I am an Australian male of 80 with limited intelligence and a troubling, to me, history of prostate interference. My BPH of 1988 progressed to Radical Prostatectomy (RP) for PCa in 2015 and now return of PCa in one PCMA detected gland outside the former prostate area near the tail bone. Apparently the PCMA capacity is limited and while only one group of multiple PCa cells was located other cells are said to possibly have escaped the prostate and are sitting there multiplying as yet undetectable.
My RP was not accompanied by any chemical or radiation procedures and subsequent PSAs were 0.01 till 2020 before steady increases to 0.16 in April 2023 and 0.32 in August 2023. My Urologist suggests Radiation Therapy (RT) of the PCMA identified PCa only while my new Oncologist feels Radiation Treatment (RT) for the whole former prostate area could be undertaken along with Androgen deprivation therapy (ADT) for prostate cancer. He used the analogy that if we had a weed in our field we would not just pull it out but treat the whole field. The many side effects of these procedures were put as risks but it seems the benefits are impossible to determine. The life expectancy and quality of life along the way cannot be matched in any real way. There are no numbers or percentages to consider and the effects on the one hand and the other PCa cell likelihood are so questionable. I have type 2 diabetes, incontinence, knee osteo problems, hypertension, reflux, congestion and a few other minor issues. It seems the side effects of these two procedures can attack all the aging conditions our bodies develop. It is impossible for humans to evaluate this position and even IT would have problems.
I performed no real investigation of my prostate journey till after my RP. I then found our prostate treatments here to be very limited in comparison with those in the UK. We seemed to have only rebore or medication for BPH and for me just RP for the PCa. There seemed to be so many more available treatments elsewhere. Is our limited approach simply best practice or was cost comparison the reason? I began to doubt and still do.
In 1990 a scheduled biopsy was abandoned due to doubt over Ultrasound’s (U/S) capacity to recognise cancer. In 2009 a random 6 core biopsy found no evidence of malignancy. In 2015 U/S was still the government’s preferred choice and no assistance was provided for my MRI ($350) that detected the cancer. A biopsy was then required to proceed even though evidence that this did not spread the cancer was scant. I don’t know how happy I would have been then to proceed without more evidence of PCa but have concerns about where I am at now. Our governments boast of Medicare that is supposed to be similar to your NHS. Despite our $5400 per annum private health fund contribution Medicare contributed just $81 to the $240 cost of my initial Oncologist visit. So cost may also be a factor here.
Initially Alpha Blockers did the job for my BPH. Then when increase above 4mg was sought greater volume had not been researched. A 5a inhibitor was introduced together with its own 4mg Alpha Blocker. This took my Alphas to 8mg anyway and the 5a inhibitor had some suspicion of causing its own PCa.
Though overall my RP was a success hospital inappropriate procedures led to problems. Untreatable fungal Infections, rashes, blockages, many catheterisations, stents and ongoing incontinence. Small bickies in comparison to many on these sites. Comparatively more than many others in the general community.
In 1981 my father passed at 67 in hospital for bladder cancer of 2 months. His pneumonia 48 hours, small bowel obstruction days, Septicaemia 12 hours and cardiogenic shock 12 hours were all listed on his certificate. The radiation that he was being treated with and finally discontinued due to his failing condition was not mentioned. If he had made a different choice he would have lived longer. Earlier they had removed two thirds of his stomach due to ulcers. Soon afterwards they learned this could have been cured with just antibiotics. Life is becoming too hard for all of us to manage and now especially for me. I need the numbers, percentages and history of others and do not have the capacity to make this decision that I must without help?????? Barrie