Just joined group.

A surgeon will not suggest brachytherapy as he will not know that much about it as a radiotherapist who is a specialist in this method.  You need to consult with a radiologist about brachytherapy and about possible HT, followed by RT to get to know what treatment may be the right one for you.

I think the 4+3 was a mistake it it Gleason 7 (3+4) so not quite so bad.  If it was actually & (4+3) I would definitely recommend treatment sooner and would wonder why AS has been suggested.

Hello MWP.

Sorry to hear your diagnosis ,it looks as if you and me are in the same boat.

 I am 58 and received my diagnosis in mid Feb 2024. I’m also a Gleason 7 (3+4) T2 but my PSA is quite a bit lower at 2,65

Im also faced with choosing which treatment to take. I attended an appointment with an Oncologist today and they seemed to give it the hard sell on HT/RT (the RT being external beam) because that is the standard treatment. There was no mention of Brachytherapy until I mentioned it. I saw a consultant surgeon last week and he gave surgery the hard sell. I was told that AS was defiantly not an option, which left HT/RT, robotic surgery to remove the prostate or Brachytherapy.  I was told again today that surgery after either form of radiotherapy is a no go due to the effect of the radiation. My understanding is this doesn’t mean that surgery can’t be done but that it can’t be done with much hope  or guarantee of saving nerves and securing bladder and bowel function. But, one can have radiation following removal surgery if needed. Since diag I have swung between Removal and Brachytherapy but each appointment brings a new thing to consider it seems. My assigned specialist nurse said at the outset that all treatment options offer pretty much the same success rate but the choice has to be about which side effects one could or could not live with. 

Either way, the choice has to be yours so don’t be pressured into one or the other. You do look to have some time to decide so, as others suggest, do your research. 

I hope all the above rambling is of some use.

Why Oh Why

Thanks again for the reply’s and info. I spoke to Truro today, that’s where I’m registered. Told my results were best suited to removal. I mentioned I would like to have a chat about brackytheropy . Told to call derriford. Called them. However as I am being dealt with by Truro i was told only Truro can refer me to a hospital that does brackytheropy but they have already said it’s not for me? I did ask derriford perhaps why was brackytheropy not mentioned when I saw the surgeon and the answer was in fact it would not of been discussed with me as it’s not “done” here and my appointment was to discuss possible removal!!  It might well be the case removal is the best option for me but  I feel like that may not be the case and I’m not convinced. Regards, Mat.

You can ask your GP to refer you to a different hospital

Steve 

Hi MWP. 

Maybe an option could be to have a completely independent second opinion privately with any consultant/hospital that you want to see in the UK. We dip in and out for my partners treatment and have been to the Royal Marsden a couple of times. It's straight forwards. We got in contact at the very start of diagnosis and discussed having a second opinion with them.( it was actually the first opinion really as we were still waiting for our actual NHS appointment)  We then contacted our GP who sent through all the scans and information to the RM and we then had an appointment the following week, it was incredibly informative and we were able to have all the scans explained and all the options were discussed. We left with more of an idea of where we were. We also discussed types of meds and what they would recommend so we were able to use this information going forwards.

Best wishes L

This is a really good idea. I did the same, with a private consultation with an NHS professor of urology.  Cost me £150 for a 40 minute consultation (30 minute slot ).

it really was money well spent and he had all my MRI images sent over from the NHS system. 
It was great to have plenty of time to discuss my case, without the rush of the NHS diagnostic pathway. (Pressure on doctors to see many patients). 

incidentally, he recommended surgery. In the end I opted for brachytherapy boost.  He was “old school” though, and the NHS MDT agreed (independently of my input) with my final verdict on the best way forward.

AW

HI AW understand what you say about Drs being old school, like many of us they like the familiar as that is what they know. Though experience is great, new ideas are important too so maybe the younger Dr can be the best option,

Eddie

Hi all. I’ve managed to speak to a cancer nurse at Truro regarding if brackytheropy is an option. She said that she will e mail the consultant and see if an appointment can be made to go to Exeter to talk about brackytheropy. I did say that I feel like I’m being left to choose what treatment I have, although consultant at derriford thought I should have prostate out… No brackytheropy at Plymouth so no talk about it maybe??I feel like even if I am told brackytheropy is a good call after I’ve been to Exeter I’m still going to be scratching my head what treatment I should really be having. I need the experts to tell me and for them possibly not to be guided at what treatment their particular hospital does or not do. I will say that I am being told as I’m 57 if I do need radiotherapy at a later date that could be a problem if I just had brackytheropy . Regards, Mat.

It is always left for you to choose.  You have to be proactive and gather as much information from good reliable sources - not Dr Google and list the pros and cons of each treatment and make your choice.  I was lucky because in the end there was only one choice - HT and Radiotherapy as it was thought the cancer could have spread.  Have you seen the Prostate cancer toolkit folder of leaflets on the prostate cancer uk website as these are great and give you an idea of what to expect at the time of diagnosis.prostatecanceruk.org.  You can also call the Specialist Prostate Cancer nurses free of charge on this number 0800 074 8383 during these times:  Mon, tues, Thur and Fri 9am to 5pm and on Wednesdays 7am - 9pm.  they are a great help and both my wife and I telephoned them numerous times during the diagnosis stage to try and make sense out of what was happening and what we were being told.  Far easier to get in touch with them than my key worker at the hospital - only managed to get in touch with her once by e mail!  my consultants secretary was far more help and a great listener - I was lucky that her father had had prostate cancer so she had first hand experience.  

All the best

Des