Active Surveillance or treatment?

Hello A12 

A warm welcome to the Macmillan Online Community - although I am so sorry to find you joining us. I don't personally think you are overreacting.

Yes, you do have time on your hands - low PSA - low Gleason 7 (3+4 and not 4+3) and I agree with you it needs sorting as it's not going away. People who know me know I am not a fan of AS!

You have all the treatment routes open to you  - surgery to remove, radiotherapy or brachytherapy.

You have time to consider all 3 options - their possible side effects and possible lasting effects. My suggestion to you is grab a pen and paper (or laptop and spreadsheet) and research each option using trusted sources, Prostate Cancer UK. Cancer research UK and Macmillan (not Dr Google or AI) and list the side effects / after effects as they would affect you and any partner. I will set you off with three links to our information:

Prostatectomy-for-prostate-cancer.

Radiotherapy-for-prostate-cancer.

Brachytherapy-for-prostate-cancer.

My personal thoughts (Not Macmillan's) are in your case surgery is like taking a hammer to crack an egg and brachytherapy may not be offered in every NHS trust but it's an option and you can ask for it.

I hope the above helps to start your research off. i am more than happy to answer any questions.

If you click on members names or avatars some of us have recorded our journey and this can also give you more details into the treatment they have had.

Best wishes - Brian.

Welcome to this forum. I am both sorry and glad to see you here.

No, you are not overreacting, because reactions are very personal.

I have become an advocate for being an "expert patient" when dealing with this illness. 

My options were rather less than yours, because my cancer was more advanced. I am on hormone therapy and have had radiotherapy. The treatment is intended to be curative.

If I were in your position I would carefully research the treatments available. Take note of the side effects but don't take them too much into account - no one get's all of them. It is quite likely that one of them will begin to surface.

Once you have done that you will be able to have a good chat with with the MacMillan Nurses on 0808 808 00 00 who will be able to offer additional guidance.

Take your time. You have that, and it is much better to take the time to choose the right treatment.

For information, I have had/am having radiotherapy and hormone therapy. I do have side effects, and none of them have stopped me enjoying my life.

Keep looking forward, because you can.

Brian - thank you. I’ll take a look at those information sources. Much appreciated. A12

Steve - thank you. I will research all the options and then speak to the MacMillan nurses. Wishing you all the best. A12

Hi A12

Possibly hang on for a while just to see if it does grow, sometimes it doesn't or minimally.

I had similar stats to you low PSA and Gleeson, tumour size started st 3mm

Active surveillance for 4 years until tumour grew to 13mm

not that I am saying yours is going to increase or at the same rate.

Only thing about surgery is u can have long lasting side effects, obviously not everyone does though.

I would say give it some time, as long as you have 3-6 months PSA tests and yearly MRI to monitor.

I should add thats just my opinion, doesn't mean it's right.

Al the best 

Steve 

Hi A12

I would say you are in a good place, its spotted, your in th system and at this stage you have choices. Don’t panic (easy to say) do your research and take ownership of your journey. 

This forum was brilliant for me providing reliable information and support. 

I went the operation route, and i used my profile as a diary if you would like to read about my experiences. I am almost 2 years post prostatectomy.

All the best,

Psticks. 

Its natural to have this sort of reaction to the word cancer but do your research on prostate cancer specifically as it has many important characteristics you need to be aware of.

I think its comes down to this. If you choose immediate treatment you may be left with permanent side effects for the rest of your life. These can be life changing such as incontinence or sexual dysfunction.

You need to weigh this up against a possible cure for a condition which may never progress further in your lifetime and justify radical treatment.

This is the reason PSA screening was not introduced by the NHS as it leads to many men getting overtreated for essentially benign conditions and left with life changing side effects. Many men hear the work cancer, panic and rush into a radical treatment.

Obviously you need to be guided by your healthcare professionals on the risks and benefits of each pathway but as you say you have time on your side so make the most of it to inform your decision.

My two bits worth !

Rob (Sandberg)

Rob - thank you. I agree that there’s a lot to think about. I’ll take my time. Wishing you all the best. A12

Psticks - thank you. I’ll take a look at your diary. Wishing you all the best. A12

If the best treatment is to wait. That’s the best possible outcome in my view.  You haven’t mentioned two key indicators that could affect the decision. What is percentage of patten 4 and what the PSA density? 

But if they low then why wound you prefer to put yourself through unnecessary treatment. This is something you should fully explore with your medical team.