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LH telephone appointment brought foreard

Dogs4me
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Sorry but after all my ramblings about LH's MRI discussion appointment being by phone and in a week's time, the hospital have phoned again and brought it forward. It is now on Monday at 7.40pm! It is now with a urology surgeon.

I am now worried why they have brought it forward. There is no pleasing some people is there .....Face palm‍♀️

  • If a call has been scheduled with a surgeon then this indicates that LH has a cancer which is on the curative intent pathway. A surgeon will advocate surgery, an oncologist Hormone Therapy with radiotherapy of some kind. Do not be pushed into making a decision as you do not have enough information at the moment to make an informed decision, in particular whether there are any aggressive features which can influence long term outcomes. Gather the information they give you and ask for copies of the MRI and bone scans. What type of surgery is being offered and is it Retzius sparing. Is it nerve sparing. Who would do the surgery and what is their experience with prostate cancer. Without the Gleason score you are flying blind. There is a very good video explaining surgery Vs radiotherapy which might help.

    https://youtu.be/ryR6ieRoVFg?si=bQkzsed7u6-4IQLZ

  • in reply to Alwayshope

    Thank you. I cannot understand why he would be offered anything yet without having done a biopsy..... it all seems weird. Monday will be a long day waiting until 7.40! 

    Thank you again for your help and I have taken note of the points you have made

  • in reply to Dogs4me

    This summarises my thoughts and I would want to know why a biopsy hasn't been done.

    No, a radical prostatectomy should not be offered without knowing the Gleason score. The Gleason score is a crucial factor in determining the aggressiveness and stage of prostate cancer, which directly influences treatment decisions, including whether surgery is the most appropriate course of action. 
    Elaboration:
    • Gleason Score and Risk Stratification:
      The Gleason score, along with PSA levels and clinical stage, helps doctors categorize prostate cancer into risk groups (very low, low, intermediate, high, and very high). These risk groups are used to determine the most suitable treatment approach. 
    • Treatment Decisions:
      • Low-risk prostate cancer: Often, active surveillance (monitoring the cancer with regular check-ups) is recommended for low-risk cases, especially in older men with slower-growing tumors. 
      • Intermediate and high-risk cancers: These may warrant more aggressive treatments like surgery, radiation therapy, or other options. 
      • Gleason score and surgery: A prostatectomy is a major surgery with potential side effects. If the Gleason score indicates a slow-growing, low-risk cancer, surgery might not be the best initial option. Conversely, a high Gleason score might indicate a more aggressive cancer, potentially making surgery a more appropriate choice. 
    • Importance of Staging:
      The Gleason score is a critical part of the staging process, which helps determine how far the cancer has spread (locally, regionally, or distantly). Staging, along with Gleason score and PSA levels, guides treatment decisions. 
    • Individualized Treatment:
      Prostate cancer treatment is highly individualized. The Gleason score is just one piece of the puzzle. Other factors, such as the patient's age, overall health, and preferences, also play a role in determining the best course of action. 

  • Hi  , it doesn’t make any sense to me.  Until you have a diagnosis you can’t decide.  PCa grows slowly so there is absolutely no panic.  Best wishes, David

    Best wishes, David

    Please remember that I am not medically trained and the above are my personal views.

  • in reply to Alwayshope

    Thank you. If the biopsy is not mentioned on Monday I will certainly ask! 

  • in reply to David2017

    I don't understand either David. It has all been very odd ....

  • On the plus side by this time on Monday u should know a lot more.

    I always think MRI the most important bit to know

    cos it tells u about tumour size and if contained or broken through.

    Good luck 

    Steve 

  • in reply to Grundo

    Thank you Steve. I will be like a cat on hot bricks all day Monday. I wish it was a morning not an evening call ....

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