Husband diagnosed today - we need to decide on treatment

Update - Note I am still getting used to how this forum works so have managed to start 2 threads - apologies for that. 

We saw the surgeon this morning. It is definitely stage T3a/Gleason 3+4 - cancer nurse said it was confined to the prostate - it isn't ! Whilst PSA is only 5.6 the prostate is not enlarged so PSA is quite high when the prostate is a normal size.

The cancer has just broken out of the prostate capsule on one side and looks like it may be in one bit of the vascular areas surrounding the prostate but not in the seminal vessels or lymph nodes. 

He said surgery should be very successful - with treatment using the prostate predict we are looking at a 15 year survival of 82%.

We have a phone appointment with radiology on 29th April now & then need to decide the way forward.

The nurse who got the info wrong told us Brachetherapy on its own was an option but been reading all the literature and I think as the stage is T3a, he would need external beam too? A question I suppose for the 29th but wondered if anyone on here knew on this ? His cancer is 15mm long - just on one side of the prostate.

Such big decisions to make - it all seems a bit unreal still to be honest !

Hello Redrose25 

Thank you for your post, don't worry about how many threads you have started. it's our Community!!

As you know we are not medically trained but work from personal experience and knowledge. I attach details of how Prostate Cancer is staged and graded:

Prostate Cancer - Staging and Grading.

With a T3a I think I would personally think twice about surgery - has the cancer left the prostate and gone walkabout? If so and you have surgery and it doesn't get all the cancer after recovering from surgery further treatment would still be needed.

You are right with Brachytherapy, as a T3a it would indeed need Brachy Boost. We have an expert on this on the Community and i have "tagged" Alpine Wanderer to this post.

As you have a meeting coming up. here's a link to help you with your questions

Questions for Your Team

I hope the above helps.

Best wishes - Brian.

Thank you thats useful :-)

Hello Redrose25 

I have had a nightmare today-I have just corrected the links in my post - they work now. Sorry about that.

Best wishes - Brian.

Aww thank you :-) I have been reading lots of studies but I don't understand a lot of it tbh- so many abbreviations ! 

Hello Redrose25 

It's hard a first trying to take everything in - why not list your questions on here - you will get honest answers from people who have been there - got the t-shirt.

Best wishes - Brian.

Hi !

If you haven’t met radiologist / oncologist that is definetily someone you need to meet for a second opinion regarding radiation therapy and hormone therapy.

T3 is high risk and needs to be treated accordingly. I’m only amateur like all of us on this forum but I’ve never seen Brachytherapy only for T3. However, with a T3, there are several gold standards, for example EBRT, with a boost like Brachy and many do whole pelvic radiation therapy (WPRT). And again, with a T3 diagnosis probably hormone therapy should be on the table.

But, if you haven’t had a meeting with oncologist then that is next step as well because they are the experts of radiation therapy.

But, your husband have several possibilities, and definitely with curative intent.

Thank you for your response - yes I think we need a good chat with the oncology team. The more I am reading, the more I think radiotherapy may be the best way forward but we will see what they say. Still cant believe its happening tbh - my husband is rarely ill let alone something like this. 

Hi !

Yes you should definetily have a dialog with the oncology team because they are the experts on radiation modalities together with hormone therapy and definetily not the urology team.

In the end, when presented with all alternatives then you can take the final decision based on facts and what feels best for your husband; not saying if radiation or prostatectomy is the best choice. Best of luck going forward and like I say, your husband have good alternatives at hands and with curative intent 

Redrose25 said:

with treatment using the prostate predict we are looking at a 15 year survival of 82%.

Don’t forget that a 57 year old man will be 72 in 15 years time, so a man without prostate cancer also has maybe 85 to 90 per cent survival rate.  The prostate predict model can be scary - until you think about it.   AW