation today , he has two options surgery which will include taking lymph nodes in area around prostate or radiotherapy...... Nothing else is suitable . They have changed his hormone treatment , tablets instead of injections. 

Edited by member 14 Sep 2023 at 19:28  | Reason: Not specified

Hello Dave, the consultant was a surgeon and he said the hormone injection he was on would/could cause scarring and that in itself would make surgery more complicated than it already is.  He's making us an appointment to talk with the cancer /radiotherapy specialist so we can make an informed decision.

Here is a recent thread on making a decision

https://community.prostatecanceruk.org/posts/t29654-Radio-Therapy-or-Surgery

I have no medical knowledge other than what I have picked up from this forum, and from watching the the 1966 film "The Fantastic Voyage", with Raquel Welch. So take my medical opinions with the lack of respect they deserve...

In your husband's case they are talking about removing lymph nodes, so clearly the cancer is spread beyond the prostate. I assume that means it will be none nerve sparing, and also he will need RT as well. I can't think why anyone would not just have RT in this case and avoid the side effects of surgery.

My PCa had also spread. The surgeon did mange to achieve partial nerve sparing but there are no guarantees. However a word of warning about lymph node removal (if your OH is considering surgery). Surgeons outline all the potential side effects of RP but I think they tend to gloss over the potential side effects of lymph node removal and the amount of nodes they actually remove. My surgeon removed 34. It resulted in a lymphocele  needing a further surgical procedure and subsequent unpleasant complications resulting in hospital admissions. Later on I developed lymphoedema in my right leg. I now have to wear a full length compression stocking to keep it under control. It is always easier to deal with side effects when you are prepared for them. It's so much harder to get your head round them when they come out of the blue. Chris

Well cribriform just mean many holes like a sieve. So when the pathologist looks at prostate biopsies they look at the way the cells are laid out and if they are really nicely laid out in orderly rows they say those cells are Gleason pattern 1, and if they are very haphazardly laid out they say it is a Gleason pattern 5. You can Google images of prostate biopsies to get an idea as to what they are looking at. If there are gaps between cells they will say it is cribriform as well.

So cribriform pattern 4 means quite haphazard with gaps.

Now that is just a description; of more interest to you is what does that mean for the diagnosis. Well from what I've googled it is not good, it is associated with more aggressive cancers which are more liable to spread.

If your OH has this, I think they will be quite concerned about spread either in the pelvis or possibly to other parts of the body. A few years ago they would have tried one treatment and then if it failed try another and so on. Now-a-days it seems they decide to throw everything at the cancer from the outset, so depending on how worried they are they could add RT, HT and Chemo. But as kerm63 says it's best wait to hear what they say than try and second guess what will happen.

Hi Willow.

I'm retired and 10 years older than your hubby. So I don't have the additional strain of work commitments he has, but our diagnosis seem very similar.

I was T3a, bone scan showed lytic areas and a couple of lung nodules, but neither believed to be connected to the cancer. At this time I was Gleason 8 (4+4), 20 out of 24 cores. PSA 6.6

I was put on hormone tablets to suppress the cancer and had non nerve sparing RARP 5 months later. During the op they removed seminal fluid tubes and 9 lymph nodes.

Pathology of the prostate revealed Gleason 9 (4+5) may have been elevated due to HT and nothing untoward was found in the seminal fluid tubes or lymph nodes.

Ten months later my PSA is undetectable, but I have been warned that there's still a high chance of recurrence.

Post op I had all the usual side effects including incontinence and ED. I'm now fully continent and can get erections with Invicorp.

Like most I dread PSA testing times. 

No-one's mentioned anything more about the anomalies in the bones, no-one's mentioned anything more about the lung nodules. 

Sods law,  only two months after the op I had a heart attack, had to be stented but will require further cardiac treatment.

I'm beginning to feel like an old clapped out car going for an MOT, the more they check things out, the more they find wrong. 🙂

On the bright side everyones says how young and healthy I look. They've obviously got eye problems and need to go to Specsavers.

Best of luck to both of you.

Adrian

Edited by member 22 Dec 2023 at 05:41  | Reason: Not specified

I have been chatting to a Macmillan nurse online who has been brilliant .... Everything seems so hard  but will look into a local support group .Thank you 

Hi Dave, I have to agree with you .

I was gowned up for the op in Nov 2022, it was cancelled through a lack of beds.

A month later, I was again gowned up for the rescheduled op, and it was cancelled due to anaesthetists concerns. 

My wife and I were shattered by both cancellations.

I eventually got the op in Feb 2023.

I know operations sometimes have to be cancelled at the last minute, but I honestly believe that some clinicians don't realise how devastating these postponements are for patients and their families.

Edited by member 09 Jan 2024 at 19:13  | Reason: Not specified

Finally, OH has had the operation and is back on the ward.....