Hello all. My details are:
Age: 60
Status: Married, no kids, retired
PSA: 10.2
Gleason: 3+4 (originally 3+3 from 2014 diagnosis onwards)
Staging: T2 N0 MX
Tumours: 3 bilateral, 4/3/0.2mm
Prostate volume: 45ml
Other prostate info: Urinary issues, Enlarged Median Lobe, Perineural invasion detected, BPH, Prostatitis. Prostate Artery Embolisation (PAE) done 2018, reduced prostate volume from 60 to 21ml.
Other medical info: Glaucoma, knee joint cartilage thinning.
Treatment location: UCLH
Treatments looked at so far:
1) HIFU
2) Cryotherapy
3) Brachytherapy
4) CyberKnife
5) Focal Laser Ablation
6) NanoKnife (Irreversible Electroporation)
7) Proton Beam Therapy
8) HT/RT
9) RP
10) Active Surveillance
All treatments so far have been ruled out at UCLH, except RP and HT/RT.
1 + 2 - Ruled out by the UCLH Focal Team due to tumours being bilateral (and thus requiring multiple treatments).
3 + 4 - Ruled out by the UCLH Oncology Team due to prostate volume and current urinary issues.
5 - Not offered at UCLH. Used only for BPH.
6 - Not offered at UCLH. Ruled out by me due to proximity of 2x2mm abdominal arterial platinum coils from PAE.
7 - Not offered at UCLH, and outcomes appear to be very similar to standard RT.
10 - Ruled out due to worsening of cancer.
I haven't been able to see Prof E for a further discussion, I only managed to speak to a member of his department. My case has been discussed at a couple of MDT meetings.
I have had a second opinion from Prof A at CH who agreed that because of the median lobe size and bilateral tumours that focal therapies were not advised.
Given all the above, my choices appear to be narrowed down to two only: HT/RT or RP. I am going to see my consultant at UCLH next week to make some decisions, and am still unsure what to do. Does anyone have any advice here?
Also, does anyone know of any other UK PCa therapies/treatments I can investigate? I am grateful for any and all useful info.
ToyCollector
