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User
Posted 07 Jul 2026 at 18:26

2019 TURP biopsy negative. Urinary stricture appeared which I self catheterise every 14. days. Will often get a UTI if I don't take one Co-Amoxiclav at same time. Works well. PSA 0.7.

2022 PSA 1.7. Took no notice as NHS requires 6.5 for red flag!

2024 PSA 4.x. Again no action

2025 PSA around 5.x now realised the velocity was high. Dr not really worried (only if around 20ish!). No symptoms (well, I guess there wouldn't be.

2026 PSA 5.8. Still Dr not concerned but mentioned fast rise and referred me but they sent me away (less than 6.5 AND prostate no hard 'lumps'. So I paid for a mpMRI. Result: worrying lesion 9mm density 0.22 in 30cm prostate. Referred back to NHS. Biopsy: lesion gleeson 8/9!!! Rest of prostate quiet. Scans showed no metastasis.

July 2026 put on Orgovyx (just finished 1st months pack). 2ndaries so far light, hot flushes, one or two other changes. 1st post Orgovyx PSA due 20th with MCT team nurse appnmt on 27th.

Two thoughts I am following now having done some research (which I use Leo AI to gather for me), one is diet due to forthcoming testosterone depletion and of course what my case should be. My conclusion so far is that I should have a complete prostatectomy reason being radiation will likely hurt my stricture and even close it up. Advantage is removal of the lesion and restructuring of urethra with the chance of no stricture. I am happy to suffer erectile dysfunction so they can 'go wide' to catch any residual cancer 'spots'. And of course eventually get off ADT. Accept the fact that monitoring/radiation will be required if things get active again.

So far I have got myself some ISOPURE Whey protein, Creatine powder and Calcium Citrate all powders which I have started by mixing with yoghurts. the full mix is low fat milk, Chia seeds, 200g yoghurt ration of 6:1:0.5 of those powders. I don't know if I'm too early but I guess I need to experiment.

Exercise?, yes I am always active on my allotment, starting power walk (aim to get over 7K steps eventually) and do resistance stuff but not sure the regime yet.

I am only to happy to get advice from those further down the path. Mentally I don't seem to be stressed much (yet!?) and need to fight this. The only thing I am worried about is the MCT having a different view and me accepting something different than to get that blighter out of the picture!

Thanks for your time.

 

User
Posted 12 Jul 2026 at 20:35
HI, thanks for getting back. No meet yet but the MDT will contact me later this month after my first post ADT PSA to check on what's going on with the reducing PSA. So I think I'm early on the path. My research shows that as I have a urinary stricture (port TURP) things could be complicated for radiation as that I understand can cause hardening and worsening of the stricture maybe resulting in complete closure! Also an op to remove the prostate would remove the cancer (?) but replacing the urethra with the stricture there may also be a complication so which way to go may be difficult assuming they offer those options. I really don't want to keep the blighter in there to spring up one day.

PS, I don't know anything further about the full biopsy and scan detail as to SVI or Cribriform or whatever, i was just told the 'good news' there was no spread. BUT, of course the thing could still be active depending on my bodies ability to react to the drug. Oh, well, one can do nothing but just wait the process out.

User
Posted 13 Jul 2026 at 04:29
Hi Allex,

You are about to make an important treatment decision and your case is complicated. In your situation, I would want a second opinion from a top Hospital (say The Royal Marsden or another highly regarded one), They would need your MRI and full histology but might also need to do further investigations.

Barry
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User
Posted 10 Jul 2026 at 22:42

Hi,  a bit surprising the doctor said 20 is the psa threshold for action.   You're 79 have you any other problems.  Older men are more often offered radiotherapy as the operation can be fairly long and you're sloped head down.  The doctor sounded a bit casual but you're on treatment now and it can be used as preparation for radiotherapy. Have they said how long you'll be on hormones and if radiotherapy treatment is to be offered.  They might think you're fit enough for an op.  They should be talking to you about their options and what you prefer.

User
Posted 11 Jul 2026 at 09:08

Hi Allex.

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

Has there been a MDT meeting to review your results and suggest a treatment path?

Have they decided that radiotherapy is the best option?

I was younger than you, just 65 years old, when I was diagnosed with T3a, Gleason 8 (3+5) PCa, my PSA was only 7.

I was offered radiotherapy or surgery. Because of heart problems, they initially questioned my suitability for surgery, which was my prefered treatment option, and were pushing me towards radiotherapy.

Whilst doing further heart checks they put me on bicalutamide. I'm still not sure whether they did this, to suppress the cancer whilst my surgery suitability was being decided, or as a preparation for radiotherapy.

After 2 or 3 months on HT they decided surgery was feasible and I had RARP.

As far as I'm aware, it is not standard procedure to have, HT prior to surgery. The drugs can affect your post op histology results. My Gleason went from 8 (3+5) pre op to 9 (4+5) . They explained that this upgrade may have been caused by the damage the HT had caused to the cancer cells.

Personally, if I was in your position, with possible Gleason 8 or 9, I'd be requesting a treatment plan pretty pronto.

Whatever they/you decide, I wish you the best of luck, mate. 👍

Edited by member 11 Jul 2026 at 09:12  | Reason: Spelling.

User
Posted 12 Jul 2026 at 20:35
HI, thanks for getting back. No meet yet but the MDT will contact me later this month after my first post ADT PSA to check on what's going on with the reducing PSA. So I think I'm early on the path. My research shows that as I have a urinary stricture (port TURP) things could be complicated for radiation as that I understand can cause hardening and worsening of the stricture maybe resulting in complete closure! Also an op to remove the prostate would remove the cancer (?) but replacing the urethra with the stricture there may also be a complication so which way to go may be difficult assuming they offer those options. I really don't want to keep the blighter in there to spring up one day.

PS, I don't know anything further about the full biopsy and scan detail as to SVI or Cribriform or whatever, i was just told the 'good news' there was no spread. BUT, of course the thing could still be active depending on my bodies ability to react to the drug. Oh, well, one can do nothing but just wait the process out.

User
Posted 13 Jul 2026 at 04:29
Hi Allex,

You are about to make an important treatment decision and your case is complicated. In your situation, I would want a second opinion from a top Hospital (say The Royal Marsden or another highly regarded one), They would need your MRI and full histology but might also need to do further investigations.

Barry
 
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