Just Diagnosed,Confused

Hello Pittster,

A warm welcome to the prostate forum, although I'm very sorry you have the need to join.

From what you say all treatments are indeed available but the MDT are suggesting active surveillance? If that's the case then yes, I'd expect you have the option to decline AS and go for surgery or radiotherapy.

You should have time on your side to consider carefully the treatment you elect to have and should obtain further information on procedures and side effects before deciding. Prior to having initial treatment I was able to discuss with an oncologist (for RT/HT) and a surgeon (for surgery) before deciding. 

All the best, Derek.

Hello Pittster 

Another warm welcome to the group from me. Brilliant answer from Derek excavator  above.

Pittster said:

I will be seeing the Surgical Consultant next week

Don't forget surgery is his bread and butter. You also need to meet an oncologist too.

Pittster said:

Tumor up against prostate edge,not sure of capsule breach

This indeed is important.

It's your body you can go for any treatment open to you - you need to ensure you are given all the options open.

Meet the surgeon - meet the oncologist - gather all the facts and then decide - we are here if you need any help.

Best wishes - Brian.

Thank you for the reply,all a bit overwhelming at the moment,will not rush into anything till iv,e heard from the specialists,just wondered if the biopsy may have missed or grazed edge of tumor to give lower grade as PSA is moderate,and the pirads 4,and the non comittal T2C/T3A from the info i was given,i hope things will be made clearer after consultant appointment.

Hi Pittster, your question about the biopsy potentially missing cancer cells outside of the prostate is very valid., My husband had a similar result in that it was uncertain whether the tumour was making the prostate wall bulge or whether it had penetrated through and into nearby tissue. I asked the oncologist whether the biopsy would  have involved taking samples from the nearby tissue. He said yes, no cancer was found but that does not mean there were no cancer cells there,we just did not find any but we  we might have missed them.’ I then asked if the area around the bulge but outside the prostate would be targeted by radiotherapy. He said ( if I recall correctly) that the radiotherapy targets an area but the radiation goes beyond the area target and diminishes as it goes further from the target point. I wish I had pushed for a more accurate response!

hth and good luck! As others have suggested, make sure you are fully informed and have all your questions ready before each and every medical encounter! Also, take somebody with you to record what is said.

Finally, please don’t panic! Your cancer, whilst it has spread is Gleason 3+3 which is good news - not massively aggressive but not to be pushed to one side and forgotten about!

Hi Pittster , sorry to hear you have joined our club, but welcome.  I am surprised that the MDT are recommending AS.  I presume your low PSA and G6 are the main factors, but ‘near the edge’ would concern me.  As others have said, you have no rush but need to talk to a surgeon and oncologist before deciding.  Personally, I wouldn’t want to have AS, but would get some treatment going within the next year.

Hi Pittser 

Stats not particularly high so nothing much to worry about there.

However if the tumour near the capsule edge I would not be hanging around but be looking for treatment soonish.

Could be worth double checking on that and also finding out tumour size just to get all the facts.

Best wishes 

Steve 

Not sure if they do these test in the UK but here in the states they would offer a PSMA Pet / CT scan next. Does UK offer the PSMA pet/ct scan or one of the genetic tests like Decipher, GPS, etc. This would give you more insight on whether AS or treatment is best option. I don't see any need to rush into making a decision. Wishing you the best!