I've declined Radiotherapy

Well that is one person who has developed rectal cancer. Now you have a second data point i.e. me. I had radiotherapy 8 years ago and haven't developed rectal cancer. You should probably lend as much weight to my experience as the other person you heard about. Even better just ignore his experience and my experience and just look at the statistics, which suggest one in 50 may develop a secondary cancer.

Prostate cancer is slow growing you are already on treatment which will slow it's growth further, so it may be that the prostate cancer can be held at bay for decades. Most people do not like being on HT but if you can tolerate that for the rest of your life then RT may not improve your quality of life.

Balancing the certainty of having prostate cancer and it possibly being curable against a 1 in 50 chance of getting rectal cancer. I would have the RT, but that is just what suited me when I was diagnosed in my early 50s. 

Basically hormone treatment will control and suppress the cancer, but will not cure it. Like every prostate cancer treatment, hormone therapy can have serious side effects. Most blokes on here seem to struggle far more with HT side effects than they do with the side effects of radiotherapy.

Here's a recent conversation on ADT.

https://community.prostatecanceruk.org/posts/t34049-Why-don-t-doctors-warn-you-about-side-effects-of-adt

Although your Gleason score is relatively low, your cancer is not prostate confined. It has spread to the seminal vesicles, staging T3b. At this stage, it's curable. If I were you, despite the risk of radiation side effects, I'd be looking at having it as a curative treatment with ADT, rather than trying to control it with hormone treatment and risking metastasis.

But the choice, is of course, yours.

Whatever you decide, I wish you luck.👍

Edited by member 27 Oct 2026 at 21:02  | Reason: Additional text

I am so sorry to hear you have joined the PC club, but fortunately I for one find this forum very supportive, informative, and enlightening. It has helped me to read both consensus and differing opinions and I hope that is also for you. So I just want to weigh in with what worries me the most: resistance to HT. Although some men on here have been successful with HT for nearly a decade or even more, as you say, others are different and not all have been so fortunate. I think my husband would choose RT all over again and more in the future to control spread and oligomets if at all possible to postpone more HT until absolutely necessary.

I'm not sure where you did your research. Can you post a link to this 40% chance of secondary cancer? Even recurrence rates of prostate cancer, following radiotherapy, is no where near 40%.

Here's some reliable research:

https://ecancer.org/en/news/8845-possible-link-found-between-radiotherapy-for-prostate-cancer-and-risk-of-secondary-cancers

Secondary cancers related to treatment represent perhaps the most serious of all complications, but studies have led to conflicting results.

So a team of researchers based in Canada and the USA - and led by Dr Robert Nam at the University of Toronto - set out to determine the association between exposure to radiotherapy for the treatment of prostate cancer and subsequent secondary malignancies (second primary cancers).

They analysed the results of 21 studies assessing the risk of secondary malignancies in patients exposed or unexposed to radiotherapy in the course of treatment for prostate cancer.

Although they cannot tell us about cause and effect, meta-analyses involving observational research are useful for pulling evidence together.

Study design and quality were taken into account to minimise bias.

They found an increased risk of cancers of the bladder, colorectum, and rectum, but not cancers of the lung or hematologic (blood) system, after radiotherapy compared with no radiotherapy or surgery.

These results were consistent when the researchers restricted analyses to studies using five or 10 year lag periods between treatment and the development of a secondary cancer.

It is important to note, however, that the differences in absolute risks between cases and controls were low, say the researchers (0.1-3.8% for bladder cancer; 0.3-4.2% for colorectal cancer; and 0.3-1.2% for rectal cancers).

Here's some more:

https://www.appliedradiationoncology.com/news/risk-of-secondary-cancer-from-prostate-cancer-radiation-treatment-rare

In a study of about 145,000 men with prostate cancer, the team found that the rate of developing a later cancer is 0.5% higher for those who received radiation treatment than for those who did not. Among men who received radiation, 3% developed another cancer, while among those who were treated without radiation, 2.5% developed another cancer.

Finally, here's what or site says sbout the risks and side effects of radiotherapy.

https://prostatecanceruk.org/prostate-information-and-support/treatments/external-beam-radiotherapy/side-effects-of-external-beam-radiotherapy

Other cancers

Radiotherapy can damage the cells in the tissues surrounding the prostate. There is a very small chance that this could increase your risk of bladder or bowel cancer. It would take at least 5 to 10 years after having radiotherapy treatment for a second cancer to appear.

Sadly over the past three years, I've lost too many friends on here, who've lost their battles with prostate cancer. Apart from their cancer, they were all healthy and full of vitality. They never overlooked the importance of positive thought. They threw everything at the disease, but it was not enough to save them. 

As you say, you may be able to manage your T3b disease, just on hormone treatment. 

However, you won't cure it, and there is a high likelihood that at sometime you'll need radiotherapy. Your uncoventional approach is inherently more risky. 

Because it's Stage 3b. It's left the prostate, invaded your seminal vesicles and might decide to venture further a field. You're not hitting it with everything. In your case, radiotherapy and ADT is simply the best way of dealing with it. There are occasions where T3b is deemed suitable for surgery, but even when it is, it's usually combined with additional radiotherapy and ADT.

I was eventually diagnosed with high grade cancer which had breached the prostate capsule, T3a staging. I was given the options of surgery or radiotherapy and ADT. I had surgery and four years later, touchwood, my PSA is undetectable. I'd have never risked not having surgery or radiotherapy and just tried to starve the cancer with ADT alone. In my opinion that would be have been foolhardy. I wanted to hit it as hard as I could when it was curable and reduce the chance of metastasis.

Don't get me wrong, you have every right to post how you intend deal with your cancer. I'm simply questioning the evidence you're using to promote your uncoventional approach. In my opinion, based on scientific fact, you are rejecting radiotherapy, for the wrong reason, based on an incorrect assumption that it hugely increases the risk of causing secondary cancer. By doing this you may be risking further unnecessary disease progression.

Edited by member 28 Oct 2026 at 10:16  | Reason: Additional text

Thanks but I'm asking on this thread whether people have declined or are considering declining the radiotherapy. I'm really uninterested in your holidaying in the Med.

What treatment you have from the options for which you are suitable is rightly down to you and I would not try to convince you to change your decision.

However, with respect, it is obvious that you have a limited grasp of PCa. For example, you say that because cancer cells cannot be seen on a scan there can't be any in the scanned area, That is incorrect as it does happen and furthermore, various types of scans are better at showing cancer cells depending where they are located and the type of tissue or bonethey are in, As the highly regarded Dr Eugene Kwon of Mayo clinic says when answering a questioin on relapse, the cancer seeds were likely there when first treated but unseen. There are also different types of PCa, some with low emitting PCa and faster developing, Do you know and fully understand your diagnosis? Then it is important to know how near cancer cells are and in what concentrations to critical organs. This is part of what is called 'Staging'. So the man you know who went on to have rectal cancer may have even been initially assessed as Gleason 3+4=7 or 4+3=7 (the latter having the more of the higher deviant cancer)but with a 7 like you but have quite a different diagnosis to you.

Work is being done on ways to predetermine whether an individual's cancer is likely to become a serious problem but this has not yet been perfected. It means some men will be treated to a greater extent than necessary while some reject treatment whether knowingly or unknowingly and find that it has advanced to the point where it cannot be cured. As regards being fit, that is likely to help a man to deal wih the side effects of treatment but not to heal it or stop it's spread. Many athletes bear witness to this, one of the more recent being Chris Hoy.

I am now 90 and although still monitored, further radical treatment will not be offered and I would not want Hormone Treatment to give me a few more months but with various side effects. I did have very strong RT in German in 2008 (more than given in the UK) and 2 sessions of HIFU, in 2015 and 2020 and am now considered to be in remission. I am very grateful I had my treatment because I would otherwise most likely have been dead quite a time ago. But my situation is very different to a young man like yourself. True you may live your normal lifespan without radical treatment but you could be missing your window of opportunity of having radical treatment meaning you could have a premature and painful death.

I wish you well.

Hello again, mate.

There will be very few men with T3b prostate cancer, with a PSA of nearly 50, being treated by ADT alone. So I doubt you'll get a response from anyone on here, who's risked what you intend doing.

You've got high risk, nonmetastic prostate cancer.

The management options for patients with high-risk nonmetastatic prostate cancer should always be discussed in a multidisciplinary team setting. The discussion with the patient in the light of his clinical and pathologic characteristics is paramount in order to offer him the best treatment strategy and to avoid unnecessary harm. Clinicians should be aware that ADT alone is an inappropriate treatment option for patients with high-risk non-metastatic disease. An accurate workup to rule out metastatic spread is mandatory before offering aggressive local control modalities.

https://journals.sagepub.com/doi/10.1177/1756287217697661

Your multidiscipline team have advised the correct treatment, radiotherapy and ADT. You've decided to reject their advice. You're perfectly entitled to do what you want.

Good luck, 👍 

Edited by member 29 Oct 2026 at 07:27  | Reason: Add link