I was diagnosed on 4th December with Gleason 7 (4+3) T2A prostate cancer. It's all on the lower left peripheral base side apparently. It seems - from the results of the biopsy certainly - that the right side appears to be 'normal'. I had two PSMA PET scans on 20th December; one MRI and one CT. I found out on Friday that there were 'no additional findings' - that's their language - so the cancer has - it seems - not spread which is reassuring certainly. (They say that the PSMA PET MRIs can see cancer seven years before other scans for which I'm most grateful.)
This also means - I assume - that the two treatment options originally presented to me (a) RP and (b) RT with some additional HT for an unspecified time remain on the table. At the moment I'm favouring RP - like so many others. (That said IF I was able to get the five fraction hypofrationated RT - without HT - I would certainly plum for it first given the 96% clear return on the five year study from the 900 men participating and that it was targeted explicitly for intermediate cancers such as the one I possess.)
I know there is a lot of expertise hereabouts and thought I would ask two questions if I might.
(i) The one thing I DO KNOW I HAVE - and have known for some years - is severe foraminal stenosis. This does impact to some extent in the lumbar region but my personal major concern is cervical around the C5 area. Happily I have learned over time how to manage it and have successfully done so. I have tried to find information about a RP in relation to the severe foraminal stenosis but could only find a solitary case report where - 16 years post RP - a patient appeared with sciatica which turned out to have been a prostate cancer spread. I'm assuming that if this would have been the case for me - at this juncture certainly - that it is most definitely something that would have appeared on at least one of the PSMA scans. I realise that foraminal stenosis is not uncommon - they say most people begin to develop it from around the age of 24 - but I wonder if anyone (a) who has had a RP had any experience of such and what the impact - if any - was for them and/or (b) anyone else knowing of any issues I should ask about in this regard.
(ii) While waiting - and simply as a proactive route to curb any interim anxieties - especially given it was broaching the Christmas period - I had a private scan of my upper femurs as I occasionally sensed I was experiencing/had felt pain on the left side there sporadically. (Amazingly, of course, any residual infraction disappeared as soon as the scan was finished.) To wit the scan did not generate any findings in term of a suggestion of cancer - which was good - but they did find that - once again to my total surprise - 'Incidental note is made of a small right-sided inguinal hernia which appears to contain an undistended testicle'. This is a first to me. If I feel about there it feels normal to me. Perhaps this has been in place for a long time. Certainly - as far as I'm aware - it has never impacted function. Certainly it has never given me a moment's trouble. I wonder if this, itself, would impact the RP?
I will certainly be raising those two issues at my Treatment Information meeting on Tuesday. I wonder also if people have any questions I should ask the surgeon that I might not otherwise think of. If so, I would be most grateful for your kind advice.
Bless you for your kind consideration and ALL.
Edited by member 01 Jan 2024 at 00:30
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