Today's meeting with surgeon before prostatectomy

It’s a really tough decision to have to make, I’m afraid. The medics are duty bound to tell you about all risks and possibilities. My husband decided immediately that he didn’t want surgery but then we had to hear about all the risks and side effects of radiotherapy and horm9ne therapy! That has scared me silly so I think I can identify with your fears. Really, the only person who can make that decision is your husband but I am sure he will listen to your concerns too.  Incidentally, there is no guarantee of no further treatment being the case with either treatment, I think?

Hi Woolly 

Had a look at bio, stats quite low really. You say tumour large, do u know size in mm.

He's probably just warning you but hopefully RT won't be needed.

In answer to your question, yes cancer can return after surgery and yes RT can still potentially provide a cure .

Hope this helps and good luck with the surgery

All the best 

Steve 

Bear in mind surgeons will tend to set out worst case scenarios. My advice would be worry only when you need to worry.

I believe the likelihood of a biochemical recurrence is as high as 30%. But that means in 70% there is no requirement for a follow up treatment.

Stay positive - the news so far has been mostly pretty encouraging.

Thank you for your reply. He’s still intending to go for surgery as this was something he had already decided on. Our decision was based on our last consultation when we were told that you could have radiation following surgery if needed, but rarely the other way round.
I think the thing that worried us both a bit today was that the surgeon pointing out to us that possibly the op alone may not be the curative option we had previously been feeling confident it would be. 
I realise there are no guarantees but  maybe we had been rather naively overly positive and optimistic! I think this was just the first point where there was doubt on the success of treatment mentioned . What a rollercoaster this horrible business is! 
I wish you and your husband all the best on your journey too x

Thank you for your kind reply Steve. 
I think the surgeon was more pointing out that whilst the biopsy revealed that most of the cancer found was low grade (and some intermediate)) - there was a lot of it! Namely the fact that it was found in 23/24 samples taken. He also said that his initial PSA of 19 was far too high. (The lesion found in the MRI was 16mm but the prostate itself was average size.) I think we had been feeling fairly confident that surgery would provide a complete cure until this point,  as there were no visible indications that  it had spread. It was the first time a suggestion that it could possibly not be the case we had heard.
I know there are no guarantees with this horrible disease - but it was probably the first negative possibility we had heard since the initial horrible shock of diagnosis.  
I’m sure once we’ve got our heads round it - we can regroup with the positivity tomorrow. It was just a bit of an unpleasant realisation today.  

Thank you so much for you kind reply. I know you’re right, it’s just such a horrible ride to be on isn’t it. X

Hi Woolly

Your stats are similar to mine before I started RT in 2017,

My tumour size was 17mm and PSA 13.

Also my tumour was pressing on the tumour edge.

That's the important thing really, if the tumour is contained within the gland then surgery should be ok without the RT although with PC nothing is for sure.

All the best 

Steve 

Hi Wooly, i decided to go for surgery straight away so that if more treatment was required, then i could have RT. Another reason was that if i had RT first, then surgery wasn't an option afterwards as RT causes too much scar tissue which makes surgery difficult. Good luck with everything, we're all here for you

Hi Woolly,

I think your stats indicate a similar situation to me. My psa was 16, biopsy revealed cancer in 6 of 7 zones (22 cores). My oncologist said brachytherapy not an option due to large volume and position of the positive cores. I opted for surgery, keeping RT in reserve if required. 

I took the better out than in approach. 

Got all the usual counselling about incontinence, impotence, stroke etc, etc.
My robotic prostatectomy was last September and it’s gone well so far. Psa dropped to less than 0.05 after the op, and have just done first of quarterly reviews, and no change in psa.

Bladder leakage has not been a problem, from the day the catheter came out. Did the squeezy excersises before the op and after. They really do help. 

A recurrence of cancer is always a risk, and post op biopsy of the removed prostate did not give me the comfort of negative margins, even though prior op MRI and PET scans had indicated no spread outside the prostate. My surgeon is optimistic that he got all the cancer, but regular psa tests will check. I can but hope and remain optimistic. If needed, I guess hormones and RT will be required  

My only unresolved issue is ED. An understanding  partner means this is not an issue for us, and I haven’t resorted to medication, but I think that could resolve this in due course.

Whichever option you go for, good luck.

Hi I decided to go for surgery as I was told it was the best option due to my age 74. Also no external signs of cancer.

The op was successful and my post op PSA is 0.02. However my main problem post surgery was soreness in my abdomen which is still causing me discomfort 6 weeks after surgery. Also incontinence is a big problem and I was doing the exercises 4 times a day before surgery and after. Unfortunately my incontinence does not seem to be improving, but everyone is different