Prostate Cancer

Hi TaiChiDance .

Welcome. From my understanding there are still fairly strict criteria on eligibility for SBRT. I have attached a link to the NHS hospitals which currently offers it.

https://prostatematters.co.uk/treatments-for-in-capsule-diagnoses-t1-t2/where-to-access-sbrt-t1-t2/#:~:text=Linac%20based%20SBRT%2FSABR%20in,Trusts%20offer%20Linac%20based%20SBRT.

We have recently had people who have been put on the Pace Nodes Trial and as a starter I have given you a link to one of them.

 RE: PACE NODES Clinical Trial 

If you want any further help then please ask.

Hello TaiChiDance 

Welcome to the online Prostate Community - I am so sorry to find you here.

I see you have already had some great advice regarding NHS SBRT and I do hope this helps.

You say in your post your husband had Prostate Cancer but "not enough options given". Are you able to share some further details of his diagnosis with us and where he is on his journey (PSA on diagnosis, Gleason Score and TNM staging). There are plenty of community members on here and I am sure you will receive plenty of helpful advice and information if we have the full details.

I hope the above helps, if I can do anything else for you please let me know.

Best wishes - Brian.

Thank you for your reply, I have tried the link you sent for NHS hospitals and it's a great site for NHS and private SBRT hospitals. I'm waiting for contact from my husband's hospital so we can discuss the other options. I'm hoping they will refer him so he can have the SBRT. Thanks again

I've just posted (I thought) a reply to Alwayshope but I can't see my reply. There is this text box with a green "Reply" button, which I pressed but can't see the reply that I sent. I wanted to reply to the comment from Brian, but not sure if it will appear, 

Hi TaiChiDance.

Good morning, sorry to see that you are having problems.

I have just noticed that your reply to Brian is above your last post.

It appears in the post above your last post I suggest you scroll up the posts and you will see it.

Please let me know if you have any further problems.

Prostate Worrier.

My reply to Brian - There are different numbers for PSA levels on this site to what we have been given. Husband's first PSA was 11.8, flagged up for referral to consultant. Then put on "watch & Wait" as low level cancer with prescription for finasteride, local anaesthetic biopsies. PSA down to 5.6. At annual follow up MRI given, told that level had increased so needed more biopsies under general anaesthetic. At appointment for results consultant explained that cancer severity levels  are from 1 (low level) which was his first level, up to to 5 (the most serious level) and results of biopsies showed he is now level 4. As MRI showed no secondaries to lymph, a bone scan was needed. The result of the bone scan also had no secondaries so will be put on hormone tablets for 4 weeks, at 2nd week to have a hormone injection given at GP's, then after 6 months another injection then maybe radiotherapy.  No other options were given for the SBRT or for 1 monthly or 3 monthly injections or even mentioned. This was 2 weeks ago. We started looking for info and finally found the info on SBRT and tried to contact the consultant secretary and urology nurses the afternoon before injection due, but no-one answered phones, left messages but no replies or contact so decided to postpone injection so we can have proper discussion. Finally a urology nurse has phoned but she said we need to speak to someone about things so she will ask another urology nurse to contact us. That's where we are now,

Hello TaiChiDance 

Thank you for your reply

It would appear at first your husband was put on Finasteride as his enlarged prostate was non cancerous (BPH).

With higher PSA readings and MRI results showing it's Prostate Cancer the standard practice is to commence Hormone Therapy followed at a later date (once the Hormone Therapy has put the cancer cells to sleep) by Radiotherapy to kill them off.

At the moment my advice would be to start the HT as advised and deal with which type of Radiotherapy he is having as his treatment progresses

Attached is a link to Prostate Cancer UK's cracking booklet on Hormone Therapy

https://shop.prostatecanceruk.org/our-publications/all-publications/hormone-therapy 

I hope the above makes the process a little clearer. If I can do anything else for you please let me know.

Best wishes - Brian.

I have attached a link to the Cambridge staging system which I think is the one being referred to. It gets confusing because there are different ways of describing how aggressive the cancer is but generally the higher up the scale, no matter which one is used, then the greater the risk. If you have a higher risk cancer then the more aggressive the initial treatment is in order to stop any progression. The first line of attack is usually Bicalutamide for a few weeks to reduce any flare from the second line of attack which is usually the injection/ implant which mostly works in a similar way to stop testosterone production. Which one you are put on, whether it is 1, 3, or 6 months does not normally matter. The hormone therapy can make the radiotherapy more effective but which type of radiotherapy offered is usually determined by what is available in your area and whether the experts think the cancer will be best destroyed by one type compared to another. It is possible to have radiotherapy without hormone therapy but this is a decision you have to make after discussion with the experts. Another option may be Brachytherapy or Brachytherapy boost.

https://www.cancerresearchuk.org/about-cancer/prostate-cancer/stages/cambridge-prognostic-group-cpg