Prostate Treatment

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Gleason 4;3=7. CPG 4.  T2/T3a  N 0 M 0. PSA 5.2

I am considering 2 options and would appreciate any advice you can give please.

1. HRT , jabs and then tablets up to 18 months, plus radiotherapy of 7.5 weeks.

2. HRT jabs and then tablets up to 18 months, plus Brachytherapy, and then reduced Radiotherapy of 20 fractions.

Is one any necessarily better than the other or give a more positive outcome? Or is that like asking how long is a piece of string? Is it better to have option 2 so that you have less radiotherapy, but yet you have a general anaesthetic to undergo?

  • Hello badger1234,

    Welcome to our online community, I notice you have joined one of our forums and we hope you are finding this a helpful and supportive place to visit.

    Thank you for your questions about treatment decisions. My name is Luzia and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    Here at the Macmillan Support Line, we can give general advice and support. We are independent from the NHS and don’t have access to medical records so can’t give personalised information. Your treatment team will be able to answer your questions.

    Hormonal therapy for prostate cancer is recommended in each treatment option.

    You outline the possibility of external radiotherapy alone or in combination with brachytherapy. It’s often stressful for men to choose between treatment options. People are fearful they will choose the “wrong” one. It’s important to remember that each man’s experience with prostate cancer is different. Even if you know someone with the same type of cancer as you, their radiotherapy treatment may be different. 

    There is no single best choice. It’s important to take your time and decide which option is right for you. Our information on making treatment decisions could be useful too. Usually, if the treatment team is giving people equally valid options, they have the same outcomes. If they did not have the same outcomes that would have been pointed out to you.

    To prepare for the next conversation with your treatment team, we suggest reading about advantages and disadvantages of both external beam radiotherapy and brachytherapy (internal radiotherapy). Sometimes this clarifies the decision for people.

    You usually have external beam radiotherapy as an outpatient. People getting external beam radiation do not have radiation in their body and are not radioactive. Therefore, you will not be considered of any risk to others. If you are having internal radiotherapy, some people have to stay in hospital for one night. People getting internal radiotherapy can give off radiation for a short time. If you are concerned around any risks you may have, speaking with your specialist team can help you understand about any advisories that you should and should not do during treatment. Our information on pelvic radiotherapy and the  Understanding Pelvic radiotherapy booklet explain much of what to expect from treatment and advice to help patients to manage any side effects of radiotherapy.

    Such a complex decision is often hard to make by yourself. You might find it helps to talk with your family and friends before deciding. You might find that speaking to other men facing the same decisions is useful. The one to one supportoffered by Prostate Cancer UK may be helpful for you. You are already part of our and our online prostate cancer forum, you may find the radiotherapy & side effects forum could be helpful too.   

    This must be a very difficult time for you. Please call one of our nurses directly if you want to talk over your situation. We may then be able to give you further information.

    Take care,

    Luzia

    Cancer Information Nurse Specialist

     Ref: LzM/KS

    Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. If you think it may be useful to chat things over in real time, we have our webchat service available 7 days a week 8am-8pm.