Hi all

Hi N and welcome 

I think the most important thing here is to find out the tumour size in mm cos PSA has shown signs of going up 

Do get a copy of both MRI reports and look at tumour size and take it from there.

With a PSA of 22 and assuming tumour size over about 10-12mm then probably time to do something.

Looks like not urgent at the the moment 

Best wishes 

Steve 

By the way my preference is Radiotherapy cos nice and easy but obviously just my opinion 

Good Morning Nhojlirb 

A warm welcome to the group although I am so sorry to find you joining us.

I assume you have been on Active Surveillance and your team have advised you you need to take some action to treat the cancer.

If the cancer is still contained within the prostate then in theory you would be eligible for Surgery to remove, Brachytherapy or Hormone/Radiotherapy as a combination treatment. All 3 come with advantages and disadvantages and it's a very personal choice.

I am 70 and at my age I don't think I would be fancying surgery as it's a major operation. I am on Hormone Therapy and know the side effects although they no longer bother me so I would be looking at Brachytherapy although this isn't always offered and isn't available in every NHS Trust.

The answer is to get a pen and paper (I am old fashioned) and write a list of the pros and cons of each treatment as they would affect you and any partner. Use trusted sources for your information, Macmillan, Prostate Cancer UK and Cancer Research UK (not Dr Google or AI). here's some links to our information:

Surgery for Prostate Cancer.

Brachytherapy for Prostate Cancer.

Hormone Therapy - Prostate Cancer.

Radiotherapy for Prostate Cancer.

You do have time to make a choice - and I would look at the one that gives you the best quality of life.

Happy to answer any questions - however trivial.

Best wishes - Brian.

PSA of 22 and G7 would put you in CPG4. AS is not an option for that group. So definitely a decision needed.

Only a personal opinion not advice I would choose a non surgical option. 

Yes, the only puzzling thing here is MRI shows no increase in size but PSA gone up a fair bit

Steve 

Thanks steve

If it helps Nhojlirb  the suggestion was made to a couple of other people on here in the same situation as you that finding out whether robotic surgery is an option for you locally and what type of radiotherapy would be offered. Some of the more recent RT delivery methods do appear to have reduced the potential of side effects. Surface-guided may remove the need for bowel prep during treatment too, albeit as a short-term gain. Once you know more about that you can add it into your research and decision-making…

At Gleason 7 I think the NICE guidelines show the same outcomes for both surgery and radiotherapy, which makes it very much a personal choice.