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User
Posted 06 Oct 2025 at 16:27

Hi there


We are a bit confused! My husband has been diagnosed with Prostate Cancer GG9 PSA 23.1 T3b N0,


The MDT recommendations were to see Medical and Clinical Oncologist with a view to treating systemically and hormone and radiotherapy. He has had his first hormone injection,.


However today we saw the Medical Oncologist who has left the decision to have chemotherapy entirely up to my husband. The rationale being that it might not make any difference if there is no spread, but they can't say if there is or will be any cellular spread. However if there are cancer cells it will kill them.


He has decided not to have chemotherapy.


Has anyone had this decision to make?


Thanks V


 

User
Posted 07 Oct 2025 at 01:39

Your husband's diagnosis is almost identical to mine, but mine was T3 (I presume T3a) not T3b. I was not offered chemo, and at time (7 years ago) chemo would not be offered to anyone less than T4, however HT was prolonged over two to three years. So maybe chemo is being offered so they can reduce HT time.


The side effects of chemo for prostate cancer usually docataxol are usually well tolerated, but many would consider it an aggressive treatment if it is not really required.


The following figures I am quoting are the approximate cure rates. If you take 100 men with your husbands diagnosis and treat them with RT (and HT) 69 will be cured and 31 won't be cured. If you give all 100 men chemo as well, then 71 will be cured and 29 won't be. That means by giving chemo to everyone 98 will have had chemo for no benefit, it didn't change the outcome, however 2 out of 100 switched from not cured to cured. It is impossible to know in advance (or in hindsight) whether you are one of the 2 people it will help or the 98 it won't help. Your husband needs to decide if chemo is worth a 2% chance of improving his outcome. (All these figures above are approximate values, your oncologist may be able to give you more accurate values).


A female friend of mine had breast cancer, it was treated early and she was offered chemo as well, 'just in case'. She declined, ten years later she is perfectly fine.

Dave

User
Posted 06 Oct 2025 at 17:35

Hi Viv, Yes, my husband was diagnosed 10 yrs ago, this G9 Tb3. He had HDR radiotherapy followed by 26 greys of radiotherapy and 3 years of hormone treatment. He refused chemotherapy and apalutamide, after some research and consideration. 


Four  ago he had spread to his lymph nodes, and Had to go back on the hormone treatment. He is now on lifelong HT and he has also decided to follow an alternative route and takes ivermectin, menbezadole and metformin, along with a number of other supplements. 
His PSA has been <0.1 since he’s been on the alternative programme. 
What ever he chooses to do I hope it goes well for you.


Leila 

User
Posted 07 Oct 2025 at 18:19
I was diagnosed in 2015 as T3b (slight spread to seminal vesicles) gleason 8 psa 21. Gleason upped to 9 after TURP (section of prostate cut away to aid urine flow).
I wasn't offered any choice of treatment, it was HT (Zoladex)for 3 yrs plus 32 sessions of RT. At that time I think chemo was used much later if needed rather than some consultants suggesting chemo early with HT/RT.
If I was diagnosed now chemo may be offered earky I guess, I reckon I'd go along with consultants opinion if there was a choice. My treatment has done what it was supposed to do although I did have 2yrs of abiraterone and enzalutimide included as part of trial. I think that giving chemo early is a recent thing, there must be some merit to it obviously but at same time HT/RT likely to work otherwise consultant wouldnt suggest it without chemo?
Peter
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User
Posted 06 Oct 2025 at 17:35

Hi Viv, Yes, my husband was diagnosed 10 yrs ago, this G9 Tb3. He had HDR radiotherapy followed by 26 greys of radiotherapy and 3 years of hormone treatment. He refused chemotherapy and apalutamide, after some research and consideration. 


Four  ago he had spread to his lymph nodes, and Had to go back on the hormone treatment. He is now on lifelong HT and he has also decided to follow an alternative route and takes ivermectin, menbezadole and metformin, along with a number of other supplements. 
His PSA has been <0.1 since he’s been on the alternative programme. 
What ever he chooses to do I hope it goes well for you.


Leila 

User
Posted 07 Oct 2025 at 01:39

Your husband's diagnosis is almost identical to mine, but mine was T3 (I presume T3a) not T3b. I was not offered chemo, and at time (7 years ago) chemo would not be offered to anyone less than T4, however HT was prolonged over two to three years. So maybe chemo is being offered so they can reduce HT time.


The side effects of chemo for prostate cancer usually docataxol are usually well tolerated, but many would consider it an aggressive treatment if it is not really required.


The following figures I am quoting are the approximate cure rates. If you take 100 men with your husbands diagnosis and treat them with RT (and HT) 69 will be cured and 31 won't be cured. If you give all 100 men chemo as well, then 71 will be cured and 29 won't be. That means by giving chemo to everyone 98 will have had chemo for no benefit, it didn't change the outcome, however 2 out of 100 switched from not cured to cured. It is impossible to know in advance (or in hindsight) whether you are one of the 2 people it will help or the 98 it won't help. Your husband needs to decide if chemo is worth a 2% chance of improving his outcome. (All these figures above are approximate values, your oncologist may be able to give you more accurate values).


A female friend of mine had breast cancer, it was treated early and she was offered chemo as well, 'just in case'. She declined, ten years later she is perfectly fine.

Dave

User
Posted 07 Oct 2025 at 08:15

Hi V,


I'm sorry that your husband has been diagnosed with prostate cancer. It's great, that in order to support him, you've joined the forum. You'll get alot of help and advice here. Welcome.


I don't know if you've already found and read our site's information on chemotherapy. If not it may be useful to have a look.


https://prostatecanceruk.org/prostate-information-and-support/treatments/chemotherapy


Good luck to you both. 👍

User
Posted 07 Oct 2025 at 18:19
I was diagnosed in 2015 as T3b (slight spread to seminal vesicles) gleason 8 psa 21. Gleason upped to 9 after TURP (section of prostate cut away to aid urine flow).
I wasn't offered any choice of treatment, it was HT (Zoladex)for 3 yrs plus 32 sessions of RT. At that time I think chemo was used much later if needed rather than some consultants suggesting chemo early with HT/RT.
If I was diagnosed now chemo may be offered earky I guess, I reckon I'd go along with consultants opinion if there was a choice. My treatment has done what it was supposed to do although I did have 2yrs of abiraterone and enzalutimide included as part of trial. I think that giving chemo early is a recent thing, there must be some merit to it obviously but at same time HT/RT likely to work otherwise consultant wouldnt suggest it without chemo?
Peter
User
Posted 08 Oct 2025 at 06:24

I was in a similar position 5 years ago, locally advanced G9, spread to seminal vesicles and 3 lymph nodes. I did not have chemo but my lymph nodes were specifically targeted with RT.  Lymph nodes are the next most likely place for prostate cancer to spread to, outside the prostate itself. There are ways to detect such spread, a PSMA PET scan being the obvious one. If located this way, a small number of lymph nodes can be treated with radiotherapy at the same time as the prostate is targeted. 


A question for your oncologist could be, "would chemo treat/kill cancer cells in lymph nodes?" Adrian's link is useful I think.


Leaving the decision as to whether your husband should have chemo up to him strikes me as somewhat irresponsible unless he has more information. 


Jules


 


 


  

 
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