T3a & mulling over options after latest MRI suggest treatment needed

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User

Posted 14 Oct 2024 at 21:01

An interesting consultation. The oncologist felt my latest MRI and biopsy didn't suggest T3a but that cancer is still contained within the capsule but is gonna get views from his multi-disciplinary team and we'll meet again in 3 weeks.

Depending on the view of his SMDT, gut feeling was that on balance there are some signs of progression so make use of my private insurance while I have it to go for MRI LINAC (SABR) treatment without need for hormone treatment.

I might investigate focal therapy but I have cancer in more than one part of the prostate, so much of it would need to be zapped anyway, so perhaps just irradiate the whole thing in the least harmful way possible (in UK), and hopefully kiss goodbye to PC for good...

User

Posted 15 Oct 2024 at 05:41

Originally Posted by: Online Community Member

Hello again mate.

If they decide that you are suitable for this treatment, to me, that would be a good path to take.

In answer to your question, all my treatment has been NHS. Generally, I have been very satisfied and impressed by the service. However, during COVID, one or two mistakes were made with my active surveillance, which in my opinion, allowed my disease to progress unchecked, leaving me at more risk of recurrence.

Da Vinci is basically keyhole robotic prostatectomy.

Edited by member 15 Oct 2024 at 05:48 | Reason: Additional text

User

Posted 15 Oct 2024 at 11:46

It's still early days for SABR as the primary treatment.
I found this from 2018, says it's much cheaper than other External beam treatment because it's short duration. It also gives similar doses to Brachytherapy, but it also has potentially worse toxicity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043737/#:~:text=With%20a%20median%20follow%2Dup,and%20high%2Drisk%20prostate%20cancer.

User

Posted 15 Oct 2024 at 12:20

Hello mate.

As you say that was was from 2018.

Since then, after trials, it's being introduced as an approved treatment. In fact, there is research now being conducted to see if its safe enough to have only 2 SABR sessions for low grade PCa and further research testing it on higher grade cancer.

It seems to be advancing very quickly, probably because it is much more cost efficent.

I started a conversation on the two session trial yesterday.

https://community.prostatecanceruk.org/posts/t31027-Recent-research-into-SABR-being-effective-after-only-two-sessions-s#post300684

Edited by member 15 Oct 2024 at 12:25 | Reason: Additional text

User

Posted 15 Oct 2024 at 16:41

I had private robotic prostatectomy 13 years ago. The main advantage was that I was able to pick the consultant who had excellent reputation in robotic surgery. The aftercare was terrible, be it in a private bedroom and very 'glossy' hospital. Private hospitals are not interested in post-surgery issues. Fortunately my consulted was very kind and devoted to his work and I had direct contact with him. In the past few years the NHS has managed to trained many urologist in robotic surgery.

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

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