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How to choose treatment!

User
Posted 16 Oct 2023 at 23:17

Hello. My first post!

Have had MRI and biopsy. Have large prostate (93cc) and am 5+4=9 T2c No MX PSa was 18.3

Had consultation today re. Treatment and having done some reading, fully expected RP to be the favoured option. I was quite surprised therefore when he spent some time talking about Radio and hormone therapy and I’m now going through so much literature (I’ve got the full pack from PCUK) and the more I’m reading about potential side effects from the RT and Hormone side of things, I’m having trouble in making up my mind. As it is a fast growing cancer, I don’t want to spend too long deciding but I’m thinking that others must also have had similar difficulty. So what was the clincher for others in deciding which way to go please? (I am going to have a phone chat with the specialist nurses tomorrow as well.) 

User
Posted 17 Oct 2023 at 00:22

You may as well start by reading this thread. It covers pretty much all the options, not just the ones in the title.

https://community.prostatecanceruk.org/posts/t26986-Can-t-understand-why-anyone-would-choose-surgery-over-Brachytherapy--I-must-be-missing-something

What is right for one person won't necessarily be right for another.

Dave

User
Posted 17 Oct 2023 at 00:39

I'm sure you realise you're a high risk patient, being Gleason 9, and some also regard T2c as high risk. The Mx suggests you haven't had a bone scan, which would be expected in this case. Is that planned?

If they're not offering RP, I'm guessing they think you are at a higher than normal risk of needing salvage radiotherapy afterwards, but this would be a question to ask them. This was the situation with me, they thought my chances of needing radiotherapy too was over 50%, and they recommended I went for just the radiotherapy, to avoid two lots of side effects.

Oncologist recommended HDR Boost, where you have half the radiotherapy as external beam, and the other half as HDR Brachytherapy. This gives you the best of both treatments - high dose into the prostate where the known cancer is, and a lower dose outside the prostate to mop up any micro-mets (mets too small to show on scans). I elected to have this to my pelvic lymph nodes too - although no cancer had shown up there, that's the most likely place it would go next, so they were zapped at a lower dose to mop up any cancer cells that had already escaped there. I also did 22 months of hormone therapy. I didn't find it too bad and chose to do more than the minimum I was recommended. Full details are in my profile.

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User
Posted 17 Oct 2023 at 00:22

You may as well start by reading this thread. It covers pretty much all the options, not just the ones in the title.

https://community.prostatecanceruk.org/posts/t26986-Can-t-understand-why-anyone-would-choose-surgery-over-Brachytherapy--I-must-be-missing-something

What is right for one person won't necessarily be right for another.

Dave

User
Posted 17 Oct 2023 at 00:39

I'm sure you realise you're a high risk patient, being Gleason 9, and some also regard T2c as high risk. The Mx suggests you haven't had a bone scan, which would be expected in this case. Is that planned?

If they're not offering RP, I'm guessing they think you are at a higher than normal risk of needing salvage radiotherapy afterwards, but this would be a question to ask them. This was the situation with me, they thought my chances of needing radiotherapy too was over 50%, and they recommended I went for just the radiotherapy, to avoid two lots of side effects.

Oncologist recommended HDR Boost, where you have half the radiotherapy as external beam, and the other half as HDR Brachytherapy. This gives you the best of both treatments - high dose into the prostate where the known cancer is, and a lower dose outside the prostate to mop up any micro-mets (mets too small to show on scans). I elected to have this to my pelvic lymph nodes too - although no cancer had shown up there, that's the most likely place it would go next, so they were zapped at a lower dose to mop up any cancer cells that had already escaped there. I also did 22 months of hormone therapy. I didn't find it too bad and chose to do more than the minimum I was recommended. Full details are in my profile.

 
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