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Post surgery pT3b histology: standard treatment options

User
Posted 24 Jan 2024 at 16:30

Hi, second post, first thread:

RALP surgery early November 2023. I am recovering from this fairly well. But histology has come back as pT3b, Gleason 4+4 (pre op was "possible T3a", Gleason 3+4). Surgical registrar told me I would need further treatment, probably radiation. Hospital then lost my referral for 4 weeks, meanwhile I am in the dark as to how serious this is. No post op PSA result as yet after 11 weeks. 

Histology report: "2.9 mm pT3b, bilateral microacinar type prostatic adenocarcinoma with ductal type adeno carcinoma of prostate involves both peripheral zones, apex and base of the gland beside left seminal vesicle, extraprostatic disease present in left seminal vesicle; anterior posterior fat is benign and right neurovascular bundle is benign; left neurovascular bundle is with tumour in the form of lymphovascular invasion." 

NHS is being incredibly slow and finally given me an oncology appointment 8 weeks from now, despite losing the referral between two different trusts (one for surgery, one for oncology). 

I've a two part question: 
1. I'm thinking of going private for a consultant to get a face to face soon to discuss the above histology. Does anyone have any recommendations in the North London, Herts, Bucks, Beds areas? 
2. Anyone have a similar diagnosis as to the above and can comment on their treatment pathway and timescales? 

Thanks in advance, 

Mike

User
Posted 24 Jan 2024 at 18:16

Hi Mike

tried PM but inbox is full apparently 

Id be tempted to bounce your situation off of professor whocannotbenamedonhere at Santis Health. He operates out of London. He did my RARP back in November  2019 and is at the top of his game. Quite a few people I know have seen him over past 20+ years and he is a pioneer in the field. For oncology I’d hook up with UCLH if the Professor can’t point you in the right direction.

hope all goes well.

simon 

User
Posted 24 Jan 2024 at 18:27

Your diagnosis was similar to mine with seminal vesicle involvement as well as lymphovascular invasion. In my case a scan showed up 3 cancerous lymph glands so it was RT/HT from the start.

In your case it may be that more scans will be needed before some form of treatment is figured out.

Jules

User
Posted 29 Jan 2024 at 17:25

Mount Vernon Cancer Centre is in that area, and is a centre of excellence for radiotherapy, and does private work (via Bishopswood Hospital and the Hal Gray Unit) as well as being an NHS tertiary care centre. It's somewhat lacking in the support services, but they aren't included in private treatment anyway (you have to buy them separately, or try and get them through the NHS).

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User
Posted 24 Jan 2024 at 18:16

Hi Mike

tried PM but inbox is full apparently 

Id be tempted to bounce your situation off of professor whocannotbenamedonhere at Santis Health. He operates out of London. He did my RARP back in November  2019 and is at the top of his game. Quite a few people I know have seen him over past 20+ years and he is a pioneer in the field. For oncology I’d hook up with UCLH if the Professor can’t point you in the right direction.

hope all goes well.

simon 

User
Posted 24 Jan 2024 at 18:27

Your diagnosis was similar to mine with seminal vesicle involvement as well as lymphovascular invasion. In my case a scan showed up 3 cancerous lymph glands so it was RT/HT from the start.

In your case it may be that more scans will be needed before some form of treatment is figured out.

Jules

User
Posted 29 Jan 2024 at 16:12

Hi Simon, 

Thanks for this, I really appreciate it. 

I read somewhere as I am relatively new on this forum, my inbox is deactivated until I make a certain amount of posts. 

I have a consult with NHS oncologist tomorrow. Will then pursue a private second opinion. 

Mike

Edited by member 03 Mar 2024 at 21:02  | Reason: Not specified

User
Posted 29 Jan 2024 at 17:25

Mount Vernon Cancer Centre is in that area, and is a centre of excellence for radiotherapy, and does private work (via Bishopswood Hospital and the Hal Gray Unit) as well as being an NHS tertiary care centre. It's somewhat lacking in the support services, but they aren't included in private treatment anyway (you have to buy them separately, or try and get them through the NHS).

 
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