Locally Advanced Prostate Cancer T3 (N1, M0) Advise

Hi Grigor and welcome

My opinion is that once the cancer has broken thru the gland edge then you are probably better off with the Radiotherapy and HT.

As has been suggested removing the gland on its own may not remove all the cells and therefore RT would probably, but not def , be required at some stage..

Your Gleeson and PSA quite  high as well so surgery on its own my not cure, RT and HT still curable.

Hope this helps, just my opinion, see what others say

Best wishes

Steve

Hello Grigor

Tough decisions ahead, why has chemotherapy not been offered ? Your young so you should be fine with it, hormone therapy is the first line of attack, also radiotherapy can help immensely. 
There are many other treatments out there, the surgery is a puzzle to me, as once the cancer has broke free it’s hard to catch it all, but I’m no doctor, always see what’s on offer, the possible after effects.

stay safe

Joe

1. Hi Grigor

I am practically in the same boat as you but a little further along. Feb 2020 had a psa rise from 6.6 to 8.8 over a year. Quite low I thought compared to some I've seen on here. Biopsy revealed locally Advanced aggressive PC gleason 9. Same T and M0 as u.It hadn't escaped the prostate only to be told a week later it had and was in nearby lymph nodes.

I was put on and still on HT for 3 years, 3 mthly Zoladex injections in the stomach. 2 yrs on I have til next March.

I had 37 days radiotherapy and every 6 month phone call from oncologist reveals psa stable at 0.01 % which he is pleased with. I am hoping to come off the HT next March where after I will be monitored 6 mthly to see if the cancer starts to appear again. If it does I will possibly have a little chemo he says.

All in all good results so far. I have been very luck to not have had any side effects from the RT and only a few warm hot flashes from the HT. Plus the apparently common side effect of genital shrinkage and loss of libido..

I have been very positive all the way through and not thought about it too much. While I have no pain I'm not going to worry. All I an say is try and keep positive and you can call on any of the guys on here, Macmillan nurses and the oncology teams are amazing.

Keep positive bud and good luck. Hope it all goes well. 

Steve,

Thanks for the reply and your comments, if okay with you if i have any further queries/info i will contact you.

Cheers

Grigor

Joe,

Thanks for the reply and your comments, I'm not sure why they never mentioned Chemo as a option but i willask.

if okay with you if i have any further queries/info i will contact you.

Cheers

Grigor

Norfolkboy,

Thanks for all the information and telling me about the treatment you have went through and the positive results and mind set you have had throughout it is very much appreciated.

if okay with you if i have any further queries/info i will contact you.

Cheers

Grigor

Morning,

Just a quick couple of questions if that's okay

I've been on hormone injections and prostate tablets to reduce prostate size since end of december.

I've been doing diy projects and am finding my bones are aching especially knuckles, wrists and one shoulder which i hurt earlier and in the morning joints feel stiff. - Is this one of the normal side effects.

Also i am still finding i am getting up 3/4 times a night to pee like before i started the HT etc - Again Is this one of the normal side effects. ( Could it be to do with to much caffeine intake ?? )

Your help is much appreciated

Cheers

Grigor

Hi Grigor.

Unfortunately aching joints can be a side effect of the hormone treatment. Not everyone gets it but I did have it for the first six months or so of HT. It gradually wore off (or perhaps I just got used to it) after that and wasn't a problem in the last two years of HT.

Both caffeine and alcohol can be bladder stimulants so try cutting out both and see if it helps. I changed the way I take fluids during the day by drinking a lot in the morning, a little in the afternoon and nothing at all after 6pm. I stopped both caffeine and alcohol for nearly three years and now just take a little wine occasionally and coffee only in the morning. Now I rarely have to get up in the night for a pee and even then it's not until about 6am.

I hope that helps.

Afternoon Norfolkboy,

Hope your treatment is going well.

I had a further blood test yesterday and my PSA came back at 2.6 which is very reassuring.

I assume this means that the HT is doing its job and stopping the cancer growing ??

I am awaiting a surgical team meeting to discus surgery option once that has happens i will then have to make the choice of surgery or radiotherapy ( which is all a bit daunting )

Any input would be much appreciated

Cheers

Grigor

Hi Grigor,

Sorry I missed this when you posted. I'm concerned that you seem only to have had advice from the surgeon (who will almost invariably suggest surgery), and not from the oncologist/radiotherapist, who generally take a broader view.

As you say, if you opt for surgery, there is a significant risk of having all the problems of surgery and then need to have radiotherapy (which has problems of its own) on top.

Before you make a final decision, do look up the side effects of both modes, both short term and long term, and see which you would find easiest to live with.

Good Luck whatever you decide!

It's also well worth reading the 'toolkit' for general advice.