Wish I had really understood the impact of treatment on QoL

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Hi all, wishing you positive thoughts and Christmas cheer.

Been on 2ww pathway (see bio) for a few weeks. I have now received my results. PSA 13, PSAD 0.31, T2c, with high percentage of involvement. I was hoping going in that active surveillance would have been the primary option for me. This was met with a bit of resistance citing the PSA density, percentage involvement and size and location on the lesions seen on the MRI. 

Now there is no rush, but I seem to have a decision re surgery or RT+ADT. From an outcome perspective they are similar, but there does seem to be differences in QoL. I think I would prefer to focus on quality of life now rather than what might happen in 10 years. So active surveillance is still in my options. I do still quite like the idea of waiting to see if the cancer gets more aggressive before treatment. 

As the title states I would really like to get real life context of the impact of surgery or RT maybe a year or more after finishing the process. Regrets if any on the choices made.

  • Hi John and welcome 

    Just one thing to say here, if they're talking about large involvement and location then probably time for treatment as you don't want it to break through capsule edge.

    You should find out tumour (s) size in mm and how near to the capsule edge it actually is.

    Also if they are against AS , well another reason.

    Best wishes 

    Steve 

  • Hi  your readings are very similar to mine.  I went brachytherapy boost. Very little effect on QoL.  Check out my bio.  AW

  • Hi and welcome, though sorry you're here.

    4-5 years ago I was 72/73, not as fit as you (COPD) but active, cycling just about every day other than when on hols and over 5000 miles p.a.

    Higher Gleeson and PSA than you, probably because I'd delayed because of Covid.

    I didn't have much of a choice  -  surgery not on because of age and COPD, so none or EBRT + HT. My inclination was none but my relatively "new" gf seemed to want me alive so I went with treatment. 

    RT no particular problem -  cycled every day, if even slower! HT? Well, ED and very brief hot flushes. Once the HT ended, pretty much back to normal, just 2 1/2 years older!

    All an easy way to buy 4 years.

    Unfortunately mine recurred after 4 years and now restarting HT x 2 from a more difficult place. Your lower numbers increase your chance of avoiding such speedy recurrence I  THINK. 

    Obviously I can only speak for RT plus, but I think had I had the choice and  even if I had known the 4 year outcome, I would have gone with non-surgery. Gained the time at very little loss of QoL. 

    A hard call for you I'm sure. But as you'll obviously know, once you call it no point to "what if.....".

    Just good luck.

    Regards, Dave