Surgery or radiotherapy

Hi Bill & welcome

With locally advanced u could be better off with radiotherapy but check it out with your consultant, trouble is if he happens to be a surgeon he will undoubtedly steer you down the surgery route. I had radiotherapy about 15 months ago, I went for RT because less invasive and potentially less side effects than surgery. Looking back I am happy with the decision I made at the time. There will be others on here that will say surgery was the best for them. Try and spend some time researching online before making a decision on which way to go.

regards

Steve

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Hi Bill, when I had my scans they weren’t completely sure whether the cancer had broken through the capsule (it had unfortunately).

I eventually decided on surgery but the cancer reappeared around a year later and I have since had radiotherapy and am not n hormone therapy.

I really worried I had made the wrong decision but they found a second rare aggressive type of cancer called intraductal cancer which doesn’t respond well to radiotherapy.

Even my oncologist said the surgery was the right decision as the RT wouldn’t have dealt with the intraductal stuff. I wouldn’t have known anything about the intraductal if the pathologists hadn’t been able to slice up my prostate after removal.

Unfortunately my oncologist thinks I have micro metastasis but scans aren’t picking this up yet.

As a result of all this I would endorse what Steve has said. Listen to the options and do your research. Get a second opinion if necessary.

Best wishes,

Ian

Thanks for the info Steve,open mind at the moment until I see consultant tomorrow and see what that brings

Cheers Bill

Hi Ian

sorry to hear that,i would never of thought  about different types of cancer and this has added another factor into my decision.

Take care and I hope your treatment goes well.

Cheers Bill

Hi Bill

good luck with appointment tomorrow.

I have same Gleason score and diagnosis (locally advanced) and I'm aged 59.  With the lack of lymph and bone metastases (phew) the consultant has said hormone therapy / external beam radiotherapy is the way to go for me.  My understanding is that surgery would be difficult / messy / easily unsuccessful and seeding radiotherapy is not appropriate with this high a Gleason score.  So hormone therapy to shrink the prostate first followed a shedload of radiotherapy after 3 months or so.  Already PSA has dropped from 141 to 43 on hormone therapy so that's movement in the right direction.

Hope this is useful.

Hi Entremet

I wonder if you can help me I went to the oncologist yesterday for my results they said the good news was the cancer is inside the prostrate and it had been caught early it is grade 7 so they gave me the option either RT or prostrate removal they said both equaly as good.  Today I went to see the radiologist for a consultation and she said they had made a mistake it has pierced through the prostrate so I have to have brain and bone scans they gave me some hormone tablets and I asked when should I start taking them she said anytime you want to.  I really am in a state of shock just not knowing now what is going on.  Have you heard of anything like this happening to others.

HI Chrissy

I'm sorry to hear about the shocking news and the feeling of not knowing what is going on.  Hopefully you will get the necessary scans and their results soon.

My understanding is that hormone therapy (and hormone tabs are the usual first stage in this therapy) is used to shrink the prostate and this has several related benefits: a shrinking prostate is less likely to spread the bad stuff; a smaller prostate is better when doing radiotherapy (if that is appropriate); urinary problems (if any) may be eased.  Also, with a "pierced" prostate (as I also have) then surgery - again, this is my understanding - is not a good idea.

So, assuming the radiologist is right then it is good that they found the error in diagnosis - not good for the state of your nerves perhaps, but it means you will get the necessary scans and so on.  The alternative of missing the error and therefore missing possible bad stuff elsewhere would not have been good.

What seems strange is the "any time you want to" advice on the hormone tabs. If you can I would go back to the hospital (or your GP) to get clarification. 

In terms of having heard of anything like this happening to others: all I can say is from my own experience - sometimes the docs and consultants are a mixed bag and are not all perfect.  The first consultant told me I probably had metastatised cancer (this on a high PSA score and a finger examination).  Subsequent multiple scans / test / delayed appointments etc. really wore down nerves before getting a diagnosis of a locally advanced (Gleason 9) non-spreading cancer. My hospital has cancer support nurses who are really great and I leant on them heavily in this time.  Following this diagnosis was hormone treatment for a month (Bicaluta-something), now followed by Prostap injections (second injection next week) and the PSA score has already come down by two-thirds ... nothing definitive but probably a step in the right direction. 

In your position I would be taking the tablets - but also getting clarification on the "any time you want to" comment and, if possible, clarity on probable next steps in treatment ("is surgery ruled out now?" for example).    

Good luck.

Thank you so much.

Hi Christine

I find it hard to believe that a consultant would take such a cavalier attitude to taking the hormone tablets 'anytime you want to'.

That would straight away raise concerns with me.

You should maybe consider taking a second opinion especially in light of their 'mistake' with the initial and subsequent diagnosis.

regards

Steve

I have the same dilemma RT or surgery went to hospital today got told the cancer is contained within Prostrate and is treatable and I will get a letter discuss pros and cons of each treatment got to say I was so relieved will start research now to gain as much info before appointment.