New diagnosis prostate cancer low risk

Hi Nick and welcome 

Wow, a surgeon who is not suggesting removal, that must be unusual.

I understand u not wanting the active surveillance but your stats are low enough to support watch and wait.

It's always a difficult choice surgery or RT.

I was going for surgery but then changed my mind because of possible side effects and it is a major op which I didn't fancy.

Your comment about RT not getting rid of all the cancer, well that can be the case with surgery as well but of course with your stats being so low probably wouldn't return with either treatment.

I should add that not everyone has issues with surgery but I do read  quite a lot of posts re ED issues.

So take your time and do a bit more research plus see what others say.

Good luck

Steve 

Thanks Steve!

I feel I'm going round in circles!

Am speaking to oncologist again later today so perhaps can gain a greater understanding of possible latent side effects. With removal, its done and seems risks are likely to be apparent within months, whereas it seems with RT it could be years before difficulties commence. 

Just want it treated and move on not remain concerned about side effects or not in the years to come.

I will heed your advice- more research!

Thanks again!

Nick

Hi Nick

Welcome to the group. You've come to the right place for advice and support. Fortunately your PC seems to have been caught really early so you have a very high chance of a complete cure whichever route you choose.

I had surgery a year ago (age 61 Gleeson 4+3=7 N0M0) and fortunately have had great results. I chose the op because I just wanted to get it out of the way as quickly as possible. I'm not a medico but have read up on the outcomes. Success rates for a complete cure are about the same for both treatments with your stats, with surgery only very slightly better. In terms of future re-occurance, I'm afraid that this can happen whether you have surgery or RT, but again it is, with your stats, statistically very low. It's more about which treatment you prefer, having weighed up the possible side effects of both. On the surgery side, apart from the obvious risks of a major op, they tend to be incontinence and ED. Statistically most people recover from incontinence within a year, some within a matter of weeks (as in my case). Around 50% of people have some level of ED, so a pretty high risk, although there are things that can be done to help with this.

Other on here will be able to tell you more about HT/RT side effect and the alternative RT treatments.

Watch and wait is an option as the PC might be growing so slowly that it never becomes a risk to your health. Potentially avoiding any treatment. For this reason it is sometimes recommended for older people whose life expectancy is obviously less than for a 57 year old fit person. Personally, I'm not a fan of waiting, for reasons of how it would affect my mental health. I also feel that the earlier you get it treated the less likely it could escape the prostate and cause more serious problems. That's just me though and others with more experience of active surveillance might be able to give better advice.

Feel free to ask me anything.

Cliff

Hi Cliff

Thanks for your response and information

Having spoken to oncologist yesterday, it was reiterated that watch and wait is a good option physically but as stated the impact of just waiting for the news the PC needs treatment is not an option for me. Having considered the risks both immediate and in the longer term and considering my personal circumstances, it was felt that surgery is the better option for me. 

I will discuss further with surgeon and hopefully, have the op, deal with the side effects, knowing that all options have been given due consideration.

Thanks for the support!

Nick

Hi Nick (Nick P ), I understand your dilemma but it is a decision only you can make.  I suggest you list all the pros/cons for you (and ask for help on here if you want more info). I am sure you will make the correct decision.  But whatever it is, just commit to it and be positive.

I didn’t have an option as already advanced but probably would have thought like you, removal sounds safest.  However, RT has advanced so much that it will kill all the active cancer cells in the prostate.  The problem appears to be (I am not medically trained) that in both options, some cells don’t get removed and remain dormant somewhere.  The stats for cure are very good with both options. Best wishes, David

Thanks David, the pro's and cons were discussed in detail with oncologist, and after discussion re my personal circumstances surgery was the preference all round, despite the wait and see remaining the best option from a medical point of view. But as reiterated by all and the medics, this is your choice as you will have to live with the consequences of your decision- good or bad. 

Thanks for your support and advice!

Nick

Hi Nick just seen your post, 

I am in a similar position to you Gleason 3+3 and my first reaction was to get rid asap and have surgery. 
After much thought and speaking to my consultant who didnt think I needed to have major surgery at this time I decided to go on A/S 

My psa slowly rose to 10 at the time  I spoke to the consultant, but it’s since came down to 8.6, I’m 70 and I’m ok with being on A/S I just put it at the back of my mind and get on with my life. 
I appreciate everyone is different and have to make a difficult choice themselves. 
Good luck with whatever route you take. 

Sounds good Nick

Just make sure they do a MRI yearly to check for growth, am sure u have that anyway 

Best wishes 

Steve 

Hi Nick,

Welcome to the forum.

Sounds similar to my journey. I opted for active surveillance but my PC was not for hanging around. Chose robot assisted prostectomy for same reasons, what if RT did not get it all, very much harder to remove. If that is the way you want to go I would advise do not hang around. COVID screwed up my chance of removal before it escaped the capsule due to delays in getting second MRI. 

If you do go ahead I would also advise that you have your eye pressures checked. I was further delayed as I have Glaucoma and again because of COVID my pressures had not been checked for over 18 months. Why is this important, well the op lasts about 3 hours and you are at an angle with your head at the bottom. This adds extra pressure to your eyes which could cause problems.

There are side effects which I am sure you have been told about. 

Please get back to me if you want any further information.

John 

Hi Nick, I’ve only just seen your post for some reason. 

I was diagnosed in April with Gleeson 7 (3+4) T3 prostate cancer in April & had it removed in July this year.

My personal reason for choosing the op route was one fold in the end. I had been offered the op or hormone & radiotherapy for a period of 18 months, I read up on everything, on here & on the Prostate Cancer UK websites and for a fortnight I flip flopped between routes to take. Then I had a meeting with a MacMillan nurse who when I said that at that point I was in the H&RT camp but if it didn’t work I’d go get the op to get it out. 

Her reply was that it was very very unlikely that I’d be able to have the option of the op after H&RT due to the damage that would be caused by the RT to the prostate & likely the area around it.

That did it for me right there and then, why would I choose a route, that after 18 months of therapy & everything that comes with that, that disallows me from using a probable curative path. At least if I had the op (which I did) and if it didn’t work (it has worked) I could then still go to second base for the H&RT.

I’m now 18 weeks post op, there are no legacy’s from the op other than I’m working on the ED part. To that end if you can persuade your consultant to prescribe your ED pills prior to the op, as some health authorities are doing that now, the quicker everything will work again or so I understand.

One last tip, for the op route, as soon as you receive your op date if that’s the route you choose, start your pelvic floor exercises then continue them straight after the catheter comes out .. don’t do them whilst the catheter is in place as that’s a no no.

Best wishes & good luck

John