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HT/RT vs Surgery

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User
Posted 05 Jan 2024 at 21:26

HI everyone, had my diagnosis about 10 hours ago. l am Group 2 Gleason score 7 ( 3+4 ) with 9 cores on the left and 0 on the right. Need to have CT and bone scan for final prognosis. My initial thought is to go for HT/RT as I don't fancy going under the knife. Last time in hospital was almost 60 years ago to have my tonsils out as a small boy. I would value any feed back. Thanks Pete

User
Posted 05 Jan 2024 at 21:58

This thread has a lot of info to get you started.

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

All your friends and family will tell you to go under the knife, but they don't know as much as you will know over the next few weeks.

Dave

User
Posted 06 Jan 2024 at 11:34
I was in the same position at the beginning of the year with a G7 diagnosis and I chose the surgery (NSS). As it happened, when the prostate was examined in the lab afterwards it was upgraded to G9. I will likely have SRT this year but mentally I am better prepared knowing that the 'mothership' is out of me and that we are likely dealing with a much smaller number of cells to irradiate.

I'd do exactly the same again given the same choices.

User
Posted 08 Jan 2024 at 12:11

I took my kids aside separately and told them the news. My treatment was with curative intent and that obviously helped.

I was Gleason 4+3. T3a after surgery. Immediate PSA after surgery 0.2 rising to 0.5 after 3 months. I had immediate HT/RT. Rolling along with PSA < 0.1 for last couple of years 

Jim 👍

User
Posted 06 Jan 2024 at 10:48

I agree with Adrian and others. 

I had surgery 12 years ago. Did I make the right choice at the time? I think so. Would I do that now? I don't know! I think the benefits - psychological and the outcome if the cancer is well contained - are amazing which you have to  weigh up  against the two main side effects - incontinence and ED - could be very serious. Although there is a lot of experience out there and the outcomes of surgery are better than when I had it. The technology of RT has made a quantum leap since my days. The main issue I would have is that the availability of good quality RT treatment appears to be patchy depending on how close you are to the hospitals or private clinics which provide that option with extensive experience - that is just my feeling. Your diagnosis so far is very favourable. Once you pick an option try and not look back. Good luck.

Edited by member 06 Jan 2024 at 10:49  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Jan 2024 at 11:37

Originally Posted by: Online Community Member

On a separate issue not sure how to break the news to my 3 grown up daughters any ideas

Just tell them and be able to explain that 12% of men get prostate cancer and the vast majority, when diagnosed early, will die with it and not because of it.

There has been plenty of 'publicity' for Prostate Cancer recently so they should know what it is.

 

User
Posted 06 Jan 2024 at 12:52

We told our grown up children immediately and they took it very well and were supportive. 

Edited by member 06 Jan 2024 at 12:54  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Jan 2024 at 18:39
I agree with last couple of comments re telling grown up children, there will obviously be upset for all, just the.mention of cancer is death to many people. But once you get to know a bit more it 'probably' doesn't lead to death for us given decent stats etc. Your children should hopefullly get to understand that, my 3 grown up children did, after a bit of time. I just told them.

Peter

User
Posted 08 Jan 2024 at 11:14
One factor, is it a fast or slow growing cancer - mostly prostate seem to be slow growers.

Then the differences are RT/HT takes quite to time overall, Surgery gives you about a month of recovery & side effects - you may be more prone to pee incontinance afterwards. (You have lost one of your valves!)

I chose the RT/HT route & have no regrets - had some Rectum problems - not too bad. (Caused by the RT)

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User
Posted 05 Jan 2024 at 21:58

This thread has a lot of info to get you started.

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

All your friends and family will tell you to go under the knife, but they don't know as much as you will know over the next few weeks.

Dave

User
Posted 05 Jan 2024 at 22:02
Hi Pete, when the CT and bone scan has been completed your Dr will provide you with what is considered the best options for your diagnosis. When presented with the facts that is when you will be able to make an informed choice. These days RT and RP have similar outcomes.

Given your preference for RT its unlikely I would have thought that your medical team would say no unless they had good reason.

Best of luck with the scans.

Mike

User
Posted 05 Jan 2024 at 22:26

I did my own research and it seemed the pros and cons of surgery and RT balanced each other out. There was very little difference in the outcomes.

I chose surgery because I hate going to hospital, and much preferred the one overnight stay for an operation, rather than 35 visits Mon-Fri, for radiology. It might seem a slightly irrational decision to others, but I knew I could not face 35 hospital visits in seven weeks.

Now apparently, they are saying that soon, in some cases, it may be possible to have only 5 visits for RT. Had that been an option to me, I'd have taken it.

RT or surgery seems to be the most asked question on this site. In reality I don't believe there's a definite answer. Some will sail through both procedures, others won't.

Adrian.

Edited by member 05 Jan 2024 at 22:41  | Reason: Typo

User
Posted 06 Jan 2024 at 10:48

I agree with Adrian and others. 

I had surgery 12 years ago. Did I make the right choice at the time? I think so. Would I do that now? I don't know! I think the benefits - psychological and the outcome if the cancer is well contained - are amazing which you have to  weigh up  against the two main side effects - incontinence and ED - could be very serious. Although there is a lot of experience out there and the outcomes of surgery are better than when I had it. The technology of RT has made a quantum leap since my days. The main issue I would have is that the availability of good quality RT treatment appears to be patchy depending on how close you are to the hospitals or private clinics which provide that option with extensive experience - that is just my feeling. Your diagnosis so far is very favourable. Once you pick an option try and not look back. Good luck.

Edited by member 06 Jan 2024 at 10:49  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Jan 2024 at 10:57

Thank you all for taking the time to reply. Yes I know I have to wait for CT scan and then hear what they say. Then desicion time.

On a separate issue not sure how to break the news to my 3 grown up daughters any ideas

User
Posted 06 Jan 2024 at 11:34
I was in the same position at the beginning of the year with a G7 diagnosis and I chose the surgery (NSS). As it happened, when the prostate was examined in the lab afterwards it was upgraded to G9. I will likely have SRT this year but mentally I am better prepared knowing that the 'mothership' is out of me and that we are likely dealing with a much smaller number of cells to irradiate.

I'd do exactly the same again given the same choices.

User
Posted 06 Jan 2024 at 11:37

Originally Posted by: Online Community Member

On a separate issue not sure how to break the news to my 3 grown up daughters any ideas

Just tell them and be able to explain that 12% of men get prostate cancer and the vast majority, when diagnosed early, will die with it and not because of it.

There has been plenty of 'publicity' for Prostate Cancer recently so they should know what it is.

 

User
Posted 06 Jan 2024 at 12:52

We told our grown up children immediately and they took it very well and were supportive. 

Edited by member 06 Jan 2024 at 12:54  | Reason: Not specified

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 06 Jan 2024 at 18:39
I agree with last couple of comments re telling grown up children, there will obviously be upset for all, just the.mention of cancer is death to many people. But once you get to know a bit more it 'probably' doesn't lead to death for us given decent stats etc. Your children should hopefullly get to understand that, my 3 grown up children did, after a bit of time. I just told them.

Peter

User
Posted 06 Jan 2024 at 23:28
I agree with others, there isn't a "right" answer. But you need to find an answer you are happy with, guided by the advice of your consultant(s) and maybe informed by those on this forum.

Broadly speaking, surgery and RT have similar outcomes according to published studies. But as I have commented here before, any long term outcomes can only relate to those treatments as they were around ten years ago. My strong impression is that RT methodology and machines have been improving considerably in that time (if your hospital has the up to date equipment) whereas surgery remains broadly similar. Both have side effects.

The one advantage surgery has, is that if there is a recurrence it is straightforward to do RT after surgery but not vice versa. And the way you look at the balance of side effects may differ depending on your current age.

User
Posted 08 Jan 2024 at 11:14
One factor, is it a fast or slow growing cancer - mostly prostate seem to be slow growers.

Then the differences are RT/HT takes quite to time overall, Surgery gives you about a month of recovery & side effects - you may be more prone to pee incontinance afterwards. (You have lost one of your valves!)

I chose the RT/HT route & have no regrets - had some Rectum problems - not too bad. (Caused by the RT)

User
Posted 08 Jan 2024 at 12:11

I took my kids aside separately and told them the news. My treatment was with curative intent and that obviously helped.

I was Gleason 4+3. T3a after surgery. Immediate PSA after surgery 0.2 rising to 0.5 after 3 months. I had immediate HT/RT. Rolling along with PSA < 0.1 for last couple of years 

Jim 👍

 
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