Results Day

Thank you. To be honest, I only know that he is Gleason 9 (4+5) - I need to find out his TNM & initial PSA reading. I think in the blur of it al, we somehow have not made a written note of these key things. I will add his full background to my bio once I have found out.

I wondered if someone could tell me please - if HT or radiotherapy will kill the cancer that has spread to the lymph nodes? Alwayshope I would really like to understand your experience with this? I read through your bio but this is all so new and I guess I just don't understand why they can't remove the lymph nodes. They told my dad it has only spread to a couple.

I think I am still in the denial phase and I can't or won't accept that there isn't a cure for prostate cancer that has spread. It seems so cruel. 

Hi Perry 

Yes, HT and RT can potentially get rid of the cancer  in the nearby nodes but you wouldn't normally remove them because once in the nodes surgery to remove the prostate gland not normally carried out, more chance of success with HT and RT.

It looks like u don't have a TNM score , I presume that they have told u in the nearby nodes?

Regards 

Steve 

 Perry1919  Once cancer has gotten out of the prostate, there is typically no more talk about removal (through surgery). 

HT and/or RT can treat cancer that has spread to the lymph nodes though I would not use the words "kill cancer".

Modern RadioTherapy is more powerful and will usually prevent cancer from coming back to the irridiated spot but that does not mean there are already small spots elsewhere since it can take 8 years before a metastatic lesion becomes visible on scans. 

That is why HT is used. Rather than attacking cancer is a single spot, it is a systemic approach to weakening the prostate cancer cells by cutting them off one of their fuels. In some lucky cases, the cancer will be weakened enough for the immune system to keep it under control while for others it will come back once HT is stopped, or it can even mutate into something that grows despite HT, which is when they start to call it "castration resistant". 

Things may seems bleak and that is a normal reaction. But many here and elsewhere have lived 20+ years with the disease so do not lose hope.

Hi Steve,

Yes, all I know is that it's the nearby nodes only. We asked them how many nodes and they didn't really give a definite answer but there are at least a few.

Perry

Thank you for the concise overview. I appreciate it.

Thanks for your optimism and encouraging words. We all should be like you in choosing such words that enhance patients moral and trust and brighten their treatment journey road.

a very famous and repeated phrase I always heard is that regardless of number of prostate cancer patients, many of them die from other causes than cancer itself. They live with it but they usually don't die of it.

Hi Desertfalcon 

It's "98% of Prostate Cancer patients die WITH IT not OF IT".

Best wishes and thanks for reminding me - Brian.

Hello it is certainly a very scary place to be when you hear those words"not curable but treatable" my hubby was diagnosed in April 23 with a PSA if 59.9 and I thought the bottom had dropped out if my world. I pushed the oncologist for how long we had and although he wouldn't give a time he said it is treatable for many years so I took that has a positive.you might find it helpful to read our journey by clicking on my profile 

Hi Perry1919 .

There are occasions when the lymph nodes are removed as part of the surgery to remove the prostate. This is usually when the cancer is confined to the prostate but there might be some risk of it being near the edge of the capsule or if the patient has some high risk factors such as a high initial PSA or Gleason score. How many lymph nodes are removed depends on what the surgeon finds and the risks to the patient increase with the greater the number because of the time they are on the table, plus there are potentially more side effects. If there is lymph node involvement initially then a radical approach would probably be taken to remove all of the lymph nodes in the pelvis and even then there is a greater probability that you would have to have RT further down the line because the surgery cannot guarantee removing all the cancer cells which might seed to other parts of the body or the prostate bed. Think of the lymph system as a superhighway with many branches through which the cancer cells can spread - if cancer is found in one node then the surgeon would remove the whole branch. The more branches that are removed then there is a higher chance of a lymphocele or lymphodoema in the pelvis or legs. The radiotherapy works more systemically over a period of time along with the HT which disrupts the multiplication of the cancer cells and weakens them.

In my husband's case he had radiotherapy to the whole of the prostate area including the lymph nodes back in 2020 and so far there has been no sign of a recurrence in this area. At his initial diagnosis he also had spread to distant lymph nodes plus a met behind the pancreas. HT initially kept these under control but the cancer became resistant to the treatment so he was offered a very targeted form of radiotherapy to try and deal with them. We know this is probably only a temporary measure but it is giving us more quality time together.

Your dad's medical team will take into account all of the scans, biopsy, his health plus his preferences and come up with a plan or give options for treatment. Having lymph node involvement means that he will probably have a diagnosis of locally advanced prostate cancer and I have attached an information sheet for you on this which gives you an idea of treatment options. I have also attached an information sheet on how prostate cancer is graded.

https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/what-do-my-test-results-mean

https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/locally-advanced-prostate-cancer