I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

What drove your treatment decision?

Email this conversation Print this conversation
User
Posted 13 Jan 2025 at 11:36

Hi Everyone,

Mark here, aged 62 , live near Chester. Fit and healthy, or so I thought until I had a PSA test in August of last year that came back as high 9.5. I then had an MRI scan followed by biopsy that confirmed numerous tumours, some with low Gleason scores which are apparently clinically insignificant, but a couple with 4+3 (worst with grade group 3) scores.

I have since had a PSMA PET scan that has confirmed that the tumours are locally contained currently (no spread to lymph or bone), which is comforting to know.  I'm quite a logical person so although the diagnosis was unexpected I have coped with the diagnosis by having the next steps mapped out and also reading others experiences on this Community (and a massive thanks to everyone who has shared their experiences!).

My consultant (private thru BUPA) has referred me to three other Consultants who specialise in Surgery , Radiotherapy and Focal Therapy to get their opinions on what is the best option for my particular diagnosis. I am aware that each option has it's own Pros and Cons and all have likely side effects in terms of incontinence and ED issues. I have found that the hardest part of this is the waiting between appointments and scans to get results as in my mind something is growing inside me! 

In my mind I'm leaning towards a radical prostatectomy in order to fully remove the tumours , but I understand the recovery and side effects may be worse. To be honest I'm finding that there is almost too much information to process and I know everyone has different diagnosis and thought processes that drive their decisions but I'd love to know what drove your treatment decisions?  

Thanks,

Mark

User
Posted 13 Jan 2025 at 15:09

Originally Posted by: Online Community Member
 But ... it also sometimes seems like a coin toss as to which treatment option to go with and surely with the tools and technology we have today there should be a defined path that leads to the 'best fit for you' ?

Me and many others would agree with you. It seems ridiculous that in this day and age no one seems prepared to put their head on the chopping block and say, "This is best for you" 

The reason I chose surgery was simply because it involved just one overnight hospital stay instead of radiation which involved 35 hospital visits over 7 weeks.  

I hate to say it, but no matter how much research you do, there seems to an element of luck involved in how well your treatment goes and how well you recover. 

You're probably already aware, that this site tends to be biased towards problems with treatment and poorer outcomes. Most blokes, whose treatment and recovery went well will probably never post on here.

User
Posted 14 Jan 2025 at 07:23

Mark I was in your position nearly 2 years ago. Firstly everyone is different and some have good or bad experiences. I chose surgery 1) I wanted it out 2) if not successful then there was a fall back to radiation 3) not a major factor but I work in an office of 59 year old women and we could not have someone else going through menopause at the same time if I chose hormone and radiotherapy! The clincher for me was when I saw the oncologist and she said in my position based on age fitness etc she would go for surgery. I had surgery April 23 - it has  been easy. I still need a pad a day to catch the unexpected leaks and even though I was 50% nerve sparing I have little natural sensation. But my last 2 psa tests have been <0.001 so that’s as good as I can expect. I suspect that from a medical perspective I am an average recovery but have nothing to base that on. Do I regret my decision - no life goes on and you adapt. Good luck. 

User
Posted 13 Jan 2025 at 15:53

I was lucky enough not to have to make a choice. Sometimes the disease is such that only one treatment path makes sense.

If you click on my avatar and scroll half way down my profile you will find links to various threads which may be useful.

BTW humans don't make logical choices, they make emotional choices and then look for evidence to justify their choice and make it look logical.

Dave

User
Posted 13 Jan 2025 at 16:26

Hi Mark

I am no medical expert but I think focal treatment would not be recommended in your circumstances because you have multi focal disease spread throughout the prostate. Focal treatment is best suited to men with uni focal disease or just one area of higher grade disease that can be focussed on and the other lesions managed via Active Surveillance.

I suspect given the nature of your disease you will be offered radiotherapy or surgery. Given your age and if the cancer is contained within the prostate or only just broken out of the prostate I  expect you will be guided towards surgery. The ultimate decision however will be yours to make.

All the very best for the future whatever decision you finally make.

 

User
Posted 13 Jan 2025 at 16:30

Originally Posted by: Online Community Member
BTW humans don't make logical choices, they make emotional choices and then look for evidence to justify their choice and make it look logical.

Like when my wife, said, "I do".

Twenty seven years later, she's still trying to justify it. 😁

Edited by member 13 Jan 2025 at 17:24  | Reason: Mistake

User
Posted 13 Jan 2025 at 16:56
Thanks for posting this, Mark. I too have just been diagnosed and I'm finding the decision about treatment very difficult. It seems extraordinary that a medical professional with a lifetime of experience who has seen 1000s of cases just like mine can't say "no guarantees, mate, but for someone of your age/weight/fitness, people who choose option A rather than B seem to have an easier time of it."

I don't know, but I expect making a recommendation which doesn't work out as hoped exposes the trust to litigation and the NHS lawyers want to defend against that. Hence we have to choose our own poison.

Thanks again for the post - it's a cliche but it is very helpful to hear from others who are going through the same stuff

Good luck to you

User
Posted 13 Jan 2025 at 17:21

 

I think many of us are floored by the expectation that we have to make the decision as in...you want me to decide!?!?  You're the experts!!!

I read widely in the time available to try and find the best option that suited my age (61), Gleason (4,4), staging (T2C) and health (generally fit). As others have noted, there isn't a clear answer more a general trend of treatment options and it became a question of multiple calls with various consultants to talk through treatment plans, durations, side effects etc. 

What finally swung it for me was the oncologist recommending surgery. I was leaning that way anyway due to the speed and clarity of RP, but he was admirably clear on the pros and cons of surgery and RT/HT. 

Good luck with whatever path you choose. 

 

User
Posted 13 Jan 2025 at 17:32

Mark, like you I thought I was fit and healthy until I was diagnosed with with Prostate Cancer 2.5yrs. I was lucky to be able to reach out all 3 experts Focal, RT and Surgeon. I looked at all 3 options and examined the pros and cons. My goal was to be rid of of the thing and hopefully give myself a better chance of cure. What I found strange was that each "expert" was ok to proceed! The RT specialist had some misgivings owing to the size of my prostate, but she was still happy to start me on the injections. The same for the surgeon and the Focal guys. Like you I was logical and looked at the 3 major objectives, get rid of the cancer, no incontinence and no ED. I was told (with surgery) 2 and 3 were inevitable in the short term and would resolve itself in the long term. My main objective was 1, and thankfully my PSA remains undetectable, however incontinence is only bedtime, and can control that with my diet. As for ED, it is an ongoing battle (again there are workarounds) - again cannot bring myself to inject my todger before sex, I also thought tablets would automatically work - I only found after surgery that you can pop all the viagra/cialis in the world, there is no guarantee after prostectomy! So in the end, my reasoning for electing for surgery was a bit flawed, but knowing what I know now, I think I would still have chosen surgery.

User
Posted 13 Jan 2025 at 17:35

I was 52 when diagnosed.

The team pushed me towards surgery. Why?

Age, likely to live long (well hopefully) so if the cancer returns I have other treatment options available over the long term

Fitness. Hence they considered I would recover quickly. I did.

Cancer was contained. So likely good outcome with good chances the treatment would be curative. 

If you are unsure always worth discussing with the uro-oncology nurses, or the wonderful nursing team at PCUK.

User
Posted 13 Jan 2025 at 21:26

Originally Posted by: Online Community Member
It seems extraordinary that a medical professional with a lifetime of experience who has seen 1000s of cases just like mine can't say "no guarantees, mate, but for someone of your age/weight/fitness, people who choose option A rather than B seem to have an easier time of it."

It may be fear of litigation, but I suspect it is basically ignorance! The surgeons and oncologists know that half their patients will end up (after their initial recovery) with only minor issues of incontinences and/or ED. But they can't predict which half!'

Sorry, that doesn't help Mark. It is a bit of a gamble, and only the patient knows how to place a bet on their future quality of life. And many of us here have had to do it.

However a couple of other points to consider - whether they are helpful or add more confusion I can't promise. (1) Radiotherapy technology has advanced considerably over the last few years (someone mentioned that above) so it is likely that current side effect risk is less than that quoted which - by definition - is based on the technology of ten or more years ago. (2) Complete surgical removal of the prostate means your PSA should drop to zero (or the detection limit of the lab) which means subsequent monitoring will pick up any residual cancer very sensitively, and action can be taken. It all depends on what your particular biggest worries are.

User
Posted 14 Jan 2025 at 04:52

hi Mark,

Its a difficult choice for those of us who GET a choice…for many the choice is taken out of their hands. I would, and was intending to, go down the surgery route until the MDT took surgery off the table😟 if you’ve read about my journey you can see that HT/RT is no walk in the park for some. However if 5 sessions of RT are available(without HT) then the choice becomes more difficult.

in the Maggies PCa networking group I’m a member of, I’ve met many men who have gone down the surgery route and none of them regret their choice even though they live with  the side effects of it. And very few men, given the choice, opt for HT/RT unless they for some good reason such as they can’t afford the recovery time from surgery, or perhaps find the thought of ED too much to bear.
On the other hand, most men I know on the HT/RT route wish they COULD have had surgery.

I’m not saying this is a reason for opting for surgery, it’s just my experience from men Ive met through Maggies.

good luck with your treatment whichever way you decide to go,

Derek

Show Most Thanked Posts
User
Posted 13 Jan 2025 at 12:03

Hi Mark.

Sorry to see that you've had to join our club, but welcome to the forum, mate.

Which radical treatment is best, is the most commonly asked question on here. Unfortunately there is no definitive answer.

If you are considering robotic prostectomy the single port surgery seems best. The recovery rate for incontinence and erectile dysfunction seem quicker and less debilitating.

If you are considering radiation, there is a relatively new, only five visits and no hormone therapy, which sounds quite appealing.

I don't think either treatment is available in all Trusts.

There are also other surgical and radiological treatments available.

It's great news that your cancer is prostate confined and relatively low grade.

If I can find conversations to the treatments mentioned above I will add links to them.

The chances are your cancer,  if it progresses, will do so slowly. There is no rush mate. Take your time to research what suits you best. When you make a decision, stick to it. 

Your attitude to the disease and the way you intend to deal with it is admirable. I feel sure you'll be OK. 

Please keep us updated. Best of luck.πŸ‘

 

Edited by member 13 Jan 2025 at 12:09  | Reason: Typo

User
Posted 13 Jan 2025 at 13:35
Thanks for your prompt response and good wishes Adrian, I have a read a number of topics on here and can see that you are a regular contributor!

I guess being logically minded I was looking for some kind of indication that if you have this score or grade of tumour(s) and these zones are affected then this would be the more likely option to take, but it's apparent that it's not as straight forward as there are multiple other factors to be considered also. But ... it also sometimes seems like a coin toss as to which treatment option to go with and surely with the tools and technology we have today there should be a defined path that leads to the 'best fit for you' ?

I have an appointment with a Consultant Radiotherapist this week so will see if he can influence my current preference.

Will keep you updated.

Cheers

User
Posted 13 Jan 2025 at 15:09

Originally Posted by: Online Community Member
 But ... it also sometimes seems like a coin toss as to which treatment option to go with and surely with the tools and technology we have today there should be a defined path that leads to the 'best fit for you' ?

Me and many others would agree with you. It seems ridiculous that in this day and age no one seems prepared to put their head on the chopping block and say, "This is best for you" 

The reason I chose surgery was simply because it involved just one overnight hospital stay instead of radiation which involved 35 hospital visits over 7 weeks.  

I hate to say it, but no matter how much research you do, there seems to an element of luck involved in how well your treatment goes and how well you recover. 

You're probably already aware, that this site tends to be biased towards problems with treatment and poorer outcomes. Most blokes, whose treatment and recovery went well will probably never post on here.

User
Posted 13 Jan 2025 at 15:53

I was lucky enough not to have to make a choice. Sometimes the disease is such that only one treatment path makes sense.

If you click on my avatar and scroll half way down my profile you will find links to various threads which may be useful.

BTW humans don't make logical choices, they make emotional choices and then look for evidence to justify their choice and make it look logical.

Dave

User
Posted 13 Jan 2025 at 16:26

Hi Mark

I am no medical expert but I think focal treatment would not be recommended in your circumstances because you have multi focal disease spread throughout the prostate. Focal treatment is best suited to men with uni focal disease or just one area of higher grade disease that can be focussed on and the other lesions managed via Active Surveillance.

I suspect given the nature of your disease you will be offered radiotherapy or surgery. Given your age and if the cancer is contained within the prostate or only just broken out of the prostate I  expect you will be guided towards surgery. The ultimate decision however will be yours to make.

All the very best for the future whatever decision you finally make.

 

User
Posted 13 Jan 2025 at 16:30

Originally Posted by: Online Community Member
BTW humans don't make logical choices, they make emotional choices and then look for evidence to justify their choice and make it look logical.

Like when my wife, said, "I do".

Twenty seven years later, she's still trying to justify it. 😁

Edited by member 13 Jan 2025 at 17:24  | Reason: Mistake

User
Posted 13 Jan 2025 at 16:56
Thanks for posting this, Mark. I too have just been diagnosed and I'm finding the decision about treatment very difficult. It seems extraordinary that a medical professional with a lifetime of experience who has seen 1000s of cases just like mine can't say "no guarantees, mate, but for someone of your age/weight/fitness, people who choose option A rather than B seem to have an easier time of it."

I don't know, but I expect making a recommendation which doesn't work out as hoped exposes the trust to litigation and the NHS lawyers want to defend against that. Hence we have to choose our own poison.

Thanks again for the post - it's a cliche but it is very helpful to hear from others who are going through the same stuff

Good luck to you

User
Posted 13 Jan 2025 at 17:21

 

I think many of us are floored by the expectation that we have to make the decision as in...you want me to decide!?!?  You're the experts!!!

I read widely in the time available to try and find the best option that suited my age (61), Gleason (4,4), staging (T2C) and health (generally fit). As others have noted, there isn't a clear answer more a general trend of treatment options and it became a question of multiple calls with various consultants to talk through treatment plans, durations, side effects etc. 

What finally swung it for me was the oncologist recommending surgery. I was leaning that way anyway due to the speed and clarity of RP, but he was admirably clear on the pros and cons of surgery and RT/HT. 

Good luck with whatever path you choose. 

 

User
Posted 13 Jan 2025 at 17:32

Mark, like you I thought I was fit and healthy until I was diagnosed with with Prostate Cancer 2.5yrs. I was lucky to be able to reach out all 3 experts Focal, RT and Surgeon. I looked at all 3 options and examined the pros and cons. My goal was to be rid of of the thing and hopefully give myself a better chance of cure. What I found strange was that each "expert" was ok to proceed! The RT specialist had some misgivings owing to the size of my prostate, but she was still happy to start me on the injections. The same for the surgeon and the Focal guys. Like you I was logical and looked at the 3 major objectives, get rid of the cancer, no incontinence and no ED. I was told (with surgery) 2 and 3 were inevitable in the short term and would resolve itself in the long term. My main objective was 1, and thankfully my PSA remains undetectable, however incontinence is only bedtime, and can control that with my diet. As for ED, it is an ongoing battle (again there are workarounds) - again cannot bring myself to inject my todger before sex, I also thought tablets would automatically work - I only found after surgery that you can pop all the viagra/cialis in the world, there is no guarantee after prostectomy! So in the end, my reasoning for electing for surgery was a bit flawed, but knowing what I know now, I think I would still have chosen surgery.

User
Posted 13 Jan 2025 at 17:35

I was 52 when diagnosed.

The team pushed me towards surgery. Why?

Age, likely to live long (well hopefully) so if the cancer returns I have other treatment options available over the long term

Fitness. Hence they considered I would recover quickly. I did.

Cancer was contained. So likely good outcome with good chances the treatment would be curative. 

If you are unsure always worth discussing with the uro-oncology nurses, or the wonderful nursing team at PCUK.

User
Posted 13 Jan 2025 at 21:26

Originally Posted by: Online Community Member
It seems extraordinary that a medical professional with a lifetime of experience who has seen 1000s of cases just like mine can't say "no guarantees, mate, but for someone of your age/weight/fitness, people who choose option A rather than B seem to have an easier time of it."

It may be fear of litigation, but I suspect it is basically ignorance! The surgeons and oncologists know that half their patients will end up (after their initial recovery) with only minor issues of incontinences and/or ED. But they can't predict which half!'

Sorry, that doesn't help Mark. It is a bit of a gamble, and only the patient knows how to place a bet on their future quality of life. And many of us here have had to do it.

However a couple of other points to consider - whether they are helpful or add more confusion I can't promise. (1) Radiotherapy technology has advanced considerably over the last few years (someone mentioned that above) so it is likely that current side effect risk is less than that quoted which - by definition - is based on the technology of ten or more years ago. (2) Complete surgical removal of the prostate means your PSA should drop to zero (or the detection limit of the lab) which means subsequent monitoring will pick up any residual cancer very sensitively, and action can be taken. It all depends on what your particular biggest worries are.

User
Posted 14 Jan 2025 at 04:52

hi Mark,

Its a difficult choice for those of us who GET a choice…for many the choice is taken out of their hands. I would, and was intending to, go down the surgery route until the MDT took surgery off the table😟 if you’ve read about my journey you can see that HT/RT is no walk in the park for some. However if 5 sessions of RT are available(without HT) then the choice becomes more difficult.

in the Maggies PCa networking group I’m a member of, I’ve met many men who have gone down the surgery route and none of them regret their choice even though they live with  the side effects of it. And very few men, given the choice, opt for HT/RT unless they for some good reason such as they can’t afford the recovery time from surgery, or perhaps find the thought of ED too much to bear.
On the other hand, most men I know on the HT/RT route wish they COULD have had surgery.

I’m not saying this is a reason for opting for surgery, it’s just my experience from men Ive met through Maggies.

good luck with your treatment whichever way you decide to go,

Derek

User
Posted 14 Jan 2025 at 07:23

Mark I was in your position nearly 2 years ago. Firstly everyone is different and some have good or bad experiences. I chose surgery 1) I wanted it out 2) if not successful then there was a fall back to radiation 3) not a major factor but I work in an office of 59 year old women and we could not have someone else going through menopause at the same time if I chose hormone and radiotherapy! The clincher for me was when I saw the oncologist and she said in my position based on age fitness etc she would go for surgery. I had surgery April 23 - it has  been easy. I still need a pad a day to catch the unexpected leaks and even though I was 50% nerve sparing I have little natural sensation. But my last 2 psa tests have been <0.001 so that’s as good as I can expect. I suspect that from a medical perspective I am an average recovery but have nothing to base that on. Do I regret my decision - no life goes on and you adapt. Good luck. 

User
Posted 18 Jan 2025 at 16:50

In similar predicament - 61, Gleason 7, localised - feel I'm being pushed towards AS - but very nervous of that. I have an appointment next week to discuss fully my MDT review - do you think, like others it's reasonable for me to speak individually with surgeon, radiotherapist etc - agree with others - having to choose is very hard.

I'm a very fit 61 year old - multiple marathon runner, which I want to continue - I feel I have so many things to balance in making my decision 

User
Posted 18 Jan 2025 at 22:39

Originally Posted by: Online Community Member
do you think, like others it's reasonable for me to speak individually with surgeon, radiotherapist

Definitely! Opinions will vary and it really does help to be able to weigh them up yourself, rather than go with the views of a single source, particularly with AS as one possibility.

Jules

User
Posted 19 Jan 2025 at 00:42
Hi Mark46,

Many of us who have not yet gone down the treatment route have this same dilemma. What do we do? Which treatment option should we take? When do we take it?

Severity of biopsy results may well dictate the timescales and sometimes which option, but not always.

I'm about to start down a 2nd run of AS, whilst I tussle with where I take this. It's likely I'll see what comes of the next MRI before reviewing with the MDT. But it does play on your mind is this a risky decision or not.

The web is full of countless articles and forums. You are unlikely to come across one as useful and sobering as this one.

I try to locate scientific factual information to counter-balance my emotional thinking of treatment choices.

I've no idea if this example helps someone make a choice but worth a read:

https://www.ox.ac.uk/news/2023-03-13-study-shows-delaying-treatment-localised-prostate-cancer-does-not-increase-mortality

A statistical graph can never override your inner fears or concerns, and hopefully this kind of information will become more available and up to date as time progresses.

User
Posted 19 Jan 2025 at 06:18

Sorry to hear this.

Try and act rapidly as these are type 4 cells so speed is of the essence. The good news is if you get it removed while localised then life can be pretty much normal post surgery. 

I’d recommend finding a top notch high volume (>100 per year) surgeon with a publicly proven track record. NeuroSAFE is prudent during surgery as gives near real-time visibility on margins while you are open. Retzius sparing approach to RARP is a good option as quicker recovery times…it’s technically more complex so a skilled surgeon really matters in this case.

I chose Guys London Bridge to have my op. It’s two hours away so bit of additional hassle but I wanted the top funded uk centre of excellence, top kit, top surgeon and crash recovery facilities on site. All these were met/exceeded. I stayed in London Bridge Hotel next door the night before as didn’t want to panic travelling at a ridiculously early hour as check in was 7am.

On the plus side surgery was a doddle and less drama than when I had my tonsils out as a kid….i had to keep reminding myself I’d had major surgery so not to overdo things.

i was dry after catheter removal at two weeks . Then minor leaks and dribbles after this for 5 weeks where I needed pads. After this all good and just occasional squirt when coughing and sneezing etc

I was back to the gym after 3 months and that was all fine. Just don’t train on a full bladder. I don’t need pads at all.

im just over 5 years post op and still PSA undetectable. Technically with cancer I don’t think cure is the right term but remission is more fitting but happy days either way.

ED not too much of an issue which tends to be fairly hit n miss post surgery from what I see. It’s not the same as pre-surgery but mostly I have about 90%-100% of function unless I’m tired. To bridge the last 20% in that case is as simple as popping something like 20mg viagra.

Please don’t feel too concerned about surgery as it’s not as big a drama as I had worked myself up to believe. It’s a massive head-spin in the final two weeks before surgery but you get there.

So happy days this far. My primary goal was always to be cancer free as all other considerations are secondary and can be managed. At the very least I’ve bought myself extra time so if the cancer does return hopefully the next gen treatments will be online.

Best of luck and use this group as a sounding board as much as you need as it was absolutely critical when I went through the process.

Btw surgery allows radiotherapy to be kept a back stop should it be needed for salvage recurrence. 

Edited by member 19 Jan 2025 at 06:21  | Reason: Not specified

User
Posted 19 Jan 2025 at 16:22

Originally Posted by: Online Community Member

In similar predicament - 61, Gleason 7, localised - feel I'm being pushed towards AS - but very nervous of that. I have an appointment next week to discuss fully my MDT review - do you think, like others it's reasonable for me to speak individually with surgeon, radiotherapist etc - agree with others - having to choose is very hard.

I'm a very fit 61 year old - multiple marathon runner, which I want to continue - I feel I have so many things to balance in making my decision 

I note you hinted you are being pushed towards AS. My question is with GL7, I was not given the option of AS, and was wondering if you could ask not to be on AS and elect for treatment?

User
Posted 19 Jan 2025 at 16:34

Originally Posted by: Online Community Member

In similar predicament - 61, Gleason 7, localised - feel I'm being pushed towards AS - but very nervous of that. I have an appointment next week to discuss fully my MDT review - do you think, like others it's reasonable for me to speak individually with surgeon, radiotherapist etc - agree with others - having to choose is very hard.

I'm a very fit 61 year old - multiple marathon runner, which I want to continue - I feel I have so many things to balance in making my decision 

You should be defining your treatment pathway. The team will guide and should at least present options. For due diligence it’s always worth getting a second opinion as I did. At worse it will cost you a few hundred quid if you want to do it rapidly with the consultant of your choice. I nearly don’t do this as didn’t want to rock the boat….im so glad I did. If you are under NHS you can also specify via NHS choices who you want to see….just have to persevere as usual format in to dynamically allocate you to whoever is on rotation on the day. I found being fairly steadfast and comfortable with waiting an hour or so longer meant I saw my chosen clinician.

Since three months post op I’ve been running, intense weight training and getting into calisthenetics….there is light at the end of the tunnel 😎

Edited by member 19 Jan 2025 at 16:37  | Reason: Not specified

User
Posted 19 Jan 2025 at 22:40

Gee Baba,

if your Gleason 7 is favorable (3+4), AS could be a considered option, but surgery could be also and in the past for a 7 would have been protocol or Radiation. AS is considered an option with some Gleason 7’s. If your Gleason was a 7 unfavorable (4+3), no way would I entertain AS. I don’t think even with a favorable Gleason 7 regardless they would or could require you to be on AS. If you were to do AS it would need to be tightly monitored because of a Gleason 7 with watching your PSA very closely, quickly for MpMRI followup and biopsy. Seeking additional consultation would be helpful to get you comfortable in your decision. 

User
Posted 20 Jan 2025 at 05:29

Ned@1, my GL was 3+4, in 2022, I did ask the nurse if I could be put on AS, she politely refused my request. I suspect, the protocol has changed now, as I have friend with the same GL and he has been put on AS. He is not too pleased about it and wants treatment, don't know if they would listen to him though!

User
Posted 20 Jan 2025 at 08:21

Our site shows NICE guidelines as to what Gleason 7 (3+4), inconjunction with other factors, are deemed suitable for active surveillance

https://prostatecanceruk.org/for-health-professionals/resources/active-surveillance-hub/evidence-based-resources

 

User
Posted 20 Jan 2025 at 17:32

I was Cambridge Grp3 and was not offered AS, I would have taken it if offered.

User
Posted 21 Jan 2025 at 07:29
I went through this delema, in mid 70s with 4/3/7 ...... here in Australia I decided on RT, as I had been told by my Oncologist that around a third of men that have a removal, they end up with RT - I cut to the chase and so far have avoided all but minor after effects!. I was also included in a new evaluation of my biopsy samples that are evaluated against a database of 5000. This was an AI process ...... result, I was told I would not require ADT and have a chance of return in 5 years of 1.4% and 3% over 10.

Two of my younger friends had removal, but still have had to use small pads 2 years later.

The choice is hard, but take your time!.

 
Forum Jump  
Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.




MenuTop ▲
©2025 Prostate Cancer UK