Is there an overview of PC stuff anywhere?

The simplest way to look at this.

If u don't want to risk ED and urinary issues don't go for surgery, having said that not everyone has issues but still the risk is there.

The one big downside to RT first is that surgery near impossible after RT.

So there u have it , both a bit of a gamble.

So I took the gamble of not being able to have surgery after the RT and so far happy with the outcome.

All the best whatever u decid

Regards 

Steve 

Thanks Steve,

But is all RT equal (external beam radiation / brachytherapy etc) and what of 'other' treatments like Cryotherapy, High-Intensity Focused Ultrasound (HIFU), Immunotherapy or Targeted Therapy, along with any that may be about to finish clinical trials (or are still in trial and available etc)?

I think u can lump RT and Brachy together cos similar

Having said that think Brachy is under GA so RT external beam slightly simpler.

Cryo and Hi fu u can lump together as alternatives but not sure of long term success rates.

Think immunotherapy more widely available now but these for more advanced cancers.

If you're pc has moved outside the gland even marginally then prob RT/,Brachy best

Steve 

Hi Able

I gave this post a great deal of thought over the last 12 hours and the honest answer is there isn't a full overview anywhere. From personal experience I find:

* Cancer Information and Support from MacMillan cancer support is great. This can be best accessed from the top of this page and then select Prostate Cancer. It's basic but honest.

* Prostate Cancer UK has plenty of information and downloadable information booklets. Again I find them basic but honest.

* Mr Google I find contains too much Bulls*it ad you have to weed out what you consider correct. (I don't use it anymore!)

* I find the American sites promote either their own business or offer amazing treatments not available in the UK.

I do feel if you are undecided between surgery / HT/RT and / Bracy (the main 3 UK treatments before Chemo) - the only way to go and it's personal is to ask others about their personal journeys. Most other treatments aren't on offer on the NHS!

Yes - your diagnosis does affect your choice and both the surgery and oncology departments of the hospital may "push" their own speciality - at the end of the day it's down to you taking advice and making the choice.

So there's your "nutshell" - welcome to the nutshell club.

I hope this is of some help.

Best wishes - Brian.

https://prostate.predict.nhs.uk/

I'm not sure if this us the app as I posted a screenshot of it recently.

Yes, that's the one GR1 so thanks for posting the link (I was looking for a phone app).

So it's more like a 'Survival Clock' with extra info but I'm not sure I know the answers to all the questions to know how accurate the predictions might be (like 'Clinical T stage' or 'Histological grade group' etc).

But that in mind, it seems a good tool and very much along the lines as the sort of fact based flow diagram process I was thinking of.

I need to play with it a bit more.

Thanks again. ;-)

I printed it all out, including the graphs to make it easier to compare.

I had another quick look this morning and it reminded me about the risk of damage to the bowel. The long term risk of ED and urinary incontinence is slightly higher after surgery, but the risk of long term bowel damage is substantiate higher for RT. we were warned about the low risk of damage, resulting in a stoma, but we're told that this would be temporary.

My husband has coped very well with the urinary incontinence, but he would have struggled with both.

But do bare in mind they are only statistics. Statistics are only applicable if they end up applying to you. They do not predict what will happen to you. They give a guide as to what may happen but not what will happen. Ignore 'Histological Group' and just put in your Gleeson Score which you said was 4+4. The app will automatically calculate the HG. You should have been given your Clinical T Stage. You may find it on letters. It is important. You will be able to get it from your CNS.

Thanks for that Brian,

It still seems to be down to me making a decision on something I'm not really qualified.

Let me see if I can explain. When my wife was having our child I substituted her sister as her 'birthing partner'. I did so because she had also (it was the 2nd for my Mrs) given birth to 3 children (3 more than me), was an SRN and was very close to her sister.

I was an electronics service tech so the only real good I could be to my wife or our child was if any of the electronics kit went wrong and they let me try to fix it.

So for me it's little to do with emotion, that idealistic holding her hand or giving birth at home, it's what's best should it all go pear shaped.

Ok, so I get I need to offer some input ... ask me to rate things as they are important to me, like say there is a sliding scale between Sex <> Life, I may be happy to go out sooner with a bang (so to speak), rather than living longer without sex and that is a personal choice, rather than 'best medical advice', that may be based on survival chances.

When my stepdaughter was diagnosed with cancer (age 39) she was given the choice of trying chemo but with the chances it would kill her and even if it didn't, what little life she would have left probably wouldn't be worth living.

When the MIL got COPD she chose to carry on smoking because whilst she might live longer if she stopped, it would feel like it to her (and she decided she lived 'enough').

If my cancer wasn't described as 'high risk', I might prefer to just observe things and know I could better enjoy what life I have left, as I could get hit by a bus next week or year and would have potentially suffered incontinence / ED (or worse) when I needn't have?

Of course all statistics are based on the percentage of actual outcomes, but whatever choices are made individuals may or may not be one of the unlucky ones.

It's the same as the stats that 1 in 8 men will get PC during their lifetimes. 7 in 8 won't. It's great if you're one of the 7, but pants if you're the 1.