Seeking Advice on Prostate Cancer Treatment Options

The Gleeson is 9 and after analysis of PSA and MRI the conclusion is aggressive Cancer within the prostate in 3 areas. The largest is 2 cm by 1 cm by 0.8 cm. No spread on the bone and I will know if there is a spread in the body tomorrow. The recommendation is either Robot Surgery plus radiation or 6 months TAB, 2-years adjuvant Bicalutamide, and combination radiation treatment. The second alternative seems to take a longer duration and may have more side effects. I am opting for surgery but I have not yet made the dcision.

The Gleeson is 9 and after analysis of PSA and MRI the conclusion is aggressive Cancer within the prostate in 3 areas. The largest is 2 cm by 1 cm by 0.8 cm. No spread on the bone and I will know if there is a spread in the body tomorrow. The recommendation is either Robot Surgery plus radiation or 6 months TAB, 2-years adjuvant Bicalutamide, and combination radiation treatment. The second alternative seems to take a longer duration and may have more side effects. I am opting for surgery but I have not yet made the decision.

Probably the most important point is if escaped the gland ie, just outside because if so probably better of with HT and RT.

Surgery together with RT (called adjuvant) potentially gives you more side effects, fairly obviously I suppose.

That's just my opinion by the way.

Steve

Thank you for your input Steve. I still do not know if it has spread just outside the prostate glands. The risk for vein damage may be higher with surgery. I am not that sure

Tis a major op, that's why I went for RT, having said that plenty on here that were happy with their surgery.

One more important point, surgery after RT extremely difficult (that's if cancer comes back) but RT after surgery def OK. 

Steve

The Gleeson is 9 and after analysis of PSA and MRI the conclusion is aggressive Cancer within the prostate in 3 areas. The largest is 2 cm by 1 cm by 0.8 cm. No spread on the bone and I will know if there is a spread in the body tomorrow. The recommendation is either Robot Surgery plus radiation or 6 months TAB, 2-years adjuvant Bicalutamide, and combination radiation treatment. The second alternative seems to take a longer duration and may have more side effects. I am opting for surgery but I have not yet made the decision.

Ok, so looks contained and I understand you opting for surgery.

Only thing I would query is why not surgery and then RT if needed later because of potential extra side effects.

Just my thoughts, doesn't mean it's right.

All the best with whichever path u go down 

Steve 

Good Evening berhe 

Is it possible please if you can repost your diagnosis/MRI details in English.

Thank you - Best wishes - Brian.

If it’s aggressive, you may want to consider brachytherapy boost.   See my profile.   AW

I was in a similar position. The advice given to me was that if you there is  a high probability you will need radiotherapy following surgery you may as well make radiotherapy your primary treatment pathway and avoid the side effects of surgery.

The choice you need to make is to choose a treatment pathway that is effective while minimising the side effects and QoL impact.

The combination of surgery and radiotherapy is going to give you the side effects of both primary treatment pathways.

Radiotherapy on its own with hormone therapy should be as effective but with less QoL impact.