Prostate cancer stage 2 3+4

Hi Bluecloud1,

My name is Anne and I am one of the Cancer Information Nurses on the Support Line.  Welcome to the online community. I see you have already joined our prostate cancer forum. I hope you have found it to be a supportive place so far.

I’m sorry to hear of your recent diagnosis of prostate cancer and understand this must be difficult time for you. I’m glad you reached out for more support. Being given a cancer diagnosis and then having to make treatment decisions can feel overwhelming.

Prostate Cancer UK has information on understanding your diagnosis and the different treatment options available. Making treatment decisions can be particularly challenging, and it’s important to have as much information as is required. You may find it helpful to read through our booklet and jot down further questions as they come to mind.  It may be a good idea to have a read through this information then have a chat with either your Consultant or Clinical Nurse Specialist (CNS) to go through your questions and concerns. You mention you have an appointment with your own Doctor this week. I’m unsure if this is your GP or Consultant, but it’s important you have the opportunity to talk things over with your Consultant before you come to a decision about treatment. This would also allow you to discuss in more detail the benefits and risks of active surveillance,  surgery, and radiotherapy.

Most localised prostate cancer grows slowly and may not need immediate treatment. However, some men have cancer that grows quickly and has a high risk of spreading. Your Consultant can explain more about your own individual situation. It’s often helpful to bring a partner or friend to these appointments as a ‘second pair of ears’.

You may also wish to consider joining a local support group for men with prostate cancer. Sometimes chatting things over with others in a similar situation can be helpful. If you feel you are struggling with the emotional impact of prostate cancer, please do remember there is lots of support out there. Your CNS is there to support you and we can also help you explore your options. We are only a phone call away if you’d like to chat things over with us.

I hope this is helpful.

Best wishes,

Anne, Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email

Ref:CC

Thank you, it was my own nhs doctor I spoke to this week. The specialist nurse at the hospital says the next step is to meet with an mdt team, which she is going to organise for me, is that the consultant you mention in the nhs as I am not on private care.. 

Hi Bluecloud1,

My name is Keith and I’m one of the Cancer Information Nurse Specialist

I hope you’re finding the support and information from our online community helpful.

The consultant that Anne has mentioned would be part of the NHS, MDT. Sorry health care professionals love abbreviations it can be confusing at times and can sometimes cause confusion.

MDT is short for multi-disciplinary team (MDT).  This team would consist of different health care professionals who specialise in your type of cancer. Including consultants who specialise in different areas such as surgery, radiotherapy, and oncology. You would be referred to the most appropriate consultant after the MDT meeting. This is where your case would be reviewed after all diagnostic tests have been completed and reported back. From this information a plan of action would be put in place. The next step would be for you to be invited for a consultation with most appropriate consultant within the MDT to discuss your diagnosis, how it is affecting you as an individual and the outcome of the discussion from the MDT. Your medical team will discuss your options in a way that you fully understand, your individual set of circumstances and what treatment option or options you may have.

This would also be an opportunity for you to ask any questions you may have so that you can make what we call an informed treatment choice.  There is no such thing as a wrong question to ask.  As Anne has already suggested sometimes its good to write any questions down before attending this meeting, as a starting point.

However, if you do have any immediate concerns, you should have been introduced to specialist nurse. If not, to contact this nurse, call the main switchboard of the hospital where you have been initially seen and ask to speak to the secretary of the last consultant, you have spoken to and ask to be put in contact with the specialist nurse. This nurse would also be part of your MDT.

I hope this information is helpful and has answered your questions. If not you can always call one of our nurses directly if you want to talk over your concerns in more detail or require any further support.

The Macmillan Support Line offers practical, clinical, financial, and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

take care.

Keith, Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

Ref KM/GH

Hi again, I have been offered brachytherapy just on its own, my cancer is 3+4 Gleason and the mri shows this in my right hand peripheral zone but then there is mention of something in the left which the biopsy seems to have missed but the biopsy letter states it is now T2c yet no Gleason score that side which is confusing, anyway I have asked for some explanation.   Has anyone had brachytherapy and did it cover both sides because if it did then that will sort the confusion out.  Also any good experiences of it and any returning cancer as I don’t think you can have it twice.    Thank you 

Dear Bluecloud1,

My name is Liz, and I’m one of the cancer information nurse specialists on the Macmillan support line and a colleague of Keith and Anne’s.

Thank you for reaching out for further support and information after being offered brachytherapy for your localized prostate cancer.

Permanent seed brachytherapy or LDR brachytherapy is when your doctor puts very small radioactive metal seeds into your prostate gland. The seeds slowly release a low level of radiation into the area of the prostate over a few months. It is a type of internal radiotherapy.

Alternatively, you might be offered temporary brachytherapy or HDR brachytherapy is when radioactive pellets are put into your prostate gland. The pellets release radiation to destroy nearby cancer cells. Your doctor takes them out at the end of the treatment. Once they've been taken out, you're not radioactive.

With brachytherapy, your doctor puts the radioactive source or seeds as close to the cancer as possible. So that the cancer gets a high dose but nearby tissues and further away the levels of radiation are low.

Your doctor may also recommend you have hormone therapy for a few months before the radiotherapy treatment. The hormone therapy shrinks the prostate cancer and makes it easier to put the pellets into the right place.

Prostate Cancer UK have a one to one peer support service where you are matched to a trained volunteer or you could post a question on our prostate cancer forum, in case any other men have had brachytherapy and can help answer questions about their experiences.

For many men with localised or locally advanced prostate cancer, treatment is successful and gets rid of the cancer. However, should you have a recurrence of your prostate cancer, your medical team would look at what treatments are suitable for you at that time and recommend accordingly.

I hope that this information has helped a little at this time, please contact us whenever you need us for further information or support.

Take care, 

Liz.

Cancer Information Nurse Specialist  

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. Ref LZD/ KE

Hi, thank you.. What I was specifically trying to find out is, let’s say you have cancer in both sides of the peripheral zone, ie T2c, then does the LDR treat both sides with an equal dose, because above you are sayings it’s focused to the cancer, which i understand if it’s just 1 side, but what if it’s both, can you just treat the whole prostate and kill any cancer that’s anywhere in it…. Hope that makes sense, and have you any knowledge on SABR ?  Thanks

Dear Bluecloud1 

Thank you for getting back in touch with the Macmillan online community, my name is Pauline and I am also one of the Cancer Information Nurses on the Macmillan Support line.

When LDR is the choice of treatment a careful planning process occurs that takes into account any and all of the tumour in the prostate. You may find this fact sheet by prostate cancer UK helpful. It should answer any questions you have surrounding LDR and the planning process that goes into this.

SABR is a type of external radiotherapy which is explained in this link. If you have any questions that cannot be answered by reading the information on this link, you are welcome to call our helpline and speak directly with either myself or one of my colleagues on freephone 0808 808 0000 (7 days a week, 8am-8pm).

PG/LZD

Best Wishes