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User
Posted 08 Nov 2024 at 19:39

Just formally been diagnosed, I’m 66 and had prostate issue for over 20 years with PSA gradually rising , Gleason is 3+4 and PSA 12.5 , biopsy shows localised in Prostate.

After MDT meeting my options will be Robot Prostectamy or Hormone and RT 

question .. will I be asked to choose or will I be advised?

I’m currently healthy and other than raised PSA no symptoms.

User
Posted 08 Nov 2024 at 23:05

You may be given a strong recommendation for one treatment or another. In my case the position of the cancer ruled out surgery. To all intents and purposes I did not have a choice.

The earlier the cancer is caught the more likely you will have to choose. I'd say about half the members on this forum did have a choice. 

I'm glad I didn't have to choose, there is a lot to weigh up, and most of us are not very experienced in medical decisions.

Dave

User
Posted 09 Nov 2024 at 11:24
Hi Blacklab196

I was diagnosed in early 2023 so quite a long way through what appears to be effective treatment - RT and HT.

I found deciding on which treatment route to take completely overwhelming. I had the choice between surgery and RT/HT. The surgeon I spoke with felt sure surgery was the best option, the oncologist RT/HT. The outcomes for me were about the same.

One of the factors that made me choose the route I took was the possible side effects of the two options. The position and stage of my cancer meant surgery would not be nerve saving, I was scared of such an invasive procedure but also worried about the effects of HT (which unfortunately for me have been quite noticeable - but not for everyone). In the end, and it is probably not the best way to make such an important decision, I decided I wanted the route that was most likely to save sexual function in due course.

I found focussing on side effects and long term treament effects was the only way I could get to a decision point given everything else was equal.

User
Posted 08 Nov 2024 at 22:24

Hello mate.

Sorry to see you've had to join the Club. Welcome to the forum.

If both options are deemed suitable treatments, it may well be, that you will have to make the choice.

Which treatment to chose is perhaps the most asked question on here and unfortunately there is no definitive answer to which would be best for you.

User
Posted 09 Nov 2024 at 05:37

In my case, the MDT had recommended surgery. At my first meeting with the oncologist he agreed with the MDT, but said that ultimately the choice was mine and if I decided on radiotherapy to let him know. In my case, the tumour was pressing on my urethra and would have required additional work/surgery on top of the radiotherapy. I weighed things up and didn't fancy a couple of years or so on HT so I was leaning towards surgery anyway, and coupled with the MDT's recommendation I went for surgery. As it happened, I had to have salvage radiotherapy a couple of years later but my PSA is now <0.010.

Deciding on your treatment pathway isn't easy but weighing up factors such as nerve sparing, incontinence risks, additional treatments, side effects, HT etc can be a minefield but, pros & cons written down on a sheet of paper over a few days might help. 

Good luck. 

Kev.

Edited by member 09 Nov 2024 at 05:50  | Reason: Typo

User
Posted 09 Nov 2024 at 07:58
My circumstances were similar to yours I was advised to go on the NHS Prostrate predict and after seeing there was little difference in perecentage chance of surviving 10 years ( both were around 92% ) I went for the HT and Radiotherapy, thankfully I was only on Bicalutamide for 3months followed by 20 fractions of Radiotherapy, the treatment went well and my PSA is now at 0.5, however had I been offered the latest 5 doses of Radiotherapy and no HT I would have most certainly chosen that, deciding which treatment path is the hardest decision most of us face, cheers John
User
Posted 09 Nov 2024 at 11:08
Not sure what the criteria is for the 5 dose radiotherapy and I'm sure others can give you much more information, best to ask the Oncologists when you meet them, but it seems to be a really good option in the right circumstances, John
User
Posted 09 Nov 2024 at 13:15

This is a BBC article on 5 dose RT. It is not yet available everywhere so consider asking for a referral to somewhere it is available if you meat the clinical eligibility for it.

https://www.bbc.com/news/health-66946336

 

Dave

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User
Posted 08 Nov 2024 at 22:24

Hello mate.

Sorry to see you've had to join the Club. Welcome to the forum.

If both options are deemed suitable treatments, it may well be, that you will have to make the choice.

Which treatment to chose is perhaps the most asked question on here and unfortunately there is no definitive answer to which would be best for you.

User
Posted 08 Nov 2024 at 23:05

You may be given a strong recommendation for one treatment or another. In my case the position of the cancer ruled out surgery. To all intents and purposes I did not have a choice.

The earlier the cancer is caught the more likely you will have to choose. I'd say about half the members on this forum did have a choice. 

I'm glad I didn't have to choose, there is a lot to weigh up, and most of us are not very experienced in medical decisions.

Dave

User
Posted 09 Nov 2024 at 05:37

In my case, the MDT had recommended surgery. At my first meeting with the oncologist he agreed with the MDT, but said that ultimately the choice was mine and if I decided on radiotherapy to let him know. In my case, the tumour was pressing on my urethra and would have required additional work/surgery on top of the radiotherapy. I weighed things up and didn't fancy a couple of years or so on HT so I was leaning towards surgery anyway, and coupled with the MDT's recommendation I went for surgery. As it happened, I had to have salvage radiotherapy a couple of years later but my PSA is now <0.010.

Deciding on your treatment pathway isn't easy but weighing up factors such as nerve sparing, incontinence risks, additional treatments, side effects, HT etc can be a minefield but, pros & cons written down on a sheet of paper over a few days might help. 

Good luck. 

Kev.

Edited by member 09 Nov 2024 at 05:50  | Reason: Typo

User
Posted 09 Nov 2024 at 06:55

Thanks for the reply, I’m leaning towards surgery but will see what the consultants have to say 👍🏻

User
Posted 09 Nov 2024 at 07:58
My circumstances were similar to yours I was advised to go on the NHS Prostrate predict and after seeing there was little difference in perecentage chance of surviving 10 years ( both were around 92% ) I went for the HT and Radiotherapy, thankfully I was only on Bicalutamide for 3months followed by 20 fractions of Radiotherapy, the treatment went well and my PSA is now at 0.5, however had I been offered the latest 5 doses of Radiotherapy and no HT I would have most certainly chosen that, deciding which treatment path is the hardest decision most of us face, cheers John
User
Posted 09 Nov 2024 at 08:23

Thanks for your prompt response , what is the 5 dose option and the criteria for having it ? 

I assume there is no HT with what option ? 

Regards Peter 

User
Posted 09 Nov 2024 at 11:08
Not sure what the criteria is for the 5 dose radiotherapy and I'm sure others can give you much more information, best to ask the Oncologists when you meet them, but it seems to be a really good option in the right circumstances, John
User
Posted 09 Nov 2024 at 11:24
Hi Blacklab196

I was diagnosed in early 2023 so quite a long way through what appears to be effective treatment - RT and HT.

I found deciding on which treatment route to take completely overwhelming. I had the choice between surgery and RT/HT. The surgeon I spoke with felt sure surgery was the best option, the oncologist RT/HT. The outcomes for me were about the same.

One of the factors that made me choose the route I took was the possible side effects of the two options. The position and stage of my cancer meant surgery would not be nerve saving, I was scared of such an invasive procedure but also worried about the effects of HT (which unfortunately for me have been quite noticeable - but not for everyone). In the end, and it is probably not the best way to make such an important decision, I decided I wanted the route that was most likely to save sexual function in due course.

I found focussing on side effects and long term treament effects was the only way I could get to a decision point given everything else was equal.

User
Posted 09 Nov 2024 at 13:15

This is a BBC article on 5 dose RT. It is not yet available everywhere so consider asking for a referral to somewhere it is available if you meat the clinical eligibility for it.

https://www.bbc.com/news/health-66946336

 

Dave

 
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