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User
Posted 08 May 2024 at 13:06

Hi, I was diagnosed with T2 stage prostate cancer yesterday and now I'm looking for some information/ advice. I was placed on Active Surveillance rather than have immediate treatment. I. Just looking for people's views on the the 2 & have I done the correct thing by going on Active Surveillance. Any help or advice would be much appreciated. 

User
Posted 08 May 2024 at 16:30

You are welcome, it is not an easy thing to decide on but I think good knowledge is important, you can then balance the pros and cons based on your lifestyle and fitness levels and support.


My wife is a star and we have the added benefit that she works in the pharmaceutical industry as a sales exec - in the urology field 😆 although in woman's health. Talk to your partner regarding the various side effects so you both understand the implications of any treatment. I find talking about it openly helps with the anxiety.


Good luck and keep us updated.

User
Posted 09 May 2024 at 18:03

Not sure.I haven't had a PSA test since 11th March then it was 6.5.

User
Posted 09 May 2024 at 18:39

Hi Skeggie


With my diagnosis (transitional zone) there are a number of factors.


Firstly, transitional zone cancers are historically known to be aggressive cancers and usually quite large.


second, If you read the statistics from John Hopkins, the usual intervention period for men on AS is two years, (59%) but remember all different medical trusts differ in their treatment regime.


Third, I am 64 and still reasonably fit,I don’t do any exercises but I am active (golf, sailing when I get chance, and I do a lot of DIY. My reasoning is if I leave it for 2 to 5 years, will I still be able to cope with the side effects, probably of radiotherapy and HT as I may not be able to have surgery.


finally, my wife was diagnosed with breast cancer in 2007had the mammogram and biopsy and was told she had a 5 cm tumour, she decided to have a mastectomy as there was lymph node involvement, guess how surprised we were when the oncologist came out and told us there was a second tumour of 4 cm that they missed in the scan.


The decision you make is based on how you feel about living with cancer, where in the prostate the cancer is and how much do you trust the biopsy… did they get the highest scoring core. What experience have you of people with cancer, this may help you make a decision as well. It is also worth noting that transitional zone cancers have less chance of recurrence than a peripheral zone cancer after surgery, 8% against 18%


All this considered, I discussed it with my wife and we both decided the risk of incontinence is preferable to all the side effect with rat and HT, ED shouldn’t be a problem as at the moment the tumour is well away from the nerve bundles.


 


hope this helps


Paul


 


 


 

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User
Posted 08 May 2024 at 13:31

Hello mate.


Sorry that you've had to find us but I'm glad you have. Welcome to the forum.


If you've got low grade, low volume, cancer that is safely contained within the prostate, I would opt for AS.


It's the option I took when I fitted that criteria. I was told that about 30% of those on AS would at sometime need radical treatment, but they seem pretty good odds to me. If you read my bio you'll see that my disease progressed whilst on AS and I eventually needed surgery.


My motto's always been if it ain't broke don't fix it. Why risk all the possible side effects of radical treatment when you may not ever require it?


My only advice would be ensure that whilst you're on AS you are regularly checked. and correctly monitored. I believe that you can opt out, if you change your mind. You do need a certain type of mindset to handle AS. You've got to be able to cope with knowing you've got the disease but are happy for it to be monitored.


It appears that AS is increasingly becoming the preferred option.


https://www.cancer.gov/news-events/cancer-currents-blog/2022/prostate-cancer-active-surveillance-increasing


Our site has this to say on AS


https://prostatecanceruk.org/for-health-professionals/resources/active-surveillance-hub/evidence-based-resources#:~:text=In%20March%202023%2C%20the%20ProtecT,regardless%20of%20the%20treatment%20assigned.


Best of luck with whatever you decide.


 


 

Edited by member 08 May 2024 at 14:32  | Reason: Links

User
Posted 08 May 2024 at 13:37

Many thanks for your advise.I was only diagnosed yesterday so it's not really sunk in yet .

User
Posted 08 May 2024 at 13:59

Now you've had the surgery are you cancer free? 

User
Posted 08 May 2024 at 14:15

At this time, I am 'cancer free' but unfortunately there's a high chance of recurrence.


I'm not sure what percentage of men over 60 years old have cancerous cells in their prostates but I think it's around 60%. Many of those will die not ever knowing they had it.


 

User
Posted 08 May 2024 at 14:42

Cheers chap.Good luck & take care .

User
Posted 08 May 2024 at 16:06

Hi Skeggie


Like you I have just been diagnosed with a low grade T2, it's in the transitional zone with a gleason of 3 + 3.


A lot of guys on here suggest with something this small AS is a good way to go as the percentage of men like Adrian who develop a more advanced stage is considered low (30%).


I personally, when things have happened to me, it has always been in the lower percentage and have always had the rarer things happen, even with this, the occurrence of cancer in the transitional zone is 20/25%.


Reading all the clinical data, my outcomes with AS in ten years is 50/50 of it being advanced, coupled with the chance of recurrence being only 8% after surgery as apposed to 18% with a PZ cancer.


This all being said, whilst I was told I was going on AS, I have disagreed and am having a consultation for surgery. 


At the end of the day it is personal choice, if you would rather not live knowing you have cancer tell your CNS you want treatment.


Good luck with your decision making but don't rush it, do plenty of research, speak to your CNS about any concerns, and have a good nose around this site, there is a lot of useful helpful advice from men who have been through this.

User
Posted 08 May 2024 at 16:11

Thank you . I will take my time & follow your advise regarding the research & talking to my nurse.Thank you again.

User
Posted 08 May 2024 at 16:30

You are welcome, it is not an easy thing to decide on but I think good knowledge is important, you can then balance the pros and cons based on your lifestyle and fitness levels and support.


My wife is a star and we have the added benefit that she works in the pharmaceutical industry as a sales exec - in the urology field 😆 although in woman's health. Talk to your partner regarding the various side effects so you both understand the implications of any treatment. I find talking about it openly helps with the anxiety.


Good luck and keep us updated.

User
Posted 08 May 2024 at 16:49

Thanks again and yes I will keep you updated .Good luck and take care.

User
Posted 09 May 2024 at 15:57

Hi Paul,if you don't mind me asking  what was the deciding factor/ factors that have made you opt for treatment over AS.

User
Posted 09 May 2024 at 16:33

What was your PSA level at time of diagnosis?


Thanks,
Omar

User
Posted 09 May 2024 at 18:03

Not sure.I haven't had a PSA test since 11th March then it was 6.5.

User
Posted 09 May 2024 at 18:39

Hi Skeggie


With my diagnosis (transitional zone) there are a number of factors.


Firstly, transitional zone cancers are historically known to be aggressive cancers and usually quite large.


second, If you read the statistics from John Hopkins, the usual intervention period for men on AS is two years, (59%) but remember all different medical trusts differ in their treatment regime.


Third, I am 64 and still reasonably fit,I don’t do any exercises but I am active (golf, sailing when I get chance, and I do a lot of DIY. My reasoning is if I leave it for 2 to 5 years, will I still be able to cope with the side effects, probably of radiotherapy and HT as I may not be able to have surgery.


finally, my wife was diagnosed with breast cancer in 2007had the mammogram and biopsy and was told she had a 5 cm tumour, she decided to have a mastectomy as there was lymph node involvement, guess how surprised we were when the oncologist came out and told us there was a second tumour of 4 cm that they missed in the scan.


The decision you make is based on how you feel about living with cancer, where in the prostate the cancer is and how much do you trust the biopsy… did they get the highest scoring core. What experience have you of people with cancer, this may help you make a decision as well. It is also worth noting that transitional zone cancers have less chance of recurrence than a peripheral zone cancer after surgery, 8% against 18%


All this considered, I discussed it with my wife and we both decided the risk of incontinence is preferable to all the side effect with rat and HT, ED shouldn’t be a problem as at the moment the tumour is well away from the nerve bundles.


 


hope this helps


Paul


 


 


 

 
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