EBRT without ADT

Hi WW

Looking at his stats I remember now unclear if gland just bulging or broken through.

If broken through would have thought HT needed.

My gland was bulging but not broken through, I didn't have any HT.

So think you need to check

Steve 

I managed to speak to someone today.  They said that it’s now classified as a T2 as it’s a bulge but the MDT meeting it was decided that it doesn’t seem to breaking through. But is a large tumour so they said that whether it’s broken through wouldn’t be confirmed unless it was removed.  The urologist wasn’t very helpful last week.  He told us that he doesn’t have PSA tests as he wouldn’t want to know.  I thought that was a very odd thing for a urologist surgeon to say, I’m still trying to understand his reasoning on that.  Once my husband told him that he didn’t really want the removal, he got very impatient and said the cancer is a war that needs to be fought with aggressive means and then closes his folder and ushered us out.  We are really hoping that the radiology department are less intimidating.  So, I’m assuming that, like you, he wouldn’t need the ADT or it would have been mentioned in the appointment after the MDT.   

Well good if now classed as T2.

Bit of a grey area I think , there are  arguments that with a large tumour very near the edge, I think U have mentioned a tumour over 20mm then HT would be a good idea.

Let's hope the RT department more helpful and can give some better advice than the surgeon 

Good luck

Steve 

Hello Worried Wife 78

my husband’s mri was inconclusive. They couldn’t determine whether the tumour was bulging against the capsule or had broken through. Biopsy of the suspicious area outside the prostate did not show any cancerous cells but he was still diagnosed as Gleason 4+3=7 T3a N0 M 0. I queried this and the oncologist said that they only have one shot at complete cure and that it’s safer and better to err on the side of caution and treat at the more serious grade. I questioned the fact that they had not found any cancerous cells outside the prostate. He said that not finding cancerous cells did not rule out the fact that the biopsy might have missed some rogue cells. We accepted his greater knowledge and experience and went along with his advice. There are research results that having RT and HT together improve the success rates.

that said, my husband was thoroughly miserable on the HT and really suffered with the side effects. He was ‘sentenced’ to 2 years of it but got to 18 months and hit rock bottom with all that was going on with the HT and other health problems. He was ‘ let out of jail free ‘ at this point as the oncologist stopped the HT immediately. It is not an easy treatment for some men to tolerate. ( but note, everybody reacts differently and everybody’s cancer seems to to be different and treatment is very much tailored to each individual - as it should be). 

Re the PSA - I have never understood why they say they can’t do universal PSA screening because it’s such an unreliable test but then place so much importance on it once it comes to treatment and monitoring.

I hope your oncologist is more sensitive to your needs for more and better information. Your prostate cancer specialist nurse might be more ready to talk with you both and explain the treatment options?

Please remember that all men are at different stages with this cancer and that all treatments are tailored by experts to what they think is the best plan for each patient. Also, please remember that you and your husband have a right to question and a right to complain. Each medical encounter is actually a meeting of experts. The doctors are the experts in the medicine but your husband is the supreme expertise of how is body is feeling and how his brain is reacting to all that is going on. Finally, knowledge is power! Do your homework and research the benefits and disbenefits of HT accompanying RT.

HTH

WW

I have always understood that PSA was for use after treatment to detect if  the treatment actually worked, that's what it was invented for.

It obviously changed some years ago when they started using PSA testing to find the cancer in the first place which I suppose a lot of the time it does work ok

Steve 

worried wife 78 said:

Once my husband told him that he didn’t really want the removal, he got very impatient and said the cancer is a war that needs to be fought with aggressive means and then closes his folder and ushered us out.

This looks like unprofessional behaviour. It seems like he was pressurising the consultation towards surgery. I feel confident that once you both speak to an oncologist, you will get a more balanced view.  AW

Hi Worriedwife 

Worriedwife said:

Re the PSA - I have never understood why they say they can’t do universal PSA screening because it’s such an unreliable test but then place so much importance on it once it comes to treatment and monitoring.

My understanding is that large screening using PSA is tricky.  Some men have a naturally high PSA but don’t have PCa.  Others have a low PSA but have PCa so where do you set the level to catch those with PCa but not over worry the ones who don’t?  Once a diagnosis is confirmed then the PSA is a very useful indicator measuring an individuals own change.  Does that help?