Prostate surgeon

Hi Admiral 

If on the edge of invasive, presume he means on capsule edge , then probably better off starting treatment either surgery or RT, once it breaks through it does get more difficult.

Just my opinion and see what others say

All the best

Steve 

Hello Admiral 

So, first off, a surgeon will always advise surgery - it's his job. Plus if the cancer is near to the edge of the gland by the time you get to surgery it may well of escaped, in which case even after surgery you will require further treatment.

Oh and yes, the NHS DO guided surgery - so the surgeon sounds like he's after your money!!

I strongly suggest you ask to see the ONCOLOGY department in your local NHS Trust and ask them what treatments they advise.

I hope this helps - please come back to me if you need any further details or information.

Best wishes - Brian.

Thank you 

Hi Admiral. I remember that Radiotherapy is not an option for you because of previous treatment but I am wondering if you could be eligible for some form of focal therapy although this might be difficult if the lesion is close to the capsule edge. You need to see an oncologist in order to get a balanced view of what might be available to you now.

With regards to what you have been told about private Vs NHS surgeons and their expertise - B******s. What is important is checking that the hospital you would be referred to does DaVinci robotic surgery, and preferably Retzius sparing, but more importantly how experienced is the surgeon at this technique. Also, neither an NHS surgeon, nor a private surgeon can guarantee that you will not experience ED. Yes, younger men do recover better than older men but this is usually because they are more sexually active and fitter so their equipment has a better starting point compared to an older person.

Thank you 

Working only on your note above, I understand that you have 3 possibilities:

1. Active surveillance
2. Radical Prostatectomy - surgery.
3. Radiotherapy and Hormone Therapy.

Of course, the side effect of active surveillance is mainly anxiety, and involves you in developing a clear understanding of how you will act if things change.

BOTH the other two offer some quite serious side effects. However, it is unlikely that you will get them all, whichever option is chosen.

Because my cancer had got just outside the gland, I only had access to the third option, which was 6 months of hormone therapy leading up to radiotherapy, with the hormone continuing for an overall total of 3 years.

I have been pleased with my experience so far in terms of radiotherapy. I have two friends who had surgery. One had a good experience, the other rather less so.

You have time to do some serious thinking.

See this link - https://issuu.com/magazineproduction/docs/js_prostate_cancer_guide_for_patients_ezine - often ued in these parts. It gives a good overview.

After this, you can ask us all specific questions which are likely to get you straight answers (sometimes very straight) that might be of more help.

Thank you

Hello Admiral,

I would be tempted to take this "advice" with a hefty dose of salt. Generally, going private gets you better food/accommodation - it does not get you better medical treatment. I have had a couple of private operations, both were done late afternoon/early evening - probably because the surgeon had been working all day in a local NHS hospital ! (Wonderful turkey & cranberry sandwiches afterwards when I got hungry !!)  Going private does usually speed things up - but, despite all it faults, the NHS doesn't hang about with cancers. Also, prostate usually is not a particularly fast growing cancer and can be slowed dramatically by drugs until a treatment decision is made. If your local NHS hospital doesn't offer what you want - ask where you can go, that does. 

Millibob said:

and yes, the NHS DO guided surgery - so the surgeon sounds like he's after your money!!

I quite agree.  Surgeon should not be touting for business by playing on fears at a vulnerable stage of diagnosis (or any stage for that matter).   AW