PSA

Hi

I'm with you on that. Hormone/Radiotherapy was the only option I was given. I have to say ( apart from the hormone side effects) and having got through the RT I can't really complain. 

Hope all goes the way you want it to.

Hi MGB

Probably unusual to have a PSa of 30+ and nothing shows up on scans.  From the biopsy do u know your gleeson score?

Could be worth trying to get a more detailed Mri such as MP mri to try and find the location.

Steve

Unknown said:

Dont want to lose me prostate if I can help it

Hi,

You have a lot to think about, but it will gradually clear in your mind.

Try not to obsess about PSA: it got you a diagnosis, which is good, even though it's always a shock, but at least you know it's a treatable cancer. But PSA levels vary enormously. people are diagnosed with a PSA of 5, 50, 500, occasionally 5,000. Don't worry about it.

A lot depends on what your TNM stage is (tumour, nodes, metastases). That will determine your options, and give an idea of curability and prognosis.

But you need to consider all options that are available to you; think about long-term effects, as well as immediate effects.

And be clear about the nature of prostate cancer. For example, if you choose radiotherapy (as I did), you will lose your prostate. That's what radiotherapy is for, blasting the prostate and the cancer within it.

regards your last paragraph Heinous  I am rather happy that my prostate is still there  albeit in a rather dilapidated state, it also still produces limited amounts of semen. I believe  that the RT turns the  gland into a kind of mush, not sure how the urethra survives , can it be that well targeted?

what is more RT means the prostate can no longer be operated on.

Maybe better to try focal treatment if Gleason is low and no metastasis.

"focal therapy can lead to good overall cancer control"
That's from the website of people promoting focal therapy. My bold.

It's fine as way of treating the 'index tumour' in a recurrence, but if your PCa is considered curable, go for a cure while you have the chance. Focal Therapy is not considered a potentially curative treatment.

T1N0M0 / T2N0M0 are pretty always considered curable; T3aN0M0 usually is.

Grundo said:

I believe  that the RT turns the  gland into a kind of mush, not sure how the urethra survives , can it be that well targeted?

The urethra is very different tissue, relatively radiation-insensitive.

'A kind of mush' is about right; for most, an inactive kind of mush.

Not many people produce any semen post RT; but for most of us, the lack of libido makes that an academic issue!

Ahhh that explains something. Despite having little interest in Sex on the rare occasion when I get an erection zero semen is produced.

As an aside that's a why the GP  decided on a PSA test. I asked why my semen volume had decreased by 80%. I thought it was because I was getting older. Thank goodness I asked - I very nearly didnt.

No problems with my urethra a small problem with bowel but I had fiducial markers (3 small gold implants the size of a small grain of rice inserted into the prostate which help target the RT more accurately so that there is less collateral damage to other organs.  I had this done because prior to being diagnosed with Pca I already had both bowel and bladder problems so didn't want them to get any worse.  thanks to the implants I am minimally worse with bowel but the tumour was pressing out onto the bowel so not surprising really.

Troc the prostate can be operated on after RT and if anything happens to me and the cancer returns this is what my oncologist will do.  He is obviously very experienced in this area so doubt that all oncologists would offer this or even do this but it is possible and is done.  I actually met someone at the hospital who has had it done at our pre treatment course of talks.