Not having treatment

Hi Ben.

I was in a very similar position to you, albeit by Gleason was 3+4, so yours is marginally more aggressive than mine. That said, as my specialist pointed out to me when comparing the 3 and the 4, you are comparing snails with snails, so it would seem there is no rush needed with your decision.

The decision making process when different options are available is something of a lottery, and is a very individual one. From my perspective, whilst only 54 at diagnosis and otherwise fit and healthy, I lost my father to cancer (not PCa) when I was aged 6, and almost as a direct consequence of that I was in no real rush to sit idly by and do nothing, running the risk of my cancer spreading. In addition, whilst the scans suggested my tumour was confined to the prostate, a broad section was close to the capsule.

I didn’t want to inflict the side effects on myself, especially at 54, but it was a straight choice between surgery and AS. The latter was an option, but given the nature of my scans I did not want to wait. If surgery offers me the best option of a long life, then I was prepared to live with the consequences. I’m now 11 days post surgery and still happy with my decision - I may grow to regret it, but such is life.

Incidentally, and you may gather this from my comments, but I suspect surgery has been recommended to you because of your age and nature of your diagnosis. I know in my local NHS radiotherapy is not offered to patients with my numbers. I’m rather glad it wasn’t, because the choice between RT and RP would have been nigh on impossible for me to make!

Very best of luck to you, whatever you decide.

HH

Thanks HH. Your surmises are correct and although I don't need to rush, it doesn't feel that way. I have a surgery date for late October and everything in the news suggests that if I don't take that, the NHS will have gone into meltdown by Christmas! 

Can I be very personal and ask if you worried about how it might affect/change you as a person? I feel that if I lose sexual function and continence, I won't entirely be me any more.. sort of diminished if that makes any sense at all! 

Ben, it makes absolute sense.

Yes, I do worry. I’m 54, am lucky to have a wife I still find as attractive as the day we met 26 years ago, and enjoy an active sex life. I’m also physically very active, playing sport and doing a lot of hill walking, so the incontinence is a big concern, perhaps more so than any erectile disfunction.

Time will tell both in terms of the extent of the side effects and how I cope with them. But if I find it a struggle then, personally, I balance that against the alternative of having a cancer growing inside me and the constant worry that it would spread to the point of not being curable.

It’s the hardest decision most of us will ever have to make, and I’m glad that, for me, that decision is in the past. I genuinely wish you well and hope your loved ones fully support you, regardless of which way the coin falls.

HH

Thank HH, much appreciated. 

... And of course, good luck fort three future

Hi Ben, I chose surgery on May this year my life was changed radically ! 5 months on the continence is almost back 100% but the ED problem is the one that gets me down, the surgeon spared some nerves so can achieve a dry orgasm which is ok and would be happy with that if only I could achieve an erection . Am on the second different prescription of viagra type pills but nothing yet !! The nurse does tell me it's still early days but being a red blooded man I  get frustrated.  I do think I made the right choice for me but with the damn Covid situation actually having a proper discussion with a professional was very limited and swayed me towards surgery as I radiotherapy is still an option should any cancer was missed! Read my profile on my progress. 

Good luck going forward 

Graeme. 

Hi Graeme, 

Thank you. Your profile is very honest and echoed very much my own concerns about not feeling complete afterwards

I'll keep watching for updates and wish you all the best for the coming months.