RT trial on the news ...

I posted about this very report this morning. 3 months too late for my husband,  but I can  imagine how unsettling this is for you when you're so close to your surgery date. 

I hope that you get to speak with someone while you still have the option to change your mind, which is at anytime before you're anaesthetised for surgery.

I am so pleased that my son and grandson will have another option as they may at greater risk, especially my grandson who is mixed race.

GR1 said:

I posted about this very report this morning.

Ah, sorry, I should have checked first.

Yes, as if it wasn't all unsettling enough, then this comes along. When I say 'comes along' I mean 'seems to be accepted into the mainstream after being trialled for 12+ years)' and I actually spoke to someone who had been on the 'trial' himself not very long ago. AS mentioned elsewhere that conversation was a fraction of the time the conversation took with the family friend who had surgery recently.

But this is where I have been guided to be 'trusting of the professionals' (and where that could well be the right thing to do in my case) but no one has so much as mentioned the trial in the general discussion. I guess some people are happy to hear what they have been offered whereas others (like me) would like to hear (or ideally put into writing so it doesn't just end up in the chaos of thoughts / emails / texts / on-line apps) that I'm also trying to handle.

But they may well say that because of my T3a I could be in the 80% rather than 95% survival at 5 years group and that is why surgery is the 'best option', but no one has as far as I can remember?

But if you also suffer with a form of self destructive procrastination, it would be very easy to just to 'decide' to do nothing, as at least that provides some level of logic / control.

Your 'last second' decision pre-anesthic reminds me of when I was about to have gas in the dentist as a child and just as I was about to go under, escaping from the chair and running out the room (after nearly ripping the sliding door off the wall as it didn't open as expected). ;-)

And I'm also sorry about the timing for your husband (but better it's 3 days over 3 months I guess) and yes, it should be good news for all of those who follow. We might also be in the same position with my Mrs and her dementia, another reason why I might not be too bothered about much future past 5 years ...

Another factor my husband took into account was the possibility of radiotherapy after surgery but not surgery after radiotherapy.

We've briefly discussed it this morning and hope that if he is faced with the need for further treatment in future due to a reoccurrence,  the treatment may be quicker and not involve HT.

GR1 said:

Another factor my husband took into account was the possibility of radiotherapy after surgery but not surgery after radiotherapy.

Not wanting to muddy the water any further but I don't think (but may be wrong) that it's as binary as that. I think you can still have surgery after RT, just that it can be 'more complicated', depending on how lucky you were with the RT and if anything has fused to anything else (bladder / rectum etc)?

And even then, I think they now have the option to inject a dissolving plastic resin between the prostate and the other organs to minimise the risk of that?

So for people in my position it's the gamble / risk of any delay whilst these 'new'(?) options are either approved or available mainstream and the cancer going walkabout versus just accepting whatever offered that should at least fix the primary issue.

That might only be a 'good call' if what you have left is worth having and why many older men especially opt for nothing or the least intrusive (in general) option.

As a bit of an aside here and in the process of 'doing my research' I was reading of the accounts of sex workers who had post PC clients and how they were also offering some level of counselling and rehabilitation and that stuff was certainly possible in many of the cases they had seen. Unfortunately there wasn't the detail in what level of PC or what treatment they had had to be able to draw any 'real world' conclusions. The stats would likely be swayed to those gents who felt there could be a chance or who didn't already have support at home in any case?

That reminds me of the blokes talking in the pub and the first asking the second why he was just having a cola. 'The Dr told me that if quit drinking I would live longer and it certainly feels like it ...' ;-(

It was my understanding that the radiotherapy causes hardening of the prostate, which as you say may make it more complicated. Not sure how protecting the surrounding tissues would protect the prostate itself when that is where the cancer is and the radiotherapy targets it. At the end of the day it would be a surgeon who would assess the possibility of successful surgery as they have to perform it and they aren't going to risk their success rate if there's the slightest risk. 

We can all only work with what is available at the time a decision is needed and way up what we can live with in terms of side effects. Quality of life is an important factor and after a certain age options that are available to youngster men may not be available. I understand that in some health authorities 70 is the cut off point for surgery due to the average life expectancy of men. My husband was 69 and told that because he was fit he couldn't have surgery. His cousin who is a few years older and not particularly fit still had the surgery after being advise to get it out because radiotherapy was still an option later if needed.

As for sex workers I'm sure they'll do anything for money and if this helps some men good for them. If my husband went down this path I'd be performing a bit more surgery on him (remember Wayne Bobbit) who had to retrieve it from a field and have it stitched back.

My husband said pretty much the same thing when I told him that he needed to modify his diet. He said if he can't eat and drink what he likes, in moderation he may as well be dead.

GR1 said:

It was my understanding that the radiotherapy causes hardening of the prostate, which as you say may make it more complicated. Not sure how protecting the surrounding tissues would protect the prostate itself when that is where the cancer is and the radiotherapy targets it.

Yeabut, unlike surgery that has very defined boundaries to it's impact, 'external' radiotherapy is 'beams' of energy and by definition are going to pass though the entire body and therefore are bound to do some level of other damage elsewhere in the process?

So the plastic shield (that I'm sure is a thing) is behind the prostate and absorbs most of the radiation before it can do any more harm (it will already have done harm on it's way to the prostate etc).

Think of shooting someone in a room though a glass window. The bullet will damage the glass, and person and could also hit someone behind them.

I'm not qualified to comment on the concept that (all) sex workers will do anything for money but I'm guessing the chances are many wouldn't, given they rely on their health for their income.

I'm not sure I follow the link between age / health and surgery (Other than when surgery wouldn't be the best / viable option), or are you saying they factor the cost of surgery against life expectancy?

I only know what I've read in all the booklets and pamphlets given to my husband at diagnosis.

It is my understanding that it all depends on the life expectancy of a man. If a 70 year old man isn't expected to live for 10 years due to other ailments, maybe the risk of surgery outweighs the benefits. My husband’s fitness was taken into account by the surgeon when he assessed his suitable for surgery. There may be other factors like the cost of surgery, which I'm sure is taken into account in many medical situations.

I don't know 'any' sex workers personally, but I lived and worked in the area where the Yorkshire Ripper operated and the fear of being murdered didn't keep them off the streets. Being murdered was the ultimate health risk because money was their motivation to feed their kids. 

GR1 said:

If a 70 year old man isn't expected to live for 10 years due to other ailments, maybe the risk of surgery outweighs the benefits.

That makes sense.

I think I was talking of the sort of legal sex workers who might be likely to write a blog or partake on a forum, rather than those illegally streetwalking etc. ;-)

I think perhaps you mean legal sex therapists, rather than sex workers.

In this case it was actually a forum for sex workers and clients to discuss all sorts of things that a Google search took me to where a client had asked about if he might be seen if he was recovering from PC and most of the replies were yes. Now, I'm sure as you say there would be some who would not allow the booking if that was declared or just take the money knowing there was little chance of a PC survivor being able to get VFM ... or even caring to try ... but many also seemed to suggest that it wasn't always about the mechanical and there was a lot of 'support' to be offered in other ways. This is why I used the term counselling.

Plus of course, with all these services being on-line now with fairly well defined menus, workers can also state if they do cater for people with a disability, and just like with Amazon and eBay, there is also customer feedback. ;-)