Confused on treatment plan

Hello Finders2dab77 

An interesting post and I have just read your journey twice - remember I am not medically trained but my thoughts are:

* The surgeon has no idea of your prognosis and it's a guess!

* I am a T3a (T3aM0N0 Gleason 9 (5+4)) - I am on a "curative pathway" even with various setbacks. That might change at some point but at the moment all is good.

* Your TRUE diagnosis with staging and up to date Gleason score will be 6 to 8 weeks after surgery when they have your prostate on the laboratory bench under a microscope. They will also be able to tell you if they have clear margins. As my good friend Alpine Wanderer says "Histology is King".

I would put off planning for the future until you know more after the surgery - how well you recover and what the histology says and if any future treatment is required. Also how you feel after the surgery.

I may not be helping you with this post BUT it's my honest opinion given the circumstances.

If you have any further questions I am happy to give you my opinion.

Best wishes - Brian.

Thanks Millibob

This was my thought as well but wife has other ideas…. My thoughts are have get the surgery out of the way , which is scaring me to pieces but I know it’s the best if action, recover then review the situation. 

Hello Finders2dab77 

I was never offered surgery for a couple of reasons BUT if the offer had been on the table I would have refused it - I am a wimp when it comes to surgery, and I wouldn't fancy the chances of incontinence or permanent ED.

I assume that Hormone Therapy/Radiotherapy was ruled out dure to you having colitis and the proximity of the rectum and intestine to the prostate.

Now in my simple medical mind I would be checking with the radiologists if

* They use either IGRT or LINAC machines or is there somewhere I could have radiotherapy using one of these machines. They are new, accurate and laser guided to hit the target and nothing else.

* Can I have an injection called "Spaceoar"? You can have this done privately if the NHS won't fund it - it protects the rectum during prostate radiotherapy.

Radiotherapy to me is the answer and much less invasive - what are your wife's thoughts (if they are printable!)

Just my thoughts.

Best wishes - Brian.

Hi Brian.

wife was originally RT as she knows I will/am scared of the operation. However, prostate out cancer out with a 40-50% chance of a cure I am being told. RT issue is as you said my colitis and it wilcreate scaring on the bowel wall which may result in a colostomy bag down the road which I don’t want as I have just turned 59. Being told I am yoing as well so recovery will be far better. If I was 69 they would be treating me with HT etc.

Paul 

Hello Paul (Finders2dab77) 

I wish you well with your treatment plan - do please let us know how you get on.

Finders2dab77 said:

prostate out cancer out with a 40-50% chance of a cure I am being told

I would love to see the evidence behind this statement - but I honestly wish you all the best and do hope it works for you. Keep up those pelvic floor exercises!!

Best wishes - Brian.

Hello Finders2dab77

I had the option of surgery v HT&RT. I weighed up best I could the pros and cons of each and possible and likely side effects and elected to have surgery.

Unfortunately the surgery was not fully successful as the cancer had spread to the prostate bed, and had not been established in the tests leading up to the decision. The surgery itself was okay, very straight forward but I under estimated the recovery time. I had never been in hospital before but felt very assured through discussion with the surgeon and specialist nurses.

The challenge I then faced was to select HT&RT in order to remove the remaining cancer, the very treatment i had turned down previously.

Again it was a positive decision as the circumstances were different, and certainly the guidance on this forum relating to RT was an asset. 

I share this as I do not believe its possible to say one is better than the other even based on the medical diagnosis as it depends so much on the persons appetite for risk, other health issues and of course lifestyle choices.

I do believe there is a positive decision to be made on either treatment plan and get behind it and believe in it as a good decision and address any new arisings therafter.

Best wishes on which ever route you take

Alistair 

Thanks Alister.

operation is my best option I am being told both by the surgeon and radiotherapist due to my colitis. Surgeon is saying incurable but have “many years” radiotherapist is saying 40% chance of cure , surgery your best option with back ups for after wards you needed. She also informed me that i was grade T2C now as. The tumour has shrunk back inside 98cl down to 42cl. So surgeon has margins to play with, scared for the operation but I think it is my best option.

Hi.     Firstly im not advocating surgery but thought I would chip in as I had surgery in Aug 2025 and am glad I did I      After surgery post op histology it was found I had bladder neck invasion which wouldn’t have been picked up without surgery. The   thought  of the surgery was far worse than what I encountered.       I had negative margins post op and had 2 undectable psa since.     Just had blood test today so it’s another waiting game.    Any questions about surgery I’ll try and help if possible.       You will get through it.     Best wishes.  Simon 

Hi Simon 

thanks for the reply. Can I ask if you were keyhole or open surgery please. I’m going to be open surgery due to my colitis , he wants to avoid my bowel and intestines. I was first diagnosed as a T3A with PSA at 83. HT has worked its magic so PSA now 13 and tumour reduced from 98cl to 42cl. 

Hi.   I had a ralp surgery