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User

Posted 12 Jul 2014 at 10:47

I have been very recently diagnosed with locally advanced prostate cancer.
I have a PSA of 42 and a Gleason score of 8. The bone scan was clear.
I am aged 61 and am otherwise fit and in good health.
The suggested treatment options are Radical Prostectomy (with follow up EBRT) or Hormone Treatment high dose Brachytherapy and then EBRT.
Has anyone with a similar profile and diagnosis been presented with these options and which route did they follow and why?

User

Posted 12 Jul 2014 at 12:44

Hi sorry to hear your news the reason I replied is to keep your post current as there are many members who can share their journey on here who will give you good advice
Best wishes to you
Carol

User

Posted 12 Jul 2014 at 18:33

Hi

Welcome to the forum, which none of us wish to be, but you will find it a mine of information, and support. You ask if anyone has a similar profile and which route they took and why, well there will be many who have similar statistics as you, and chose different paths regarding treatment,as we are all different. The path you choose will be for you to decide once you have the full facts, as all treatments have side effects, which differ from person to person.

My choice of treatment, was based on my priorities, I was diagnosed nearly 2 years ago and had a PSA of 94.4, Gleason 4+3, T3b M0 N1 locally advanced, and was only offered RT + HT under the NHS, but after research decided the best treatment for me would be RP so I sought out the best surgeon for me, and paid privately for the operation, I have also needed RT after my PSA came back at 0.42 following the operation and this week my PSA came back at 0.05, so I am happy with my choice, i will have ED for life, but that is a small price to pay, given the alternative. This was my decision and I do not regret it one bit, as the decision of which path you take must be yours, armed with as much information as you can,but when you finally make your decision, totally commit to it, and have no regrets or what if's.

All the best

Roy

User

Posted 12 Jul 2014 at 20:32

Treatment options offered you are interesting. I was diagnosed with locally advanced PCa April last year: G8, T3a, PSA 5.2 M0 N1 - limited spread to local lymph nodes. The NHS offered me curative intent treatment comprising HT + IMRT (74 Gy over 37 sessions). I took a second opinion privately from a surgeon who specialises in robotic RP. His view was that in my case there was little to choose in terms of outcome between the 2 options. He emphasised that I should consider quality of life risks associated with the alternatives. I decided on the HT/RT route.

Obviously, your first option has the risks of both RP and RT. Have you been advised whether the RP procedure would be nerve sparing? As for RT, I was advised that it has a significant risk of impotence and a low risk of incontinence. What I didn't know was that the planned RT would include treatment to the seminal vesicles (which hadn't been shown to be affected by cancer), the effect of which is permanent sterility - an elaborate vasectomy! BTW, this didn't trouble me.

Your second option includes HT which has its own risks. I've been treated with HT for the last 12 months with side effects limited to minor hot flushes. Some others have worse experiences. I think that long term HT makes attention to fitness and diet a must, there being risks of muscle and bone wastage among others which makes It important to know how long you might be on HT.

While it's early days, the HT/RT combination (described by my oncology as the "gold standard" for cases like mine), has resulted in a good response by my body. Had there been a clear-cut advantage for RP I might well have taken that route.

As you'll read on here and hear from doctors, all cases are different. I suggest that you review with your doctors the risks and benefits of each treatment option: setting it out in a tabular form might help. You could also consider taking a second opinion - this won't offend your doctors and doesn't cost much. If you take this route, ensure that the second opinion doctor had access to scans, test results and notes.

Good luck,

Viv

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