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Friday the 13th

User
Posted 14 Sep 2024 at 13:06

Hi, got my MRI and biopsy results after 10 days this 13/9. MRI showed 2 areas which were positive.slightly enlarged, PSA 8

T2c 7(3,4) N0 65% of prostate.
no M yet but need full scans
63 years BMI 33.5 

urologist at first was steering more radio because of BMI above 30. I said I could lower that and he finally recommended surgery. Got a phone appointment with radiologist coming Tuesday.

Im wanting surgery as it has a slightly longer term benefits and less long term side effects but I don’t like the radical nature and under knife risks!

it is a 4 week waiting list!

My fears are having radical surgery .

ive been looking at posts these past few weeks and i see many useful tips and shared experiences. 

User
Posted 14 Sep 2024 at 19:04

Radical in this context means your first treatment and given with curative intent. It's Latin for root, meaning you're removing all the roots (like pulling up a weed).

It's not used for focal treatments, salvage treatments (subsequent treatment after the first failed to cure), or palliative treatments.

User
Posted 14 Sep 2024 at 13:47

Hi Martin,

I know you’re not that old, but the outcome of treatment at your age is probably going to be similar I would think.

So it comes  down to side effects, but I’m not sure that the long term side effects of surgery are worse than going down the HT/RT route. Certainly I have found that the side effects of having HT for 2 years have not been good for me, but you can live with them if you work at it. With surgery permanent ED is a possibility and it does take quite some time to get back to your old physical self…you need to be patient with your recovery and I would think it might take longer if you are not physically fit (not sure whether you are or not).

I would wait until you’ve seen the Oncologist before making a decision, although I’m surprised it’s only a phone appointment…I think face to face is much better. Write down any questions you have before the appointment.

All the guys at Maggies I know that have surgery have said they made the right choice and are doing well, but everyone is different.

Good luck whatever you decide,

Derek

User
Posted 17 Sep 2024 at 15:52

I am surprised they put a condition on your BMI and general health. I am over 2yrs post RARP, and there was no condition put my fitness or BMI. 

User
Posted 17 Sep 2024 at 17:55

Hi,   I was worried about having surgery at first.  But as it got near I became optimistic and relieved it was to be done, and decided I was going to switch off and be asleep for 2hrs, no problem. 

You may know all this but...

I recall climbing onto the trolley and 2 nurses started attaching things, I quite enjoyed the attention.   The anaesthetist said I'd go to sleep in 30 seconds.  That was it until I was awoken about 2 1/4hrs later.  I was surprised to learn someone had shaved my stomach and I checked my hands and feet still worked.   They put me back to sleep as there was no bed until 3hrs later.  The day after I was walking round the ward checking patients. 

Ear plugs are essential at night.

You have the op on a different table that slopes so your head is down.  Also if you've a lot of fat it makes cutting the 5 holes in your stomach more difficult.  The head down slope puts strain on you that's why fitness is important.

Don't think the surgeon is your friend as I only ever saw him once although he's still there as head guy.

If you can get that weight off it might help.  What and how much you eat and drink is the key. 

I guess you'll have a pre-op with heart check a week or two before the op.

Regards  Peter

 

User
Posted 17 Sep 2024 at 18:20

Originally Posted by: Online Community Member

I am surprised they put a condition on your BMI and general health. I am over 2yrs post RARP, and there was no condition put my fitness or BMI. 

I think this is always assessed, even if you didn't notice. Some surgeons will operate up to BMI of 35 for someone otherwise very fit and with >10 years life expectancy, but the risks of something going wrong are still higher, and the recovery time much longer.

Stomach and visceral fat is the thing which makes the operation difficult for the surgeon, and for the anesthetist.

Edited by member 17 Sep 2024 at 18:24  | Reason: Not specified

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User
Posted 14 Sep 2024 at 13:47

Hi Martin,

I know you’re not that old, but the outcome of treatment at your age is probably going to be similar I would think.

So it comes  down to side effects, but I’m not sure that the long term side effects of surgery are worse than going down the HT/RT route. Certainly I have found that the side effects of having HT for 2 years have not been good for me, but you can live with them if you work at it. With surgery permanent ED is a possibility and it does take quite some time to get back to your old physical self…you need to be patient with your recovery and I would think it might take longer if you are not physically fit (not sure whether you are or not).

I would wait until you’ve seen the Oncologist before making a decision, although I’m surprised it’s only a phone appointment…I think face to face is much better. Write down any questions you have before the appointment.

All the guys at Maggies I know that have surgery have said they made the right choice and are doing well, but everyone is different.

Good luck whatever you decide,

Derek

User
Posted 14 Sep 2024 at 19:04

Radical in this context means your first treatment and given with curative intent. It's Latin for root, meaning you're removing all the roots (like pulling up a weed).

It's not used for focal treatments, salvage treatments (subsequent treatment after the first failed to cure), or palliative treatments.

User
Posted 17 Sep 2024 at 12:01

Talked with surgeon and radiologist. Really got the usual pros/cons.  Issue will be bmi/fitness. I have a little time to  make 30 from 32.8 and increase fitness. Give I’m 63 and t2c I’m going for surgery ( very scared ) and be assessed in 4 weeks and that will ultimately give the best informed decision! The specialist nurse is best to bounce things off!

User
Posted 17 Sep 2024 at 15:52

I am surprised they put a condition on your BMI and general health. I am over 2yrs post RARP, and there was no condition put my fitness or BMI. 

User
Posted 17 Sep 2024 at 17:55

Hi,   I was worried about having surgery at first.  But as it got near I became optimistic and relieved it was to be done, and decided I was going to switch off and be asleep for 2hrs, no problem. 

You may know all this but...

I recall climbing onto the trolley and 2 nurses started attaching things, I quite enjoyed the attention.   The anaesthetist said I'd go to sleep in 30 seconds.  That was it until I was awoken about 2 1/4hrs later.  I was surprised to learn someone had shaved my stomach and I checked my hands and feet still worked.   They put me back to sleep as there was no bed until 3hrs later.  The day after I was walking round the ward checking patients. 

Ear plugs are essential at night.

You have the op on a different table that slopes so your head is down.  Also if you've a lot of fat it makes cutting the 5 holes in your stomach more difficult.  The head down slope puts strain on you that's why fitness is important.

Don't think the surgeon is your friend as I only ever saw him once although he's still there as head guy.

If you can get that weight off it might help.  What and how much you eat and drink is the key. 

I guess you'll have a pre-op with heart check a week or two before the op.

Regards  Peter

 

User
Posted 17 Sep 2024 at 18:20

Originally Posted by: Online Community Member

I am surprised they put a condition on your BMI and general health. I am over 2yrs post RARP, and there was no condition put my fitness or BMI. 

I think this is always assessed, even if you didn't notice. Some surgeons will operate up to BMI of 35 for someone otherwise very fit and with >10 years life expectancy, but the risks of something going wrong are still higher, and the recovery time much longer.

Stomach and visceral fat is the thing which makes the operation difficult for the surgeon, and for the anesthetist.

Edited by member 17 Sep 2024 at 18:24  | Reason: Not specified

 
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