Advice sought

Advice sought

User

Posted 20 Dec 2024 at 17:51

I was recently diagnosed with localised prostate cancer. This was after a routine PSA test that came back as 5.18.

This was followed up by an MRI resulting in PI RADS 4.
I had a biopsy and my gleeson score was 3+4.

Whilst i am scheduled for a prostate removal at the end of Jan, I am having second thoughts due to concerns about potential risks and side effects.
I am hoping to hear from anyone who has undergone radiotherapy or brachytherapy. Your experiences and advice would be greatly appreciated.
thank you

Edited by member 21 Dec 2024 at 07:27 | Reason: Not specified

User

Posted 21 Dec 2024 at 05:12

Hello mate.

I'm sorry that you've had to join our club but welcome.

There are a few fellas on here who've had brachytherapy and radiotherapy. I don't know if your cancer is deemed suitable for the newer, only five sessions, of radiation therapy?

Being only 54 years old, you are quite a bit younger than most of us old codgers, so it's extra important that you're happy with whatever radical treatment you chose.

The chances are mate, whatever treatment you opt for, that are likely to be side effects. Having said that, as both surgical and radiotherapy techniques improve, the side effects seem to decrease and more blokes seem to be left unscathed.

We'd be better placed to give comment, if you gave a little history of your condition, including, PSA level, Gleason score, MRI results and cancer staging.

I'm glad that you joined the forum, we will do our utmost to support you.

Best of luck and please keep us updated. 👍

Edited by member 21 Dec 2024 at 05:14 | Reason: Typo

User

Posted 21 Dec 2024 at 07:30

Thank you for your reply. I have edited and added my post with the scores on.

User

Posted 21 Dec 2024 at 07:48

I had brachytherapy in 2016 at the age of 70 with PSA 2.19 Gleason 3+4=7 ,Click on my Avatar and scroll down a lot to see my journey if it helps but you are a lot younger than me so need to look at all the options .

8+years on was given all clear 2021 ish ,I think i have been lucky with no great side affects.

John.

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User

Posted 20 Dec 2024 at 21:58

Click on my picture and read my profile. I had HDR brachy and ebrt. I'd say those two are relatively easy, but two years of HT isn't a great experience.

Dave

User

Posted 21 Dec 2024 at 05:12

Hello mate.

I'm sorry that you've had to join our club but welcome.

There are a few fellas on here who've had brachytherapy and radiotherapy. I don't know if your cancer is deemed suitable for the newer, only five sessions, of radiation therapy?

Being only 54 years old, you are quite a bit younger than most of us old codgers, so it's extra important that you're happy with whatever radical treatment you chose.

We'd be better placed to give comment, if you gave a little history of your condition, including, PSA level, Gleason score, MRI results and cancer staging.

I'm glad that you joined the forum, we will do our utmost to support you.

Best of luck and please keep us updated. 👍

Edited by member 21 Dec 2024 at 05:14 | Reason: Typo

User

Posted 21 Dec 2024 at 07:30

Thank you for your reply. I have edited and added my post with the scores on.

User

Posted 21 Dec 2024 at 07:48

8+years on was given all clear 2021 ish ,I think i have been lucky with no great side affects.

John.

User

Posted 21 Dec 2024 at 07:49

Cheers mate.

Your Gleason 7 (3+4) is grade group 2 and your PSA is relatively low. Is your cancer contained within the prostate, is it a T2 staging? Was active surveillance not an option?

It's not as successful for Gleason 7 (3+4) as it is for Gleason 6 (3+3) but dependent of other factors can be an option.

https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01315-5#:~:text=Active%20surveillance%20has%20been%20proposed,grade%20upgrading%20and%20adverse%20features.

Edited by member 21 Dec 2024 at 07:57 | Reason: Add link

User

Posted 21 Dec 2024 at 08:21

Yes it was a T2 N0 Mx graded.
When I was diagnosed active surveillance sounded as if it could have been an option, however after an MDT meeting they said active treatment was recommended.

User

Posted 21 Dec 2024 at 08:23

Adrian

I have tried to private message you, but the app won’t allow me due to me being a new member.

User

Posted 21 Dec 2024 at 08:30

When I asked about brachytherapy I was told that the hospital doesn’t offer this.
Did you have to travel elsewhere to get this done?

User

Posted 21 Dec 2024 at 09:06

Originally Posted by: Online Community Member

Adrian

I have tried to private message you, but the app won’t allow me due to me being a new member.

No probs mate. Obviously the MDT decided that in your case AS wasn't suitable. The decision on what treatment to take is difficult. Had it then be available, I think I might have chosen the 5 session radiotherapy without HT rather than surgery. Which although to date seems to have worked, but has left me with permanent ED issues.

I wish you the best of luck with whatever treatment you have.

User

Posted 21 Dec 2024 at 09:18

Originally Posted by: Online Community Member

When I asked about brachytherapy I was told that the hospital doesn’t offer this.
Did you have to travel elsewhere to get this done?

In my case the hospital offered a lot of treatment options. I'm told that in your situation you will need a referral to another trust. I don't know how bureaucratic that will be.

Dave

User

Posted 21 Dec 2024 at 10:24

Originally Posted by: Online Community Member

When I asked about brachytherapy I was told that the hospital doesn’t offer this.
Did you have to travel elsewhere to get this done?

Yes, if you are in England, you are entitled be referred to any other NHS England hospital which is willing to take you.

A new radiotherapy treatment which is replacing seed brachytherapy in many cases is the 5 sessions of SABR without the need for hormone therapy. It's either done daily over a week (split over a weekend off) or alternate days over 2 weeks. This was run as a trial which was successful. NHS England has said it's to become a standard treatment. The trial sites have continued offering it as standard, but it's taking longer for other sites capable of SABR to get going, so again, it might be something you need to be referred somewhere else to do.

One consideration I would have at your young age is that you are looking for 30 or more years remission, and that's quite a big ask of any treatment. This is the case where you might want to consider which treatment has another curative treatment which can be used as a follow-on (salvage) if necessary. This consideration would favour prostatectomy over radiotherapy as your first treatment, because that can be followed by salvage radiotherapy later, whereas doing a salvage prostatectomy after radiotherapy tends to have more significant quality of life issues. There are now some other salvage options after radiotherapy for some circumstances such as the focal therapies, which can be used in some specific situations with possibly few if any quality of life implications.

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