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Is HRT a longer term option ?

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User
Posted 24 Mar 2025 at 12:22

The history of my life with possible prostate cancer is fairly well documented in my profile. I elected to opt out of further PSA testing in December 2023 after 12 years of PSA testing & two biopsies which found no trace of cancer.

I spent most of 2024 experiencing problems with breathlessness - I have CLL which was not considered to be related to this problem - an echocardiogram in April 2024 suggested that there was nothing significantly wrong with my heart but I was placed on the waiting list for an angiogram with a NHS waiting list approaching 12 months.

A CT Scan in November 2024 found problems with fluid on both my lungs & to a limited extent my heart with a thickening of the pericardium which was constraining my heart. The lower half of my body became severely swollen by the build up of fluid & I was admitted to Gloucester Royal Infirmary for further tests & the draining of the fluid build up. The tests showed that I needed both a triple heart bypass & what is called a 'pericardial peel'. Surgery was undertaken at Bristol Heart Institute on 17 February - I neither smoke, nor drink & I am not overweight. Unfortunately the state of my heart is such that only a single bypass could be completed along with the removal of a large part of my pericardium.

Whilst in Gloucester Royal Infirmary blood tests revealed that my PSA, when corrected for Finasteride, had risen to 182 - there was a debate as to whether I would be eligible for heart surgery given a view that prostate cancer may shorten my life such that an operation on my heart could be a pointless exercise & not, from a NHS perspective, represent 'value for money' ! This was resolved in a meeting with an Urology Consultant & in January 2025 I was prescribed HRT.

I will soon be 78 and am not enthused by the idea of a further biopsy followed by radiotherapy. I feel much better after heart surgery but given that they were unable to complete all that they hoped I regard my future as somewhat 'uncertain' - that doesn't bother me, I just enjoy everyday as it comes. My reading is that HRT on its own is not necessarily a long term solution to my probable prostate cancer but my inclination is to opt for that treatment alone - is there anyone in the Community who has taken a similar course of action & if so what has their experience been like ? 

Thanks

User
Posted 24 Mar 2025 at 17:13

Grafton, I am not in the same situation as you. All my curable options have been used up and I am now into the control phase, I do see where guys who are not suitable for surgery or RT, have HT on its own. 

Give the number at the top of the page a call tomorrow and have a chat with one of the brilliant nurses.

Thanks Chris 

User
Posted 24 Mar 2025 at 20:33

I am not in your position, having had treatment in 2018 which seems to have been successful.

As a general rule people who can not be cured are likely to end up on HT for life, and life averages at about 5 years, but can be as short as six months and can be eighteen plus years and counting. Most people have minor side effects from HT, but some people find it unbearable.

It seems for you they have not found cancer over many years, though with a PSA of 182 it is hard to believe you don't have cancer. 

I can well understand you not wanting to continue this never ending search to find your cancer, and I think a bury your head in the sand attitude is quite reasonable in your situation. I don't think there is much point in you going on HT until you have some proof you have prostate cancer, or some symptoms you can ascribe to prostate cancer. 

You know you are going to die of something at some time, but it could be heart disease, prostate cancer, getting run over by a bus. Obviously you need the oncologists advice, but maybe the best option is wait for some symptoms and start HT then. 

Dave

User
Posted 24 Mar 2025 at 20:49

Freddie's post at the bottom of this thread is interesting. If you don't have treatment and wait for a symptom to appear you will probably be in Freddie's position, where you will be incurable, but have the cancer controlled for an unknown number of years. At 63 it isn't a great position to be in, but at 78 it might not be too bad.

https://community.prostatecanceruk.org/posts/t31410-Treatment-no-longer-recommended#post305841

 

Dave

User
Posted 24 Mar 2025 at 23:32
I wonder how good the tests you have undergone, were because I am also surprised that with a PSA of 182 no PCa has been found. In your situation I would want high quality scans done elsewhere and biopsy of suspicious area(s), otherwise a cmprehensive template one. But there seems little point in doing this if regardless of any cancer being found you are settling on HT rather than any radical option that might be available. I had 8 months of HT (Zoladex) administered immediately prior to RT and concurant with it, I took the view that I would only have HT thereafter if there was no other option. This meant I had two lots of HIFU, the second in my eighties and am said to be "in remission". I will only have HT if a significant tumour is eventually found and as a last resort.
Barry
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User
Posted 24 Mar 2025 at 17:13

Grafton, I am not in the same situation as you. All my curable options have been used up and I am now into the control phase, I do see where guys who are not suitable for surgery or RT, have HT on its own. 

Give the number at the top of the page a call tomorrow and have a chat with one of the brilliant nurses.

Thanks Chris 

User
Posted 24 Mar 2025 at 20:33

I am not in your position, having had treatment in 2018 which seems to have been successful.

As a general rule people who can not be cured are likely to end up on HT for life, and life averages at about 5 years, but can be as short as six months and can be eighteen plus years and counting. Most people have minor side effects from HT, but some people find it unbearable.

It seems for you they have not found cancer over many years, though with a PSA of 182 it is hard to believe you don't have cancer. 

I can well understand you not wanting to continue this never ending search to find your cancer, and I think a bury your head in the sand attitude is quite reasonable in your situation. I don't think there is much point in you going on HT until you have some proof you have prostate cancer, or some symptoms you can ascribe to prostate cancer. 

You know you are going to die of something at some time, but it could be heart disease, prostate cancer, getting run over by a bus. Obviously you need the oncologists advice, but maybe the best option is wait for some symptoms and start HT then. 

Dave

User
Posted 24 Mar 2025 at 20:49

Freddie's post at the bottom of this thread is interesting. If you don't have treatment and wait for a symptom to appear you will probably be in Freddie's position, where you will be incurable, but have the cancer controlled for an unknown number of years. At 63 it isn't a great position to be in, but at 78 it might not be too bad.

https://community.prostatecanceruk.org/posts/t31410-Treatment-no-longer-recommended#post305841

 

Dave

User
Posted 24 Mar 2025 at 23:32
I wonder how good the tests you have undergone, were because I am also surprised that with a PSA of 182 no PCa has been found. In your situation I would want high quality scans done elsewhere and biopsy of suspicious area(s), otherwise a cmprehensive template one. But there seems little point in doing this if regardless of any cancer being found you are settling on HT rather than any radical option that might be available. I had 8 months of HT (Zoladex) administered immediately prior to RT and concurant with it, I took the view that I would only have HT thereafter if there was no other option. This meant I had two lots of HIFU, the second in my eighties and am said to be "in remission". I will only have HT if a significant tumour is eventually found and as a last resort.
Barry
User
Posted 25 Mar 2025 at 10:01

Dave

Thanks for your reply. I was prescribed HRT in January - I needed to show that I had a 'management plan' for my probable prostate cancer in place to facilitate the decision to offer me heart surgery. I am experiencing a seemingly increasing number of 'hot flushes' but I can live with that.

 
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