AS or SBRT

[pd63]

Gleason 3+4, transpirineal saturation biopsy, 8 of 24 cores positive don't have any more biopsy details, contrary to specialist nurse advice 2 weeks ago who said surgery or ebrt/ hormone therapy, oncologist has told me AS is possible or SBRT and no hormone therapy needed psa 4.2.Any comments, AS feels like kicking the can down the road but oncologist says that seeing as I'm active, swim 2 clicks 3/4 times a week and can still climb mountains, Lake district/ Sotland/North Wales, still get a hard on as well, that AS would be a reasonable option, any possible treatment could be delayed for a while.

Any comments would be appreciated.

[Tall_Allen]

AS is a reasonable option. You have plenty of time to decide.

A genomic test (Decipher or Prolaris) may give you confidence or move you towards treatment.

Any radical therapy will cure you (surgery or radiation). If preserving your erections is your number 1 consideration (it was mine), explore SBRT or HDR brachytherapy.

[pd63 in reply to Tall_Allen]

Been told SBRT would be thd treatment at Christies in Manchester UK, reputation as good as anywhere in this country.Gotta telephone appt with urology surgeon tomorrow but ain't having it taken out due to risk of long term incontinence, brother had ebrt 11 years ago and he's doing very nicely

[pd63 in reply to Tall_Allen]

Telephone appt with senior urologist today advised treatment, don't have to decide straight away, he said 6 months hormone therapy and SBRT would be the way to go

[pd63 in reply to pd63]

Discussed the disparity between oncologist and urologist advice, specialist oncology nurse will take the matter up with the oncologist she said the urologist should have Discussed surgery only not treatment options basically he's a surgeon not a cancer specialist.Watch this space it's good to know the specialists sing fron one hymn sheet ha ha

[Tall_Allen in reply to pd63]

Decipher or Prolaris?

[pd63 in reply to Tall_Allen]

Presume you mean gene testing, not available on UK NHS as far as I'm aware

[seansand]

I was very similar to your situation and went for the knee jerk surgery, but in hindsight I wish I had done at least some AS and done a lot more research before deciding. Six years later I am stage 4. Good luck.

[pd63 in reply to seansand]

Still not decided on AS or SBRT oncologist says no need to rush, my head's in a better place than at initial diagnosis, definitely not surgery due to possible incontinence.As I'm low risk/favourable intermediate no ADT is needed which is a bonus.

[j-o-h-n]

Make damn sure you take a picture of that hardon, you'll need it as proof in the future (make sure you take at least two clicks).

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/22/2023 3:34 PM DST