I have been recently diagnosed with Gleeson of 3 + 4 and a cancer that has not spread beyond the prostate. I will soon have to choose between hormoen/radiotherapy and surgery. Any thoughts welcome.
I struggled to make a choice. Kept changing my mind but with looking at experiences and chatting to a few friends ( including ex nurses, not in the cancer field ) decided on surgery. I’m just over 5 weeks since my op. One thing I didn’t realise is that apparently it affects your hormones. I had hot flashes and a cancer nurse told me about the hormone change. I had quite a bit of pain in hospital and for a few weeks after but gets much less soon after. I’m wearing a pad at the moment. I use the Squeezy ( nhs ) app for my pelvic exercises. I’d definitely recommend using it.
I was diagnosed with a Gleeson of 4 + 3 nearly two years ago. I am 75 and above the age where they would normally offer surgery but am fit and healthy so went ahead with da Vinci keyhole surgery. Recovery from the op was very fast side effects included incontinence which improved quite quickly and was easily managed. One nerve was preserved so, after recovery, sexual function was similar to pre-op. 3 month PSA was close to zero so I thought, job done.
Six months after the op my PSA started edging up and continued to do so until it reached the point where further intervention was required. A scan did not show any spread so I was given 35 sessions of radiation directed at where my prostate used to be and put on hormones for six months.
I didn't feel any effects from the radiation until about three quarters of the way through when my bladder control was adversely affected. Anti-spasm medication fixed that quickly and I had no further issues.
With the hormones I get the occasional 'warm flush', nothing too dramatic, there is a tendency to put on fat round your middle or to develop 'moobs' but a bit of care with diet and exercise has meant these effects have not been an issue.
My treatment has been in France where sexual function is considered important so I have Edex injections which help to minimise any 'shrinkage'!
So, I have had a variety of treatments and have been fortunate that none of the side effects has been particularly intrusive. Despite my age I am fit and otherwise healthy which I am sure helps.
Surgery or radiation? Every case is different, the point has been made earlier that if surgery is not 100% effective, as was my case, you have radiation as a back up. There is no fixed answer, it is whatever you and your medical team feel is best for you.
I am 74 and was diagnosed in January Gleeson (5+4), locally advanced. Surgery not an option so Hormone treatment for 2 years and now waiting for a date for EBRT. Side effects of HT not too bad- sex is now off the menu, hot flushes most evenings but they don't really bother me. No increase in weight but it has somewhat redistributed itself around my middle! I try to take lots of exercise (8-10,000 steps a day) which I think has been a great help. Also I was getting lots of pains before it started in the perineum & abdomen. These have now totally gone and my PSA has gone down from 13 to 0.3.
Don't you just love it. I was diagnosed exactly 1 year ago (Gleason 7 (3+4) Intermediate Risk). Also I was unsuitable for surgery, I was initially on Hormone tablets for a month, then a 6 monthly injection. Told I could be on the Hormones for 3 years.
After a month of VMAT Radiation in October, it was the fatigue that hit me the hardest. I wanted to stay in work all the way through my treatment (best way to keep my mind from wandering). It ended up taking well over 30 minutes to walk the 7 minute walk to work. I wasn't going to give in though.
My Prostate was squeezing my bladder so my pee was down to a trickle. So annoying when you sit there and not much comes out.
Anyway, like yourself, I didn't put weight on, but my waist expanded. Sex was off the menu, on the bright side, my libido had vanished so I never thought about it. Talk about every cloud having a silver lining...
Last Hormone Injection was Christmas Eve, Oncologist told me 15th February I was in Biochemical Remission, and as long as my PSA levels can stay between 0 and 2, I wouldn't need any further treatment. Woo-Hoo!! Last reading was 0.09
So I ended up only being on the Hormones for a year. There's that cloud again.
My Testosterone machine however, that could be a year until that is working properly again.
I to have a Gleason of 3+4, PSA of 8 and T2 stage, 59 YO.
I have some appointments in the next couple of week with the surgeon and oncologist. Like others I am unsure which path will give the best outcome. Lots of reading and YouTube videos which on one had is great to have the information but is not making the decision any more clear cut.
I have a very active outdoor lifestyle and I think maintaining that as much as possible is likely to be the driver for therapy choice.
I feel the hospital are pushing towards LDR Brachy - anyone got any experience of the treatment and side affects?
After a bit of dithering-I have gone the route of radical prosectomy. Three reasons. First, I had more confidence in the surgeon than the oncologist. Secondly, because although invasive, you know it's gone for good and that will be the end of treatment.. Finally, i spoke to various people who had gone the surgery route and everyone was satisfied with it. I dad have to go through a lot of hoops because there was concern about spread but fortunately everything ok. Good luck with your decision making.
I had an initial Gleeson 3 + 4 and T3a. I also had a MRI and a whole body bone scan that came back normal. I was offered radiotherapy or surgery. I knew of two friends who had both had surgery with good results. I elected for surgery with encouragement from my wife to try to get the cancer removed in one go. I had an open radical prostectomy since the robotic was not available in my county and I didn't want to start the decision making process at another hospital. In the end I paid to have the operation 2 weeks after speaking on the phone to the surgeon rather than waiting 6 plus months for the same surgeon on the NHS. I believe I was extremely fortunate in having a very experienced surgeon who also did a bilateral hernia repair at the same time. Ten weeks later I am continent and feel back to normal apart from ED which hopefully will improve with time. Histology of the prostate showed a Gleeson 4 + 5 but T2c. My PSA has fallen to unmeasurable at less than 0.01.
Glad your surgery went well. Sorry you had to end up having to go private, then getting the same surgeon you would have had on the NHS.
Did you get any Viagra prescribed after the surgery? I know that at the Freeman Hospital in Newcastle you get Viagra prescribed after surgery, for circulation purposes. Don't think they give you many but they are supposed to help get the blood flowing through again.
I had Hormones and Radiotherapy, unable to have the surgery for medical reasons. Some 8 months after the Radiation treatment ended I still have ED. If it comes back, Woo-Hoo!!, And if not, so be it. If I can still be in Remission it will be worth it.
The price I might have to pay.
Even though you went private I bet you are happy at the outcome.
