RP or Radiotherapy or other

Evening Solar I’m like you just diagnosed a couple off weeks ago and I bet your heads all over the place like mine,luckily surgery was taking out off my hands due to Rheumatoid arthritis so will probly have RT -+ HT my score was 3+4 so not far of yours,it’s a dilemma and there’s plenty off experienced people on here who will give good advice but it’s ultimately up to you,the waiting to start iworse but you’ll get there

Hi Solar

Two important questions, what is the PSA, presume confined to the gland and not spread outside,?

I would take a step back, you're young and surgery can produce ED issues, obviously not always I have to say.

It feels like you're being pushed into treatment quickly for no obvious reason unless your answer to my original question is different to what I thought it would be.

Def take your time and look into RT which is a good non invasive option.

Also see what others say

Best wishes

Steve 

Hello Solar A warm welcome to the online Prostate Community.

You are between a rock and a hard place here. To give you the best advice we need your full diagnosis and even then it's a personal choice. I am going to guess with a Gleason 6 and the option of surgery it's not left the gland so you should have 3 options - not 1.

* Options - Surgery  / Brachytherapy  / Hormone Therapy and Radiotherapy.

You are young and should have the choice between the 3. All I can suggest at this point is you write a list of the pros and cons for each option and work out which is best for you in your personal circumstances. The guide from Prostate Cancer UK is very good - see the link below

https://shop.prostatecanceruk.org/our-publications/just-diagnosed/prostate-cancer-guide-if-you've-just-been-diagnosed

Apart from that ask questions on here. I can start you off - I have gone down the HT/RT route (no choice) and had issues on my journey but two years on I am good - you can read my journey by clicking on the icon of the beach.

Feel free to ask any questions you want - someone here will have "been there - done that" and you will get honest answers.

Best wishes - Brian.

Thanks Steve

PSA was originally 4.8 (3 years ago) then 3.5 and last month 4.5. Tumour I think is confined in gland but close to pushing through. If I go ahead with RP surgery will be only 1nerve sparring so ED more likely.

I've read about alternative treatments Focal Threat, Nano knife Hormone Treatment, Brachytherapy but appreciate alot of these are without sufficient data.

Feeling overwhelmed by the options/outcome.

But being cancer free is my first concern and I'm concerned by leaving it to long the cancer may worsen if it develops outside the gland.

Hi Solar

sorry to hear about your situation. However, now you have posted here and found us, you are no longer quite so alone.

Nobody, not even doctors, can tell you what to do! You have complete control of what he opens to your body. My best advice is to go to www.prostatecancer.uk and read all the relevant leaflets so you are as informed about treatment options open to you . Do as much research as you can so you can make an informed decision, in other words!

my husband is T3a N0M0. He opted for HT and RT. The radiotherapy was nowhere near as bad as we feared - just very tiring driving backwards and forwards to the hospital. The after effects carry on for some weeks after completion - mostly fatigue and brain fog. The HT has been more difficult and seems to get more difficult the longer we carry on - tiredness, night sweats, down days, loss of hair, weight gain - especially around the middle. His last 3 monthly injection is next month. ( I do think he has secretly fallen in love with the nurses who give the injections, though!!!!!)

he actively did not want surgery because:

1 he did not want an operation

2. he did not want to be incontinent

3. he was worried that the surgery could result in the cancer cells being scattered into surrounding tissue. (One tumour was bulging either against the prostate wall or had broken through - they were not sure)

4 he was 75 at the time so at a higher risk for surgery

hth and good luck!

Probably easiest way is to whittle it down to the main 2, surgery or RT which both have similar success rates, even Brachy is a good treatment.

Your stats are low but if tumour starting to push through suppose u do need to decide although looks like slow growing

Do much research and  go for the one where  you consider any side effects to be tolerable.

Steve 

Hi Solar,

2-3 weeks is very fast . You have a 6 Gleason score so you have a bit of elbow room. I would have a look at what else is available and discuss the pros and cons with your consultant. Maybe have a second opinion. There's other options, Radio Therapy, Brachytherapy and HIFU (High intensity focused ultrasound)? I'm not actually sure of all your choices as it's not my area of knowledge, but I do know there's more than one choice and that you don't have to rush . It's a decision that you want and need to feel comfortable with, rather than being rushed through because they can do it. Don't worry about saying you are not ready if you feel you are being pressured into a decision. It's your body. It may be that you do a bit of research, ask some questions and then decide with the original option of prostatectomy, but at least you will feel more positive about your choice after ruling out other things.

Try not to worry too much. You have a contained cancer that is probably very slow growing, 3+3 is inline with a cure. The main thing you need to look at here is what will be the best treatment to have for you and the possible outcomes. What position is the cancer, what side effects could result from each treatment :nerve damage/ urinary problems/ED. Once you found out about all these options then go ahead.

As for support there's plenty to be had here, hopefully more people will chip in and tell you about their treatment choices.

Best wishes L

Here's a little video for your research to go with the other links 

https://youtu.be/ryR6ieRoVFg?si=rsxoIor6rbiOQdAp

Hi Solar, have a read of my bio. I’m further advanced than you, with some aggressive features, but I’m still on a curative pathway. I had brachytherapy four weeks ago with virtually no side effects (apart from taking tamsulosin tablets to ease urine flow for 3 months). I need extra RT to mop up any escapees, but you may only need brachytherapy plus maybe 6 months of hormone therapy to weaken the cancer before & after the operation (brachytherapy kills cancer over some months - it’s not instant.).  Ask your consultant. If the NHS don’t do brachytherapy in your local hospital, you can be referred for the operation and then back to your local hospital for the follow up. AW

Thanks, that's a great help and sounds like you are making great progress

That is most helpful as Brachy was one of the option I wouldn't to find out more about, given as it's non invasive. I'm worried that surgery would leave to other issues( hernias) other than the expected ones

Have you had many side effects ?....Leakage, ED and dhow long did it leave you feeling like you were unable to work

I would imagine that the period between diagnosis and getting a treatment started if possibly the most confusing uncertain time, well at least this how it feels!

No side effects, as the Tamsulosin pills are dealing with any flow restriction, so all urinary and bowel functions are normal post brachytherapy. I did forget my tamsulosin pills one long weekend away and I noticed decreased flow, but once home and back on the pills I was fine again.  Up in the night twice (both non urgent, and both because I’m drinking lots of water to stay hydrated as instructed by the radiotherapy people). No leakage whatsoever and no urgency day or night. I’m retired, but I could have easily returned to work the day after the operation. My wife and I average 12km a day hiking to stay fit, and this recommenced immediately. Period between deciding for brachytherapy and the actual operation was easy as they put me on hormone therapy to shrink the cancer and prostate to reduce the target area! My prostate is currently only 17cc!! AW