Surgery

Hi Mcjc, all the men I know with T4 haven’t had surgery. Hopefully others will answer too. I think having the cancer near the rectum would make radiotherapy on its own very challenging due to the potential damage it would cause. Best wishes,

Hi M 

Just my opinion but I think that the last chance for having surgery is a T3 and even then can be challenging as T3 indicates broken through the prostate gland.

I see that the surgeon is suggesting surgery followed by Radiotherapy but this would potentially give you more side effects.

What is your preference, would u consider just HT and RT?

Hopefully others will give their opinions.

Best wishes

Steve

Hi 

this is the dilemma from the start 

a surgeons argument always is reduce tumor bulk and the psa reduces and if you give RT and there is a recurrence then doing surgery as a salvage is very difficult as the tissues will be like rock due to RT . And they do do it in centres like Germany etc and there is observation studies which are good for  T4 lesions and he says the only reason it was not included as an option here in uk in the trial was lack of funding 

the oncologist argument is you have to have RT to the prostate anyway after surgery . Surgery will not give full clearance so why don’t you go for something which will give curative treatment in one shot RT and is evidence based as in the trial proven to be of benefit ( surgeons say that’s Bcos they have funding in that arm of the stampede trial whereas they did not !) and RT also has side effects as lesion near rectum 

so I think end of the day each has its pros & cons and I have to weigh risk benefits ratio . I will probably go for majority who say RT is better . Second option . Let’s c what other friends on forum say . Keep it coming 

In a way I see where the surgeon is coming from, give it two best shots to clear it but u r going to have to go through all these treatments which can be very draining. Also don't forget side effects.

Radiotherapy is a lot simpler and using HT before to reduce tumour size making it easier to zap .

If it was me, just my opinion, I would go for the latter.

Steve

Yes I agree with you . What if surgery leaves me with incontinence and a permanent catheter Bcos spincter was involved in mri .am only 49 . And a colostomy bag Bcos near rectum then I can’t be fit for RT 

I think I will go for RT lot safer . Thanks for input