Almost 24 weeks have passed since my referral. I see the urology/radio oncologist next week. I don't know what to expect, but anticipate IMRT + HT or possibly a suggestion of A.S.
I will soon be 78 and am seeking advice/input.
PSA 1.4 in 2018, 13.1 July 23, 14.32 Nov 23. DRE normal. Gleason 3+4, 90% of 3 and 10% of 4 on the left and 3+3 1% on the right. 6 of 15 cores positive, only 1 of the 6 positive on the right. MRI showed 14 mm tumour, and biopsy was 9 mm, 5 mm, and 1.3mm. No EPE or PNI or cribriform. Prostate size 36 cc. Prostate density 0.39. HOLEP TURP in 2011.
Urologist said T2a NO MO. Grade 2. When I suggested it should possibly be T2c because of being on 2 sides of the prostate he agreed! Someone suggested that as the DRE was said to be normal it should be T1c - so I am a little confused.
I have CKD 3b (eGFR 42) and a solitary kidney due to cancer 6.5 years ago. I was told now 'unlikely' to recur.
Never smoker, not a drinker. BMI 26.5. Physically and mentally fit. Occasional ectopics.
I absolutely don't want HT due to CKD and all the other side effects. At a push I would very reluctantly consider 4 months of HT if it was to achieve the possibility of a cure and the avoidance of permanent HT down the road.
Given my profile and stats what is the opinion on A.S. or IMRT without HT?
Should I grasp the nettle and opt for 4 months HT and would that be sufficient?
Would higher and/or longer IMRT be necessary if no HT. Only IMRT available to me in my NHS region. I was refused brachytherapy due to previous HOLEP and margins.
Thanks
Jonal