Is successful prostate cancer removal with CKD 3b possible without suffering acute kidney injury

Hello Crookysb0f429 

A warm welcome to our group - although I am so sorry to find you joining us. 

I can't give you a full answer to your question (as I still have most of my prostate - the NHS keep taking small bits) although I can understand where you are with this as I started my journey with an eGFR of 8 (now that's CKD!!).

My personal view (and I am 70) is:

* Prostate removal is major surgery with many possible side effects, urinary and sexual and takes some time to recover from. Do you want to go through this at 76?

* Your husband has 1 kidney - not 2. I know what CKD and a low eGFR feels like (click on my name or avatar for the full story). I would be doing anything that didn't involve risk to my remaining kidney.

You don't give your husband's PSA scores or TNM scores from any biopsy but these figures would help us to give a more educated answer.

Don't forger the above views are my personal views not Macmillan's and I am not medically trained - just my thoughts from the information given and what I know from my personal journey.

Happy to answer any further questions, and I hope this helps.

Best wishes - Brian.

Thank you for your comments. It's much appreciated. We will consider the situation carefully. We are also now checking out the various modes of radiotherapy. Still undecided and don't know what is the best journey to take. My husband's tmo is stage 3 and m0 and no. If I've got that right. He had a biopsy  he had 12 cores taken, 1/6 left had cancer in the anterior periphery  and  zero 0/6 in the right side. But His MRI PIRAD 3/4 indicates there could be more.  His bone scan is clear. His epe is also 0 and pin too. He also has 66cc prostate size because he already had a large benign prostate. His BP is thankfully under control. His latest PSA is 10.8, it was 9.2 a month ago. So it's increasing. Any further comments would be grateful appreciated. Especially if anyone has had CKD and robotic surgery. 

Hi Crooky, sorry to hear about your husband’s diagnoses. He certainly has had his fair share of health problems. 

my husband was 75 when diagnosed and we were advised then that having surgery was less advisable for those over 70 due to the risks involved - and he has 2 functioning kidneys!. My husband was Gleason 4+3 , T3a, N0 M0. We were told Gleason 4+3 is intermediate to high risk.  He was treated with the intention to cure with hormone therapy and radiotherapy. To really advise, as Brian ( Millibob ) says, can you provide more diagnostic detail as I have stated for my husband?

re chronic kidney disease. Before I retired ( quite some years ago now so probably I am giving out of date info) I worked on kidney hospital wards. There, the time people were considered to be needing to be prepared for dialysis was when the GFR was about 12-15. Your husband has some way to go but due consideration, I would think, ought to  be given to how to best preserve his one functioning kidney, obviously, and other age related risks of undergoing surgery. This might influence his medical team’s decisions about treatment. Then, too, there are side effects from both treatment pathways to consider.

If surgery is considered not appropriate, please don’t worry! There is little difference in cure and survival statistics for curable prostate cancer whether surgery or radiotherapy combined with hormone therapy is chosen. If the cancer is not considered curable or, indeed recurrence occurs ( possible after both treatment pathways) there is a whole armoury of treatments to manage and control the cancer.

I got myself into a terrible state of anxiety when we were going through all the tests etc. I hope you are ok yourself!

best of luck!

• Thank you for your comments. It's much appreciated. We will consider the situation carefully. We are also now checking out the various modes of radiotherapy. Still undecided and don't know what is the best journey to take. My husband's tmo is stage 3 and m0 and no. If I've got that right. He had a biopsy  he had 12 cores taken, 1/6 left had cancer in the anterior periphery  and  zero 0/6 in the right side. But His MRI PIRAD 3/4 indicates there could be more.  His bone scan is clear. His epe is also 0 and pin too. He also has 66cc prostate size because he already had a large benign prostate. His BP is thankfully under control. His latest PSA is 10.8, it was 9.2 a month ago. So it's increasing. Any further comments would be grateful appreciated. Especially if anyone has had CKD and robotic surgery da Vinci, which is being suggested, which is supposed to be better than open surgery. 

Hi Crooky

i found a lot of information about stages and different treatments at www.prostatecancer.uk They offer lots of different booklets etc. Being fully informed helps give some sense of control ( in what seems at times like a pretty uncontrollable situation)and also helps you come to the best decision for yourselves. Hopefully, too, somebody will come along and be able to give you more information about and their experiences of robotic surgery.

I am wondering if you have actually spoken with an oncology consultant ( for radiotherapy and hormone therapy) or an urology consultant ( for surgery)! We were directed straight to an oncologist. I queried the possibility of surgery and he said that he would happily arrange for us to speak with a urologist if we wished. 

it’s a big decision and we all want to be sure we are taking the best for ourselves ( I always say pc is a couple’s disease!)

I wish you all the best !

• Thank you for your comments and the link. We will check out the info.  We are seeing an oncologist on 18th Dec. We saw urologist 21st Nov who has put my husband on robotic surgery list for early Jan. But in the meantime I'm researching as much as possible in prep for our oncologist meeting. Yes I agree it's a couple's disease. I hope you are fairing well. 

Hi Crookysb0f429 the others have given you some great advice. I am 76 and personally unless surgery was the only possible option, would definitely not go down that route.  If RT and HT are options then that would be my route.  Feel free to come back with any questions and we will do our best.