Treatment advise

Is the 6 your Gleason or PSA score, and what's the other one?

With your current diagnosis, you probably don't need to do anything in a hurry. You could take Active Surveillance for 3 months, and see how you handle it mentally, and also see how quickly your PSA is changing (should be PSA tests every 3 months in the first year on AS), assuming your PSA is raised in the first place. You could also use the time to learn more about prostatectomy and how it might impact you. While on Active Surveillance, you have the right to change to active treatment at any point.

Active surveillance is not entirely risk-free - sometimes there's more significant cancer than they found, and occasionally this leads to it spreading elsewhere, but the chance of this happening in 3-6 months is quite low.

Do you have any additional risk factors, such as being a Black African or Caribbean man, or having a father or brother with prostate cancer? I would factor those in to the decision too if so. Also, the percentage/size of tumour and location in the prostate (e.g. near the edge?) would be things to factor in too, which you haven't mentioned.

I don't have any of the risk factor but been having PSA tests for nine months and they have risen each time, originally 9 months ago I was told it was  BHP, but after a second set of biopsies taken because of the rise in levels I was diagnosed with prostate cancer, they said it was a 3on the left side and 3 on the right side giving it a score of 6

Hi Tonks 

Sorry to hear about the diagnosis. It’s a bit of a roller coaster ride for sure.

just be mindful in ~45% cases histology is usually upgraded with post surgery histology. I was very much in the same place with stage 1 Gleason 6 prostate cancer in September 2019. Based on the fact that even low grade cancer has all the mechanisms to potentially migrate (metastasise) I took the decision to act quickly. Pleased I did as I found a top high volume professor to do the work at a flagship hospital. As I turned out my cancer was more extensive than scans and the biopsy had shown and it was very close to breaking out of the prostate capsule. Histology came back Gleason 7 (3+4) T2C N0 MX. This far my PSA are coming back as undetectable and have my  4yr blood test scheduled for November so fingers crossed.

ED was never an issue for me other than if I’m tired so I count myself fortunate in that regard. Continence has always been excellent once it settled 5 weeks post op. I do get the odd minor drip now and again on a full bladder but it’s nothing more than that so pretty much normal. I never have issues lifting heavy weights in the gym etc 

fyi I had a Retzius sparing robotic assisted radical prostatectomy + neuroSAFE at London Guys (private) with the expert hands of the Prof whocantbenamedonhere and his sidekick Da Vinci Xi robot 🤖 

Thanks for your reply, my head is saying remove it, As I keep thinking with the state the NHS is at the moment , with strike etc , if I went for surveillance are my appointments blood tests etc gonna get cancelled then they miss something.