Locally advanced prostate cancer with proximity to urethra

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User

Posted 14 Jul 2025 at 10:55

I was diagnosed at the end of May 2025 with prostate cancer which has also spread to the tissues around the urethra. Gleeson 8 (4+4). Does anyone have this unusual spread of cancer? I have been asked to consider HDR brachytherapy in addition to the external beam radiotherapy, but the doctor I saw yesterday is unsure whether to go ahead with the HDR brachytherapy due to the proximity to the urethra and bladder. He has left the decision to me! Does anyone have any experience of this?

User

Posted 14 Jul 2025 at 13:29

Welcome to the club that nobody wishes to join! I can't recall anybody having the same diagnosis as you but there are so many variations with this Disease. The way forward is not always clear and there can be trade offs for more aggressive treatment giving better results in terms of cancer control/obliteration but the possibility of more severe side effects. In view of the doubt expressed by your doctor I would seek a second opinion if it was me. It does look like radiation which can go beyond where surgery can is more appropriate in your case. I don't know where you expect to be treated but in your shoes I would want to be treated in a major hospital where they dispense all types of radiation so you get the best available.

Barry

User

Posted 14 Jul 2025 at 16:29

Sorry to hear about your diagnosis. If you have private would definitely recommend a second opinion via say some of the leading profs at UCLH or Guys London Bridge if not too much of a trek. Worth a few hundred quid if you don’t have private just to open up choices without too much delay.

User

Posted 14 Jul 2025 at 17:00

Hello Alan,

Sorry for your diagnosis news, and that you find yourself here. However lots of very helpful guys with past experiences to call on.

I had 3 weeks of EBRT followed by HDR Brachytherapy. My cancer wasn't located where yours is. However, the consent form I signed listed (among other things) the increase in chances of ED from 10%-50% to 50%-100% and of Urethral stricture 1 in 100 to 1 in 10 (or around that).

I guess its the strictures that could be more of an issue for you being where your cancer has been located. I was given the sign off sheet to take home so I could fully read and digest the implications so that might be worth an ask along with asking for a second opinion which would be a wise plan.

These are issues that can affect you months or years down the line, I'm only 7 month on, but so far so good. Not sure if being older or younger is a good thing here. I'm 49 maybe more time for issues to develop?

All the best John

User

Posted 15 Jul 2025 at 21:26

Thanks Barry, TechGuy and John. Good to hear your views and experiences. I will continue to investigate!

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