Husband diagnosed today - we need to decide on treatment

Hello Redrose25 and welcome from another wife. You have been given a choice of treatments all of which are designed to keep your husband on the curative pathway. One statistic is that 98% die with it and NOT of it and provided the cancer responds to treatment then there is no reason why your husband shouldn't have a normal lifespan. 

My understanding is that T3a means that the cancer has broken out of the capsule so this is something you need to confirm with the experts and can feed into the success of the different types of treatment e.g. with surgery you would be looking to see how successful it is to get clear margins. For radiotherapy you need to find out what areas are going to be treated and maybe Brachytherapy along with radiotherapy and hormone therapy might be a better option. The number and length of positive cores from the biopsy, the size of the lesion, number of lesions, whether there are any adverse findings like cribriform, initial PSA, age all play into determining risk factors and whether there could be a recurrence in the future. Take your time to look into the different types of treatment, prostate cancer is usually slow growing. Make a list of what side effects each treatment comes with and work through which ones you can live with and make sure that you talk to the experts.

For Brachytherapy can I suggest you read the profile of Alpine Wanderer 

I have attached a couple of links to help inform you.

https://issuu.com/magazineproduction/docs/js_prostate_cancer_guide_for_patients_ezine

https://www.nice.org.uk/guidance/ng131/chapter/Recommendations#localised-and-locally-advanced-prostate-cancer

Positivity is good and the best way of dealing with the side effects from any treatment is to keep as fit as possible and to adopt as healthy lifestyle as possible. 

My husband was diagnosed with advanced metastatic prostate cancer 4+ years ago so at a different end of the scale but thanks to the treatments available we still have a good quality of life. 

Please ask any questions and we will try to help.

Hello Redrose25 

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 I am in the 4th year of my personal prostate cancer journey.

With a Gleason 7 /T3a you have the choice of treatments and my advice is to find as much information on each including the pros and cons of each treatment as they would affect you and your husband. Make a list of the pros and cons for each treatment. Use trusted sources for your information, Macmillan, Prostate Cancer UK and Cancer Research UK (not Dr Google).  I will start you off with 3 links:

Surgery for Prostate Cancer

Hormone/Radiotherapy for Prostate Cancer

Brachytherapy for Prostate Cancer

Feel free to ask any questions. You will find that many Community Members have their journey on their profile and you can read this by clicking on their name or avatar.

No question is stupid or trivial as we have all been where you are and are happy to help.

Best wishes - Brian.

Definitely try to have a detailed discussion with both radio therapy and surgical consultants. I was in a similar position a few months ago. My up front preference was surgery (based on internet research), but had to wait for the urology team to analyse everything before they would even consider me for surgery. And then my wife and I had a long discussion with the consultant who described what he could do, how clear the margins were etc. We compared that with the long discussion we had previously had with the oncologist and weighed up all the pros and cons on both sides. Based on everything we heard, we went with surgery  as it felt best “for us” (have a peek at my bio to see what I was thinking at the time).

So far I am very happy with the decision. Everything seems to have gone very well and I am back to feeling fit and full of energy. That’s just one story. I’m sure there will be a lot of feedback here for all treatment types though!

In the end you have to work through the pros and cons and balance them with your personal situation and preferences.

Wishing you both the very best and hope everything works out as positive as possible.

Thank you for your reply - lots to think about - I agree about the T3a she said it was that & then I asked if it was contained in the prostate and she said it was. We will clarify this with the surgeon when we discuss our options.

Thank you for your reply - my first thought was surgery but we will see what the surgeon has to say when we see him - your point about margins is really useful as this is something we can ask him. Long journey ahead I think ! 

Good evening.

it is one of the hardest decisions you will ever make. I know when I was diagnosed I was told that I had two options and both were curative.  What I did find bizarre is that nobody would point me in any direction and they literally left it up to me to make the decision. as someone who likes to be in control for the first time in my life I want somebody to take that decision making from me but they wouldn’t. Funnily enough, I had a bit of a wobble and my GP wrote to the consultant who at this point said I had chosen the best treatment for me. Why he wouldn’t tell me this earlier I’ve no idea and I suppose it doesn’t matter because I chose surgery and you couldn’t turn back the clock. I will say that the surgery is nowhere near as scary as I expected. Minimal pain no analgesia required discharge the next day. Most of the issues that come with surgery resolve all the time, I’m at the very beginning, but I do have Hope And confidence in my consultant.

Al  xx

Yes, I agree.  Well worth enquiring about brachytherapy as a mono therapy.  Very few side effects too.   If there is a doubt about capsule breakthrough, then brachytherapy boost may be the better option, with perhaps 6 months hormone therapy to mop up any tiny cell escapees.  AW