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Treatment quagmire …

User
Posted 07 May 2026 at 20:25

Hi, I’ve now enlisted into the club nobody wants to be in, but it is what it is and I need to deal with it. I’ve just been diagnosed (April) -  having got over the initial shock, anger, fear  & mental anguish I now need to decide on treatment route.

I’m 67 yrs old, diagnosis is Grade 2 (3+4), T2 N0 MX

Three options have been suggested: 1) Active Surveillance, 2) Prostatectomy via DaVinci; 3) Radiotherapy. 

Iif anyone can help me make a little more sense of this with places to go for info etc or real life examples I’d so appreciate it. 

My preference at moment is SABR or HiFu if suitable (this would be private as my Hosp in Oxford doesn’t offer this). The surgery scares me to bits especially at my age along other health issues I have. 

 

Any thoughts from this community or advice on these treatments, I’d hugely appreciate it. Many thanks Phil 

User
Posted 11 May 2026 at 10:04

Hi, Phil.

5 session SABR wasn't available to me when I needed treatment. I think had it been an option and I'd met the criteria for it, I'd have probably gone for it rather than surgery

 Having said that, surgery has appeared to worked well for me.

Here's a good video on treatment options:

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

IF you're considering surgery, here's a good video:

https://drive.google.com/file/d/1fyYTLZpxnB9HaR7O4xQ5Ff58Pj4Cn6ZB/view

Please keep us updated and good luck, mate.πŸ‘

User
Posted 11 May 2026 at 12:35

TechGuy - thanks for note you left me, I cannot reply directly but absolutely great info  thanks so much 

User
Posted 11 May 2026 at 21:36

Originally Posted by: Online Community Member
I have meeting at Churchill Hospital tomorrow with Oncologist ...

I hope that goes well.

A lot of us here have been through exactly the same dilemma as you. On paper the outcomes of the different routes are similar, though I suspect with your situation Active Surveillance would not postpone treatment for long.

One thing I always point out to people asking your question is that by definition 10-year outcomes relate to treatments as they were 10 years ago. As far as I can tell robotic surgery has stayed rather similar at most centres (though there will be surgeons with much more experience) while there have been big advances in radiotherapy approaches. If you are eligible for the new 5-fraction approach in a modern stereotactic machine, without needing hormone therapy, there is a prospect of a good outcome without the side effects which many have found most troublesome.

However one thing I have learned from this forum is that we are all different, and no one here has the specific information about your situation that your own consultants have. You need to consider their advice and decide accordingly.

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User
Posted 10 May 2026 at 23:36

I was the same with the view of surgery. But the key seems to be to find a highly experienced high volume surgeon with good stats. I chose a leading Top professor Whocantbenamedonhere at London Bridge guys Hospital who have the latest robotic kit. if you’re going privately it’s easy to select you want to do the work as long as you don’t mind travelling. I was about two hours away from London Bridge and it was relatively easy. Some of the chaps on here have come down from Manchester to see the same surgeon. I haven’t looked back since I had the surgery in November 2019. So pleased I found the prof as he is a legend in  urological surgery and blew my local consultant out the water with stats.

I looked at hifu also initially at UCLH which seems to be the central of excellence although the vibe I got was the chances are a number years down the line you’ll probably have to look for surgery anyway as prostate cancer tends to be multifocal.

I don’t know much about focused radiotherapy so can’t really comment there.

Please shout if you have any more questions and rest assured when it’s property treated you’ll look back with relief that it’s all behind you. it’s a hell of a rollercoaster in the first few months but once you get over the treatment life carries on pretty much as normal in between annual blood tests.

User
Posted 11 May 2026 at 05:52

Thanks so much for this reply, it really does help so muchπŸ‘

Latest is I’m seeing a RT Oncologist tomorrow, to discuss a radiotherapy treatment called SABR that’s on offer to me. It’s given over 5 intensive sessions. I’ve been researching it. 

I then have appt on 26/5 with surgeon.

its tthen make your mind up time for me …

 

User
Posted 11 May 2026 at 10:04

Hi, Phil.

5 session SABR wasn't available to me when I needed treatment. I think had it been an option and I'd met the criteria for it, I'd have probably gone for it rather than surgery

 Having said that, surgery has appeared to worked well for me.

Here's a good video on treatment options:

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

IF you're considering surgery, here's a good video:

https://drive.google.com/file/d/1fyYTLZpxnB9HaR7O4xQ5Ff58Pj4Cn6ZB/view

Please keep us updated and good luck, mate.πŸ‘

User
Posted 11 May 2026 at 12:35

TechGuy - thanks for note you left me, I cannot reply directly but absolutely great info  thanks so much 

User
Posted 11 May 2026 at 15:53
Hi Phil,

My diagnosis and options given were very similar to yours.

I had a couple of meetings with a surgeon, but after much research I decided to go for MR-guided SABR.

The 5 treatments are delivered inside a combined MRI and a Linear Accelerator. The key part for me was that during each treatment the radiologist is looking at live real time detailed images, the tumours are being tracked real time and targeted accurately.

I'm about 3 months post treatment, side effects are minimal and my PSA has dropped to a normal level, so at the moment it's looking good.

The hospital that treated me was in London but they do have one in Oxford.

Good luck

Paul

User
Posted 11 May 2026 at 16:08
best of luck Paul and thank you for sharing with me.

I have meeting at Churchill Hospital tomorrow with Oncologist and on my list is to ask about the SABR real time MRI (Linear Accelerator). I'll let you know cheers Phil

User
Posted 11 May 2026 at 21:36

Originally Posted by: Online Community Member
I have meeting at Churchill Hospital tomorrow with Oncologist ...

I hope that goes well.

A lot of us here have been through exactly the same dilemma as you. On paper the outcomes of the different routes are similar, though I suspect with your situation Active Surveillance would not postpone treatment for long.

One thing I always point out to people asking your question is that by definition 10-year outcomes relate to treatments as they were 10 years ago. As far as I can tell robotic surgery has stayed rather similar at most centres (though there will be surgeons with much more experience) while there have been big advances in radiotherapy approaches. If you are eligible for the new 5-fraction approach in a modern stereotactic machine, without needing hormone therapy, there is a prospect of a good outcome without the side effects which many have found most troublesome.

However one thing I have learned from this forum is that we are all different, and no one here has the specific information about your situation that your own consultants have. You need to consider their advice and decide accordingly.

User
Posted 11 May 2026 at 22:37

Hi Mate 

I had Rarp at the Churchill 4 weeks ago all very efficient ,clean and proffesional. actual operations the easy bit!

I have been very leaky since though which is much harder than I expected to deal with. Did lots of excercises before and after. It sems cyclists have the best outcome in this.

Good luck with your choice.

Edited by member 11 May 2026 at 22:55  | Reason: Not specified

 
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