Recently diagnosed and so confused on what to do next!

Hello Gary (Gary73) 

A warm welcome to the Macmillan Online Prostate community, although I am so sorry to find you here. I am Brian one of the Community Champions here at Macmillan and have been on my own personal Prostate Cancer journey for over 3 years.

I am not a fan of Active Surveillance myself and when it comes to cancer it's not going away so action is best in my view.

You have been offered surgery - it's self a major operation - there are many Community members here who have gone down that route - here's a link to someones recent journey there:

 JohnyBoy  and our guide to it;

Surgery for Prostate Cancer

I am wondering if Brachytherapy may be better for you - less invasive and works well - though not offered in every area - you can request it in your nearest Health Trust offering this - here's a link:

Brachytherapy for Prostate Cancer

I am sure other will be along later but I thought I would start the ball rolling.

Best wishes - Brian.

Hi Gary,

Sorry to hear your news.  I was offered three options AS, Radical prostatectomy or Radiotherapy, in November last year.  Just turned 60 years old in January.  During that appointment I was told that I could speak to a surgeon and an oncologist about the later two options.  In your case, it you haven't already, I would take up that offer and speak to the surgeon.  You have mentioned that radiotheraphy route is being discouraged presumably by the hospital.  Can you also ask to speak to an Oncologist?

In my case the surgeon reviewed my MRI and I came out of that meeting deciding to have surgery instead of AS.  (My operation was 3rd January 2025).

Given your relatively young age you definitely need advice from your medical professionals and weigh up the side effects against how aggressive your cancer is.

Hi Gary

Active surveillance Def an option but a couple of things to check, size of lesions in mm because the larger they are the more likely u may want to start treatment.

Also  u don't mention a PSA figure.

All the best

Steve 

Hi Gary (Gary73 ), sorry you have joined our club but I am sure the team here will be able to help you.  None of us are medically trained but you do start to become quite knowledgeable about PCa as time goes on.  So as I see it, your cancer isn’t that aggressive and that gives you time to think about things. It would be good to understand where the cancer is in the prostate (how close to the edge) to understand how urgent things are (generally there is no rush).  I must admit I am with Brian (Millibob ) in that why wait for years before you get it sorted out, you are young so will take an op better than in say 20 years time.  There are down sides with all treatments, so it is important to talk to the surgeon as a couple, before making your decision.  If we can help, please ask.  David

Hi, I would have thought brachytherapy would be a good option, I had it last Friday with nothing else …. The detail is on my profile.  

Hi Gary

It's a dilemma that many of us have faced and I think many of us find making decisions about our treatment difficult and worrying. I opted for active surveillance when first diagnosed but have since had surgery.  I felt reasonably safe with AS whilst my Gleason was 6. I had regular PSA tests and annual MRI but because of changes observed on the MRI I also ended up having annual biopsies which was bit of a downer. I decided it was time for treatment once my Gleason score increased to 7 and I had 16/24 positive cores in a targeted biopsy.  For me one of the deciding factors to start treatment was that there was good chance that at that early stage nerve sparing surgery was possible, which has certainly minimised my side effects.

You only have a small number of cores which have come back positive for cancer which would suggest you have plenty of time to make a decision.  I may have been lucky but I found my surgeon very easy to talk to and very supportive without putting any pressure on me to rush into a decision.  The hospital were also quite happy for me to delay my surgery to a time that was more convenient for me, all I had to do was ask.  There are also other options available such as HIFU but only in some areas so it may be worth asking.

Looking on the bright side, you have been diagnosed at a stage where treatment can be curative. Good luck with your journey.

all the best

Dave

Hello Gary (Gary73)

Sorry to learn that you have joined the club, but welcome. I have been on active surveillance for just under a year, although it still something of a novelty - other members may be able to provide a longer-term insight. 

If you click on my avatar ('empty chair' on left side of my name), you will be able to see my current stats and also my journey so far. 

When you have a moment, I'd encourage you to complete your profile as the information will help others, especially those in a similar position, to provide you with guidance which is as helpful as possible.   

Best wishes, Peroni. 

Sorry my psa was 2.9

also notice some mention that when they have Gleason 7 that they came off AS I was to told because I’ve got 3&4 rather that 4&3 I’ve got a less aggressive form. 
Im meeting a consultant surgeon today and got plenty to ask. 
thanks again for everyone’s replies 

Ok Gary, so PSA low, I would expect tumours to be small in mm, do check that 

Steve

Hello yeah I asked the Gleason 6 was 4mm and 7 was 7mm. 
thanks