Is surgery right for me

Garry

Just looked back over your previous thread, are they going ahead with the op even though u are waiting for an emergency MRI for swollen lymph nodes?

In the meantime I can understand your hesitation, 52 is not the sort of age u need side effects like ED or incontinence.

I remember u saying that the tumour is confined to the prostate. do u know the size of the tumour (s) in   mm.

When I was first diagnosed the size was only about 5mm and I want on active surveillance for 4 years 

Finally if you are holding back because you are worried/afraid about the op then I would pluck up the courage and go for it.

If you are holding back because you are not sure if it's the right way forward , then perhaps consider postponing it at least until the MRI comes back.

I am sure that u will get some reassuring posts from people who have been thru surgery.

Steve

Hi Gary,

You are not losing it, I had the same feelings, it is normal.

I was diagnosed with T3b N0 M0 and decided to opt for a non-nerve sparing prostatectomy with EPLND in June 2014 fully knowing the side effects. At the time of the surgery I was 61. I believed it gave me the best chance of being cancer free. With the robotic surgery it is possible to have a nerve sparing procedure which can reduce the risk of the side effects.

I do now suffer from ED and minor incontinence but thankfully have remained cancer free with <0.1 psa, so I have absolutely no regrets over my decision.

There is no right choice, all treatments have their merits, it is down to the individual. 

Good Luck

Gary,

While I normally would say radiotherapy is as good a choice as the op, in your case your age is the defining factor, I think.  52 seems to be too young for radiotherapy and as Pete has said above, nerve sparing robotic is probably your best bet.  This will reduce the chances of ED and incontinence if it can be achieved.  But, as you will find, everyone has their own take on it.  

Pete was 61, I was 63.  Both T3b N0 M0 and he went for the op and it looks like a big success with an excellent PSA <0.1 (max limit 0.2).  I had radiotherapy (no choice in the matter) and 4 years on my PSA has been stable at 0.8 (max limit is 2.0) for 18 months.  So we both may be cured?  Both treatments have similar outcomes success wise.

As Pete had non-nerve sparing he now has ED which he knew was a side effect and made his decision.  And he is happy with it.  I don't have ED problems so I have been lucky I think.  And I am happy too.  You're probably more confused than ever so do take your time to research all avenues and hopefully whichever treatment you decide on will be a success.

Regards

Hi sd 

My cancer is 34mm so they have to go wide on the right hand side so no nerve sparring.

Also in the letter they sent me  my consultant said there is a 40% chance of cancer returning but I'm thinking there's a 60% chance it won't its just all so hard 

Garry 

Hi Pete 

Thanks for the reply it just seems my world has been turned upside down I know if I have the surgery I can never get PC again but it could return elsewhere it's all just so confusing and I wish Google didn't exist 

Hello Gary,

I can relate -- I'm 51 and had nerve-sparing RP surgery in January. It was difficult for me to decide between surveillance, surgery or another treatment option. One of the deciding factors was that I realized I'd never be as young as 51 again, and the younger I was the better chance I had for a recovery. The recovery period was not always easy, but I often thought thankful that I wasn't going through it while in my 60s or 70s. Today, less than six months after the surgery, I'm back to an active lifestyle, including volleyball and hiking. I was worried about the surgery too but am so glad I had it.

John

Garry,

Its a bloody hard decision for you.  With no nerve sparing then probably ED and maybe/maybe not some incontinence.  Bear in mind that in many operations, on opening you up, there is a good chance the cancer has spread beyond that seen on your scans.  So then the danger is that a few cells may be missed despite the surgeon's best efforts. 

But, if the operation did fail later on down the line and your PSA rose above 0.2 then you still have salvage radiotherapy to fall back on.  If you opted for radiotherapy first then its very difficult to do the operation later as the prostate will be frazzled. 

There are treatments available for ED which might be a good idea to read up on just so you know what you might face later.  Have you considered cyberknife?  The Royal Marsden Hospital does this:

https://www.royalmarsden.nhs.uk/your-care/treatments/radiotherapy/cyberknife

Regards

Hi John

Thanks for the reply could I ask how you got on with ed and incontinence.

They have told me that they have to go wide on the right side so no chance of nerve sparing but he will try and spare the left side 

Garry 

Hi sd 

Thanks for the information will be checking this out on Monday 

Garry 

Hi Steve 

My tumour is 34mm  and ive still heard nothing from the hospital regarding my so called emergency MRI and my surgery is this Thursday 

Garry