Prostate Cancer Treatments-your choices and in retrospect would you do anything differently.

I have localized pc with a Gleason score of 9 (4+5) diagnosed back in 2020. The treatment I was offered was radiotherapy or hormone injections. I opted for hormone injections every 12 weeks, and luckily the only side effects were extra fat around the waist, (I had to buy larger size trousers!) and small increase to breasts. This for me was more acceptable than possible side effects from radiotherapy and so far it is working well keeping my psa down to just below 1. Everyone is different of course and you have to make your own choice. Hope this helps, and good luck with whatever treatment you choose!

Thank you, Bas, I really appreciate your response!

Hi Tatami53

I have to admit, I’m not in the lower bracket my scores are all very high, I’ve thought about stopping all treatment as I’m 70 now, and been fighting for over six years, the medication is wearing me down especially in this hot weather. But why should I give up I want to fight for my wife and family, besides there’s a cure waiting for me someday.

living in Japan must be hard for someone with PC, do they have NHS ? I’m certain every oncologist has different opinions on how to treat you, making a decision is hard, but with a lot of reading and advice hopefully from others here, you may come to a conclusion on which way to go.

Stay safe

Joe

Thank you kind sir! Yes, keep fighting! I admire you greatly. Of course you want to fight for your wife and family. I'm sure they love you and want you around. 

I don't think it's hard in Japan for someone with PC. I live in Tokyo, which is a metropolis, and the Japanese are very health conscious. That said, all the treatments and procedures that may be offered elsewhere may not necessarily be offered here. 

Yes, they have an excellent National Health Service (or National Health Insurance). I can see the top doctors (and have), as most of them speak some English. There are caps on most procedures, and my yearly premium, now that I'm older and not working as much is really wonderfully affordable. (Had I stayed in the US, I'd probably be bankrupt by now, their whole insurance system is insane.) 

Yes, I'm doing a lot of reading and studying. In fact, the junior urologist gave me two documents regarding surgery and brachytherapy in Japanese, and using Google Translate, I translated both of them and brought them back to him and said, "The next time you have a foreign patient here, give them these documents in English. They will thank you." He was shocked and grateful. 

If you've been fighting it for six years, then hats off to you. You must be doing something right. But when you say "medication," may I ask what that is? You certainly wouldn't be on hormones six years in, would you? 

Meanwhile stay well. Yes, the heat has not helped at all, that's for sure. Thank you!

Hi

At first I went through six cycles of chemotherapy with hormone therapy then twenty sessions of external radiotherapy, now I’m on enzalutamide and have been for over two years, I’ve been on prostap 3 monthly injections that’s for life. I take a few supplements and medication for a few other things that’s going on, I swear sometimes you can hear me rattle.

Well they may do things differently, but they will have your health as a top priority.

Stay safe

Joe

Thank you sir, for all your input. Please stay well. 

Dee,

What treatment do they recommend in your case?

With everyone reacting differently, it's a hard choice to make.

My local hospital have stopped doing Branchytherapy.  I know that I was happy with the Hormones and VMAT Radiation, side effects yeah, but being in Remission now makes it all worth it.

Yes I still have ED and Hot Flushes, but hopefully they won't last forever.  No more Hormone Injections while I am in Remission so that should help.

No doubt you will make a good decision based on all of your research.  Hope everyone's advice from this forum has been a help.

Best of luck.

Steve, hello and thank you. 

They basically laid out surgery, brachytherapy and hormone therapy, possibly EBRT as well. But they did not strongly suggest one over the other, except the senior urologist said EBRT could affect the bladder and rectum.

I saw another top urologist yesterday who said to do the surgery. If indeed any cancer cells remained after doing the surgery, he said radiation would be easier than trying to do radiation, then surgery. 

As I listened to him, for the first time, surgery started to make sense. 

I am going to spend today researching and tomorrow I will have to try to make a decision. It's the biggest one I've ever had to make. 

Thank you for your advice and support.