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Re-graded (up) in MDT. Cancer on the Surface

User
Posted 15 Sep 2025 at 13:23

Hi,


I was recently diagnosed (August 2025) with stage 2 Prostate Cancer, at 49 years old. It was initially reported to be a small affected area and localised. After researching, I was considering HIFU treatment. However, today the Consultant has said that my Cancer has been re-graded to state 3a. Apparrently, there was disagreement in the MDT meeting between Radiologists - with one saying that the Cancer is on the surface of the prostate, and not fully contained. 


I have two concerns regarding treatment options:


1. My local Trust only offer Radical Prostatectomy or long term Radiotherapy. I have asked for a referral to UCLH for HIFU. However, the Consultant thinks that the referral won't be accepted with the Cancer potentially on the surface of the Prostate. 


2. I've been treated (by Endocrinology) for several years for secondary hypogonadism, with Testosterone Replacement Therapy. My levels have been consistently mid normal range since (18nmol/l). The Urology Consultant says that I should come off TRT. However, the previous impact of low testosterone on my cognitive function was dramatic. I would struggle to work and make a living. Not to mention all of the other QoL symptoms. I've understand that although Prostate cancer is all sensitive to Testosterone. However, the Androgen suppression support is considered outdated - based on studies from the 1940's. Newer studies seem to prove that increased testosterone does not impact the Cancer growth. Basically, I want to avoid Androgen suppression and retain TRT treatment.


Appreciate any opinions and advice...

User
Posted 15 Sep 2025 at 17:58
Go for the surgery option, it will potentially cure you and won't need hormones to do it and won't leave any prostate tissue to be susceptible to testosterone.
HIFU is not a cure for a T3 tumour.

 
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