In 2019 my husband was 67 and diagnosed with prostate cancer. His PSA was sky high at 160 and his Gleason score was 9 i4+5), the good news it was totally contained in the Prostrate. If there is one thing you get used to it's the bad news comes with some seemingly good news. We were advised against removal so he under went the hormone treatment, radiotherapy and brachy to blast the life out of the demon. His PSA went super low, under 1, after about 2 years the hormone injections were stopped.
March 2024 his PSA went up to 2 so the consultant requested MRI which showed a shadow. There followed a colonoscopy, CT scan, PET scan and biopsy. July 2024 it was confirmed the Prostrate Cancer has spread to his rectum, unusual apparently, as it more usual that it spreads to lymph nodes or bones.
They have started hormone treatment again and his PSA is down to 1.15.
At this stage the hormone treatment is classified as palliative care. The cancer will not go away but could be contained. As his PC is so aggressive they can't say how long it will respond to hormone treatment. They can change the hormone, try various combos including chemo.
The good news, there is always some, the cancer doesn't seem to have spread anywhere else. This means he can consider, can't remember medical terms, having his bowel and bladder removed and getting 2 bags for life. All being well this would extend his life, possibly 5 years. It is a very complex operation 1 in 50 don't survive it, with operations on cancer cells their is a risk of the cells getting into the blood stream, after the op he will be in intensive care for 2 weeks with up to 4 months rehabilitation.
We have a PET scan in a month so the removal man can see what he's up against and confirm the feasibility of the op.
Currently I don't think this is happening to my husband. I can talk about it like it's someone else's life.
Thank you yesterday was difficult, just reinforcing the reality. Definitely will get some sleep 
Hello Mrs Wave
I'm so sorry to hear of your husbands diagnosis. Life sure does throw challenges we could do without!
I can fully understand this feeling of separating yourself from the bad news. I used to do this when working on an extremely busy acute surgical ward if there was a medical emergency. Only after the ‘dust had settled’ did the full reality set in. Yet, I think I always functioned properly in dealing with the emergency! Self protection mechanism?
Re your husband’s decision. I think this might be best made by looking through the lens of ‘quality of life’? Both treatment pathways will impact on his quality of life and it seems both have different side effects. It’s, as ever with this darned disease, a tough decision for him to make. I would suggest you both look into both pathways and get as much info as possible. That way, his decision will be fully informed and you will be alongside him knowing what’s what and able to support.
One of the questions I would be asking is, if he proceeds down the medical route, will or could there come a point where surgery is inevitable to relieve any possible complications, such as obstruction etc, further down the line. Likewise, I would be asking if the surgical route means that the medical treatment might be needed further down the line. As you might gather, I’m not an expert in these matters!
I do hope all goes well for you both. Our thoughts will be with you and please remember that this is a forum which can provide a tremendous amount of support whenever you need it 
