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Hypertrophic Obstructive Cardiomyopathy

User
Posted 07 Oct 2025 at 20:37

Hi all PC warriors,

New to the group, but just wanted to put out there what I believe is a unique type of position health wise. In February of this year I was diagnosed with a heart disease called HOCM, or for those who do not know "Hypertrophic Obstructive Cardiomyopathy". Then in the July I was diagnosed with PC with a gleason score of 3+4 = 7 stage 2. My MRI showed that it had not spread to seminal vessels or in pelvis "although I know that is not 100%" reassuring, a MRI at PIRAD 4 was what I was forwarded for biopsy.

Anyway, had the chats with urology, all of the leaflets, surgery RALP was suggested at first, but after discussion at the MDT, I was deemed as being at risk of the heart going into failure if "general anesthetic" is used.

So far my option is now being SABR but I may still have to be careful if an hormone therapy was to be used along side. Can I ask if anyone else has similar type heart condition, and what "options" were any of you offered.

I sadly feel that if I just opted to see how the PC was left to just take its course, it may be my heart that kills me first, and I wonder how many 3+4 = 7 grade 2s can go on for years without progression! 

User
Posted 07 Oct 2025 at 22:41

Hello, mate.

I'm very sorry that you've had to join 'the club', but welcome to the forum.

Your diagnosis isn't bad,  prostate confirmed low grade cancer. What is your PSA?

Sometimes, Gleason 7 (3+4) patients can be offered active surveilance. Were you given AS as a treatment option?

I didn't have your particular heart disease but I had badly blocked arteries which put my fitness for RARP in doubt. My surgeon and aneathetist both had concerns. Apparently you are put in a Trendelenburg position during surgery, where your head is 15-30 lower than your feet, this exerts extra pressure on the heart.

Despite their worries, I still wanted surgery. I contacted my cardiology consultant, who told them in his opinion, I was fit for surgery. They eventually agreed.

I had the op, it was completely unproblematic. However, only two months later, I had a heart attack. I ended up in hospital for a couple of weeks. They unblocked two of the arteries (rotablation) and stents fitted (angioplasty). I'm fine now.

As regards SABR, I believe it can be done without hormone therapy. In fact, had it been an option to me, I'd have taken it.

So, if I were you, I'd be asking, am I eligible for active surveillance? Are you sure my heart condition rules out surgery? Can I have SABR without HT?

Once those questions are answered, I'd then decide which treatment would suit me best. 

Here's an excellent presentation on all treatment options and their possible side effects.

https://youtu.be/zYTU94-8pTc?si=1Z29_l8rbTwF6DHl

I wish you luck with whatever you chose.👍

Edited by member 07 Oct 2025 at 23:00  | Reason: Typo

 
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