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

Notification

Error


Should I consider surgery at 43

Email this conversation Print this conversation
User
Posted 15 May 2025 at 20:59

Hi all, 

1st post and not something that I was expecting to have to research anytime soon but here we are. 

After a voluntary PSA which had result of 6.59. Followed up 8 weeks later at 5.9. I was sent for an MRI which prompted a biopsy. 

Result = 5 of 20 cores positive Gleason 

3+3=6 up to 5mm core length from left anterior and left posterior. 

I am 43, in good health, not over weight etc. I have zero symptoms other than maybe urinating slightly more than a normal person (been the case for 10-15 years and not excessive). 

I am married with 2 very young children. 

As you can imagine my head is spinning at the moment but trying to focus on the positives of this being discovered very early, contained and i have options on actions. 

I have private healthcare and my urologist who is, i am told is 1 of the UK leaders in RALP surgery has initially suggested active surveillance for now and surgery likely further down the line. 

I have a follow up meeting with him along wit my wife next week. 

After discussing this at length with my wife and reading as much material as I can. 

My current thinking is at 43, do I really want 10-15-20 at best years of surveillance before taking action. 

 The anxiety of knowing that the cancer will grow at some point (probably before im 60) and by that point I may respond to surgery a lot more negatively. Is it best to tackle surgery now, while the cancer is very small/contained and whilst I'm young(ish) fit and healthy. 

Obviously I have read the possible side effects and this is why my head is spinning. 

I have read that a younger patient with a low gleason score should have a better chance of avoiding long term side effects but obviously I'm aware the risk will still be there. 

In my mind I would rather take the surgery now and be cancer free (hopefully) in the next 6-12 months and pray that I do not have any long term side effects. 

But maybe I have my head in the clouds and I am naive to be taking on a high risk of life changing side effects when maybe I do not need to. Just feels like I'm going to need to take this risk at some point maybe now whilst I'm young is lessening the long term risks. 

Im aware that there are no perfect answers here and I am not looking for anyone to tell me what I should do. 

But if anyone has any helpful information based on their own experiences worth sharing or point me in the direction of any reading material which will assist me in making an informed decision I would be very grateful.

Thank you in advance,  

Neil

Edited by member 15 May 2025 at 21:59  | Reason: Not specified

User
Posted 15 May 2025 at 22:23

Hello Neil

I'm sorry that you've had to find us but welcome to the forum.

On the limited information you've given,  I would go on active surveillance. There is no rush to make a decision, and your PSA has actually decreased in two months.

Gleason 6 (3+3) is the lowest it gets, in fact there are some experts who say that it shouldn't be classed as cancer.

I'm not sure why you've been told that that the 'cancer' will grow, that's not always the case.

Good luck, mate and please keep us updated.

 

User
Posted 15 May 2025 at 23:03

There's no hurry to make a decision. Even if you think you do want a prostatectomy sooner rather than later, you could sit on Active Surveillance for a few months to give you more time to think it through, talk with people, etc.

When you speak to the surgeon, you can ask what they think the chances are of reasonable erectile function and good continence. They can't make any guarantees, but they can look where the cancer is and how far it is away from structures which might impact those.

User
Posted 16 May 2025 at 11:34

Sorry to hear you’ve embarked on the journey many of us have been through. The good news is once the head stops spinning and you have an action plan. It’s not too bad.

Sorry to hear you’ve embarked on the journey many of us have been through. The good news is once the head stops spinning and you have an action plan. It’s not too bad.

 

I’m about 5 1/2 years post surgery and acted quickly with Gleason 6. which was just as well because like many on here with Gleason six is was actually more advanced then the scans had shown.

fundamentally it’s cancer and even low grade has been shown to exhibit all the usual traits of a cancer cell and able to grow/migrate to other areas although less likely at this level. I went through quite a few leading pathology research papers when I got my diagnosis and they were critical about the views that Gleason 6 should not be classed as cancer.

Also be mindful that in about 44% of cases post surgery the cancers are upgraded. 

Unfortunately it tends to be a multifocal disease and gland cells on the anterior (around edge) of the prostate tend to be more prone to mutation…hence I guess why it can break from through capsule suddenly. 

the side effects can be pretty much mitigated if you find a highly experienced high volume surgeon. Having private insurance gives you access to these individuals and it really does make a difference outcomes in terms of  continent. Erectile function is still a bit hit and miss but if you have nerve sparing combined with Nero safe to give you optimum cancer control then you’re giving yourself the best chance there too. Check out single port robotic surgery using retzius sparing technique with NeuroSAFE.

I was offered active surveillance and so pleased I didn’t take it because I would’ve gone T3. My view was it’s cancer so action is prudent. And the only good cancer is when it’s in the surgeon’s tray.

Also be mindful of the psychological impact of having ongoing surveillance which would incorporate MRIs and biopsies. Biopsies ongoing would concern me because they can potentially set up an environment for cancer sales to spread migrate (as stated by a leading Prof @ UCLH).

if I had to do it again, I would take exactly the same route. I concur with your thinking of getting out as soon as possible because at some point which we can’t determine the cells do migrate and spread through the bloodstream or lymphatic system.  it comes down to the basics with cancer if it’s localised the sooner it’s out the less chance it has to spread. Unfortunately, it really is as simple as that.

Although leading up to surgery, I was so scared I have randomly had tears running down my eyes for no reason and Friends said my voice picture changed. So the stress was evidently enormous. I shouldn’t have worried at all cause surgery for me was like a breeze less trauma when I have my tonsils  Absolutely  no pain. A bit of discomfort for two weeks with a catheter and then a few weeks after that coping with leaks and drips until things stabilised. I’ve been in the gym since about six months after surgery and now I’m doing three hours in a session of calisthenics and never have to think about it. What I do  is ensure  my bladder isn’t full when I’m doing intense exercises. No issues at all

 

Please shout any of us if you need a sounding board as this forum is a fantastic community.

Try not panic try and get your head together and form an action plan which fits how you want to tackle it.

Simon 

 

 

Edited by member 16 May 2025 at 12:06  | Reason: Not specified

User
Posted 16 May 2025 at 11:51

 

@techguy Thank you very much for the advice, I really appreciate it. 

Reading your profile it appears that you were in a similar position based on diagnosis. 

I see you were treated in London Bridge (same as me) would mind private messaging your surgeons details so that I can research? 

Being a new member I am unable to send private messages. 

Edited by member 16 May 2025 at 11:59  | Reason: Not specified

User
Posted 16 May 2025 at 13:14

Hi again.

Your question is about grade 6 (3+3) prostate cancer. Please think carefully about possible ways of dealing with it. On this site you will get individual horror stories of how Gleason 6 cancer has spread and how dangerous Active surveillance is. 

If you read my bio you'll see my initial Gleason 6 (3+3) and active surveillance is a bit of a horror story but I know that the initial biopsy, probably like Tech Guy's missed the more aggressive cells. So in fact, we were never Gleason 6.

View this link which will explain things clearly to you and give you a far more balanced and professional view.

https://youtu.be/a0sjUallZQU?si=lMLdMJ3PxV5GA_uX

Dr Schotz's stresses that true Gleason 6 does not metastasize  We can spend all day arguing about the possible inaccuracies of biopsies but if you are a true Gleason 6, Dr Scholz is worth listening to.

Edited by member 16 May 2025 at 13:44  | Reason: To add link

User
Posted 16 May 2025 at 17:15

Thank you for the post Rob and for the private message, I really appreciate it. 

I'm sure I will probably reach our for further advice along the way. 

 

 

User
Posted 21 May 2025 at 18:14

Hi Neil

You've been unlucky to have been diagnosed with PCa at just 43 but as other have said, your Gleason score is the best news you could have received and others would swap with you in an instant. What to do next is a path we've all been on and its so very personal to you, your age, your outlook on life and you physical condition. Take your time is great advice particularly with a 3+3 score; making your mind up in 6 months would be fine. I'm 65 fit and had a 3+4 score and was offered AS, RARP and Brachytherapy. I've a friend who's AS catastrophically failed and he's near my age and diagnosis - I should say that its rare and others on here have had many years treatment free with AS but given what he's going through my confidence was shaken and I decided I couldn't deal with the perpetual testing and waiting. I saw an oncologist at the Marsden who confidently talked 'cure' to me but ultimately I decided I just didn't fancy the process. So surgery it was and as techguy has said check out single port robotic surgery using retzius sparing technique with NeuroSAFE which is exactly what I had on 8th April at London Bridge. I had to have my catheter in for 2 weeks not 1 which was less of a pain than I thought it would be and after removal I was fully continent within 3 hours (I'm a very very lucky bloke). Six weeks on I'm getting back to exercise and there's even life in the old dog if you get my drift. I researched the f+++ out of RARP (by the way ChatGPT has been an absolutely invaluable resource) and single port using retzius plus NeuroSAFE was for me the gold standard. In terms of surgeons one stood out although it's a close call with the next guy. My post-op histology confirmed 3+4 & negative margins and I'm pretty confident my first PSA in 2 weeks will be non-existent. Just a word on continence which is such a big issue, it seems to me its a combination of your age, anatomy, physical condition, pelvic floor strength, skill of the surgeon and a bit of luck that nothing is discovered when he's operating. In that respect you've a head start in age & physical condition so try not to worry about it too much as although it is a big topic on the forum it's not all bad news. Feel free to message me if you want more information about the surgery if you decide to go down that route. Good luck on your journey Neil

Cheers, Adam

Show Most Thanked Posts
User
Posted 15 May 2025 at 22:23

Hello Neil

I'm sorry that you've had to find us but welcome to the forum.

On the limited information you've given,  I would go on active surveillance. There is no rush to make a decision, and your PSA has actually decreased in two months.

Gleason 6 (3+3) is the lowest it gets, in fact there are some experts who say that it shouldn't be classed as cancer.

I'm not sure why you've been told that that the 'cancer' will grow, that's not always the case.

Good luck, mate and please keep us updated.

 

User
Posted 15 May 2025 at 23:03

There's no hurry to make a decision. Even if you think you do want a prostatectomy sooner rather than later, you could sit on Active Surveillance for a few months to give you more time to think it through, talk with people, etc.

When you speak to the surgeon, you can ask what they think the chances are of reasonable erectile function and good continence. They can't make any guarantees, but they can look where the cancer is and how far it is away from structures which might impact those.

User
Posted 16 May 2025 at 11:34

Sorry to hear you’ve embarked on the journey many of us have been through. The good news is once the head stops spinning and you have an action plan. It’s not too bad.

Sorry to hear you’ve embarked on the journey many of us have been through. The good news is once the head stops spinning and you have an action plan. It’s not too bad.

 

I’m about 5 1/2 years post surgery and acted quickly with Gleason 6. which was just as well because like many on here with Gleason six is was actually more advanced then the scans had shown.

fundamentally it’s cancer and even low grade has been shown to exhibit all the usual traits of a cancer cell and able to grow/migrate to other areas although less likely at this level. I went through quite a few leading pathology research papers when I got my diagnosis and they were critical about the views that Gleason 6 should not be classed as cancer.

Also be mindful that in about 44% of cases post surgery the cancers are upgraded. 

Unfortunately it tends to be a multifocal disease and gland cells on the anterior (around edge) of the prostate tend to be more prone to mutation…hence I guess why it can break from through capsule suddenly. 

the side effects can be pretty much mitigated if you find a highly experienced high volume surgeon. Having private insurance gives you access to these individuals and it really does make a difference outcomes in terms of  continent. Erectile function is still a bit hit and miss but if you have nerve sparing combined with Nero safe to give you optimum cancer control then you’re giving yourself the best chance there too. Check out single port robotic surgery using retzius sparing technique with NeuroSAFE.

I was offered active surveillance and so pleased I didn’t take it because I would’ve gone T3. My view was it’s cancer so action is prudent. And the only good cancer is when it’s in the surgeon’s tray.

Also be mindful of the psychological impact of having ongoing surveillance which would incorporate MRIs and biopsies. Biopsies ongoing would concern me because they can potentially set up an environment for cancer sales to spread migrate (as stated by a leading Prof @ UCLH).

if I had to do it again, I would take exactly the same route. I concur with your thinking of getting out as soon as possible because at some point which we can’t determine the cells do migrate and spread through the bloodstream or lymphatic system.  it comes down to the basics with cancer if it’s localised the sooner it’s out the less chance it has to spread. Unfortunately, it really is as simple as that.

Although leading up to surgery, I was so scared I have randomly had tears running down my eyes for no reason and Friends said my voice picture changed. So the stress was evidently enormous. I shouldn’t have worried at all cause surgery for me was like a breeze less trauma when I have my tonsils  Absolutely  no pain. A bit of discomfort for two weeks with a catheter and then a few weeks after that coping with leaks and drips until things stabilised. I’ve been in the gym since about six months after surgery and now I’m doing three hours in a session of calisthenics and never have to think about it. What I do  is ensure  my bladder isn’t full when I’m doing intense exercises. No issues at all

 

Please shout any of us if you need a sounding board as this forum is a fantastic community.

Try not panic try and get your head together and form an action plan which fits how you want to tackle it.

Simon 

 

 

Edited by member 16 May 2025 at 12:06  | Reason: Not specified

User
Posted 16 May 2025 at 11:51

 

@techguy Thank you very much for the advice, I really appreciate it. 

Reading your profile it appears that you were in a similar position based on diagnosis. 

I see you were treated in London Bridge (same as me) would mind private messaging your surgeons details so that I can research? 

Being a new member I am unable to send private messages. 

Edited by member 16 May 2025 at 11:59  | Reason: Not specified

User
Posted 16 May 2025 at 12:19

Hello Put

Since you have private health insurance, as I did 14 years ago (surgery at a private hospital in London) you probably have picked one of the most experienced urologist in the country. Given the difficulty of predicting progress of prostate cancers, I would be inclined to listen to the consultant urologist but do take other advice. Watchful waiting, at your age, is not a bad idea but I would have a couple of questions? How much negative margin is there and what is the rate of rise of your PSA which can be a significant factor rather than the its absolute value - my decision to have immediate surgery was mostly based on these two factors.

I was 71 when I had RARP, inspite of side effects I suffer, I have no regrets.

Good luck.

 '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

 

 

User
Posted 16 May 2025 at 13:14

Hi again.

Your question is about grade 6 (3+3) prostate cancer. Please think carefully about possible ways of dealing with it. On this site you will get individual horror stories of how Gleason 6 cancer has spread and how dangerous Active surveillance is. 

If you read my bio you'll see my initial Gleason 6 (3+3) and active surveillance is a bit of a horror story but I know that the initial biopsy, probably like Tech Guy's missed the more aggressive cells. So in fact, we were never Gleason 6.

View this link which will explain things clearly to you and give you a far more balanced and professional view.

https://youtu.be/a0sjUallZQU?si=lMLdMJ3PxV5GA_uX

Dr Schotz's stresses that true Gleason 6 does not metastasize  We can spend all day arguing about the possible inaccuracies of biopsies but if you are a true Gleason 6, Dr Scholz is worth listening to.

Edited by member 16 May 2025 at 13:44  | Reason: To add link

User
Posted 16 May 2025 at 15:07

Here is a link to the paper I mentioned ref post surgery histology upgrades:

https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0526-9

Here is another that contributed to my decision making back in Q3/2019:

https://blogs.scientificamerican.com/guest-blog/the-hallmarks-of-cancer-6-tissue-invasion-and-metastasis/

 

User
Posted 16 May 2025 at 16:30

Hi Neil,

Firstly just wanted to say sorry you find yourself here and I hope you and family are doing ok.

I was diagnosed last summer at 46, two young kids same as yourself so I understand a bit of what you are going through. 

My Gleason post biopsy was also 3+3=6, my cancer was multifocal and staged as 2Tc meaning it was on both sides of the prostate. There is debate around it but that raised the risk for me and I was recommended surgery by two urologists and an oncologist. I had my RARP in late September and don’t regret the decision.

Whilst my cancer was upgraded to 3+4=7 post op that isn’t going to be the case for everyone and as long as AS is well managed it should mitigate that risk so I think both would be good options for you.

Side effects from RARP are a consideration, I’m fully continent now so one of the lucky ones but ED whilst some improvement is still an issue. Everyone is different obviously but I think being young and fit likely improves your chances of a good outcome as does the skill of your surgeon but it is a long road to recovery.

I also have private healthcare and one thing I think really benefitted me was getting a second opinion. Hearing more than one specialist recommend surgery really helped me make a decision.

All the best mate

Rob

User
Posted 16 May 2025 at 17:15

Thank you for the post Rob and for the private message, I really appreciate it. 

I'm sure I will probably reach our for further advice along the way. 

 

 

User
Posted 18 May 2025 at 20:37
Hey Neil,

Not what you want at all - I feel for you! I had my first biopsy at 41 and although it came back clear, I was given a pretty clear indication it was probably a temporary reprieve. It did take until I was 48 until they eventually found it lurking and at that stage it was 3+4 and only 2 of 24 positive cores with fairly minimal (10%) pattern 4.

At diagnosis however, my consultant was very much of the opinion that as a 'young' man, treatment was absolutely the right choice. Surveillance would be just kicking the can further down the line until it would inevitably and ultimately be more advanced and more difficult to treat. Delaying may also take treatment options off the table that currently exist.

I ended up speaking to a couple of urological surgeons about RARP and a couple of oncologists about Brachytherapy (mainly) and Radiotherapy (less so) as treatment options. I would fully explore all options as the treatments are vastly different yet have very similar long term (curative) outcomes.

Don't be afraid to get second opinions/referrals, I'm 1000% of the opinion that the more people you can talk to and learn from, the more confident and at peace you will be with you ultimate decision.

You've done all the diagnostics and know exactly what you're dealing with and it's amazing what you'll learn from having more conversations with the professionals. Even if you went privately, consultations at this stage (armed with all your diagnostics) might set you back a couple of hundred quid but IMHO, give you much more back.

Best of luck.

Paul

User
Posted 21 May 2025 at 18:14

Hi Neil

You've been unlucky to have been diagnosed with PCa at just 43 but as other have said, your Gleason score is the best news you could have received and others would swap with you in an instant. What to do next is a path we've all been on and its so very personal to you, your age, your outlook on life and you physical condition. Take your time is great advice particularly with a 3+3 score; making your mind up in 6 months would be fine. I'm 65 fit and had a 3+4 score and was offered AS, RARP and Brachytherapy. I've a friend who's AS catastrophically failed and he's near my age and diagnosis - I should say that its rare and others on here have had many years treatment free with AS but given what he's going through my confidence was shaken and I decided I couldn't deal with the perpetual testing and waiting. I saw an oncologist at the Marsden who confidently talked 'cure' to me but ultimately I decided I just didn't fancy the process. So surgery it was and as techguy has said check out single port robotic surgery using retzius sparing technique with NeuroSAFE which is exactly what I had on 8th April at London Bridge. I had to have my catheter in for 2 weeks not 1 which was less of a pain than I thought it would be and after removal I was fully continent within 3 hours (I'm a very very lucky bloke). Six weeks on I'm getting back to exercise and there's even life in the old dog if you get my drift. I researched the f+++ out of RARP (by the way ChatGPT has been an absolutely invaluable resource) and single port using retzius plus NeuroSAFE was for me the gold standard. In terms of surgeons one stood out although it's a close call with the next guy. My post-op histology confirmed 3+4 & negative margins and I'm pretty confident my first PSA in 2 weeks will be non-existent. Just a word on continence which is such a big issue, it seems to me its a combination of your age, anatomy, physical condition, pelvic floor strength, skill of the surgeon and a bit of luck that nothing is discovered when he's operating. In that respect you've a head start in age & physical condition so try not to worry about it too much as although it is a big topic on the forum it's not all bad news. Feel free to message me if you want more information about the surgery if you decide to go down that route. Good luck on your journey Neil

Cheers, Adam

User
Posted 21 May 2025 at 18:59

Thank you so much for your really helpful post Adam. All of the messages on this site have been unbelievably helpful and supportive. I really appreciate them all. 

Being a new member I am unable to private message you. It would be great if you could message me the details of the surgeons you mention as would like to do some research on them. 

 

Thanks again 

 

 

User
Posted 13 Jun 2025 at 02:35

A prostate cancer diagnosis at a young age can be very distressing. Based on the information you have provided, your Prostate Cancer is considered no more than “low risk” according to the Prostate Cancer Guidelines of the National Comprehensive Cancer Network of the United States of America. According to their guidelines you have the choice of Active Surveillance, Radical Prostatectomy or Radiation Therapy.

Active Surveillance has the advantage that it does not interfere with your quality of life, especially sexual functions, which are important for a young man like you and your wife.. You will have additional years free of sexual dysfunctions.

You are concerned that you would not be able to tolerate an operation for the removal of the prostate when you are 60. I think you will. Many men on these types of forums in the 70’s have had the surgery. I had an operation at 55 for the removal of a third lung lobe, a birth defect, and survived that, which I consider a much more invasive operation. Also, there is radiation therapy, which is just as effective in treating prostate cancer as surgery.

In my reading of the literature, I found that Radiation therapy and radical Prostatectomy have about equal cure rates, or multi-year remission rates. Radiation Therapy has improved in recent years, and the old literature will not give you the latest information on cure rates or side effects. One source cited data that showed that External Beam Radiation combined with Brachytherapy was more effective than surgery, with longer remission periods for more men.

My cancer is more aggressive than yours and after 16 of 28 scheduled radiation sessions, a PSA test had a value of 0.505 ng/mL, down from 0.944 before the radiation. I am tolerating the radiation very well, with no major problems. At age 91, I did not have the option of surgery because of the possible complications, and I doubt that I would have chosen surgery at a younger age..

 

I would suggest that you consult with an oncologist for a second opinion on the treatment. Urologists are trained as surgeons, and since that is what they know, most will recommend surgery. Your urologist appears to be an exception to that, and I think he is giving you good advice. Suppress the anxiety and just look ahead, and when the time comes for action, give radiation therapy a good look.

User
Posted 18 Jun 2025 at 12:01

HIFU!!! HIFU!! HIFU!!!

Ask about it, I wish I was in your position when diagnosed because I would have run at this treatment.

Edited by member 18 Jun 2025 at 12:02  | Reason: Not specified

User
Posted 23 Jun 2025 at 13:53

Hi all,

 

I bit in the way of an update on my situation.

It’s been 6 weeks since being diagnosed and after the initial shock and panic I feel a little more at ease now.

Infact, I’m now feeling positive about having caught this so early and having options on what to do (or not do) next.

 

My urologist, has recommended active surveillance and has suggested that surgery currently would be a little overkill.

 

However, I have been doing as much research as I can and I have spoken to several other urologists (some of those suggested by the very helpful people in this forum) to gain different opinions to help me and my wife make the best informed decision.

I am fortunate that I have private medical insurance which has allowed me to speak to some of the leading urologists in London. This has helped me decide that I would like to have surgery, which will be single port/retzius sparing with neurosafe. I am aware of the risks of side effects, the surgeon has approximated that I am at 1% risk of continence issues and I have around 80% chance of back to regular potency within 12 months. The surgeon has performed over 4000 surgeries which gives me confidence there isn't  anyone more suitable. 

The main reasons that I am not keen on AS is the fact that at 43, chances are at some stage in my life I am likely going to need some form of treatment for this. I figure its best to act now, which gives me the best possible chances of good outcomes both on cancer and side effects.  

It also removes the risk of being under diagnosed and the potential for any spread. Plus removes the hassle/stress of being monitored for the next 30-40 years.

The whole point of me going for PSA screening was in the off chance that I had cancer, that I would be catching it very early. That turned out to be the case, to then decide to not do anything about it (other than further regular PSA tests) just doesn’t seem logical to me.

I am still conducting further research, I want to speak to a HIFU specialist so see if this should be a consideration also.

Please feel free to give you opinion on the above – good or bad.

If there is anything else I should be thinking about or looking into please let me know also.

Thanks again for all the helpful advice in this post and in private DMs – it has been really helpful and reassuring.

Edited by member 23 Jun 2025 at 15:21  | Reason: Not specified

User
Posted 23 Jun 2025 at 14:46

Originally Posted by: Online Community Member
My current thinking is at 43, do I really want 10-15-20 at best years of surveillance before taking action. 

 The anxiety of knowing that the cancer will grow at some point (probably before im 60) and by that point I may respond to surgery a lot more negatively. Is it best to tackle surgery now, while the cancer is very small/contained and whilst I'm young(ish) fit and healthy. 

Obviously I have read the possible side effects and this is why my head is spinning. 

I have read that a younger patient with a low gleason score should have a better chance of avoiding long term side effects but obviously I'm aware the risk will still be there. 

In my mind I would rather take the surgery now and be cancer free (hopefully) in the next 6-12 months and pray that I do not have any long term side effects. 

Hi Neil.

It is quite evident that you did not want to go on AS. That's fair enough, you have to have faith in that option, and you clearly haven't. Your urologist recommended AS, but you've been right to get medical second opinions. You've decided to opt for surgery, also fair enough. Ultimately the decision is your and yours alone.

I don't think anyone when dealing with this disease, can be sure of outcomes. You can only make a decision, stick with it and hope for the best.

I remember being told by my surgeon, when  I was Gleason 8, with capsular breach, and having an unfavorable heart condition, "If you were my dad. I'd did be telling you to opt for radiotherpy and hormone treatment." I can remember replying, "If you were my son, you'd know how pig headed I was. I want surgery, and if possible surgery is what I'll get." Up to now I was right. But who knows what tomorrow brings.

I wish you and your family all the best and hope that you have a speedy recovery

Good luck mate.👍

Edited by member 24 Jun 2025 at 08:07  | Reason: Additional text

User
Posted 23 Jun 2025 at 15:51

Hi Neil,

Thanks for the update and pleased to hear you are feeling more positive.

Deciding on treatment options is not easy and everybody will have their own reasons for picking a particular path. You’ve done the right thing getting second opinions and you are making the decision knowing the various risks for each option. Ultimately none of the options are risk free but you are going into it with your eyes open.

For what it’s worth I can understand your reasoning to opt for surgery. I felt the same way that it would only be a matter of time before radical treatment was needed (my prostate was described as biologically unstable!) and I haven’t regretted my decision. An experienced surgeon and your age gives you a really good chance of a full recovery. 

I had the five port RARP surgery with nerve sparring so slightly different but any questions please ask.

All the best mate

Rob

 

 

 

User
Posted 24 Jun 2025 at 10:05

Hi Pnut

It’s a rough journey, but good to hear you closing in on the decision.

I looked at hifu and a few other focal treatments. UCLH seem to be the pioneers with this in the region. The thing that put me off was the fact that prostate cancer tests to me multifocal disease and also tends to appear in the anterior regions first. Both made my eyebrows raise when I learnt this…. Focal treatments like active surveillance effectively kick the can down the road but have their benefits balanced against risk.

The prof and his team at London Bridge are at the top of their game and are using the latest kit. If you choose this route you would be in very good hands as they are a lovely.

Please keep us posted and shout if you need a sounding board.

Simon

 

 

Edited by member 24 Jun 2025 at 10:07  | Reason: Not specified

 
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