About to start treatment

[Paulo1968]

I am a finance controller, divorced, father of 3 who live with me week yes week no. In happy gay relationship now.

I was recently (15/02/2018) diagnosed with PC possible a T3a No Mo Gleason 8 (4+4) psa 12,7. I made a MRI, biopsy and PET exam. Body scan clear. MRI and PET showed seminal vesicles and lymph nodes free but potential extracapsular disease is a possiblity.

I have seen 3 doctors and a radiotherapist, as well as discussed with a cousing who is doctor, to understand treatment possibilities and make up a decision on the way forward.

Decided for surgery with robot with a likely RT after it depending on the pathologic report.

Surgery scheduled for next week 05/April/2018.

I am not looking forward to starting treatment as I don't have any symptoms, but clear for me I need it as early as possible.I have read a lot, but I am so much afraid of the consequences of surgery and the follow up of PSA after start up of treatment.

Happy to receive any feedback or question.

Thank you fr allowing me in this group,

Paulo

[Darryl Partner]

You are welcome here...and here too healthunlocked.com/prostate...

[Paulo1968 in reply to Darryl]

Thanks Darryl, How can I post in the suggested site for gay men? Still around trying to understand how this work...

[Darryl Partner in reply to Paulo1968]

Go to the group and tap “follow “

[rf3rf3]

Good luck,a Paulo. Sounds like surgery is a good call for you. Did you consider radiation therapy?

[Paulo1968 in reply to rf3rf3]

Hi rf3rf3,

I did consider radiation together with hormone therapy, as it was the way to go. Both treatments needed to be there together. One of the doctors I saw advised me for RT and I spoke with a radiotherapist.

Well, difficult, because the odds of success are similar, but at the end for me there were a few aspects I found surgery better for me:

1) with surgery you remove the tumor, seminal vesicles and some lymph nodes that can go for analysis and you get a complete pathological report, which may indicate what you need to do afterwards;

2) consider the age I am, strong radio as a primarily treatment in a long term basis gives us a higher chance of developping cancer somewhere else close to the place we irradiate and not only the prostate;

3) I was told that with surgery the psa has to drop to zero or close to zero and in the case of RT the psa may fluctuate over some time and this is more difficult to decide whether or not we need an adjuvant treatment. For me this is a bigger problem, as I have from temper very dificult times in copying with uncertainty;

4) If you chose RT + HT, doing surgery afterwards would not be possible and at least I still have a chance of anoter treatmnet after surgery.

5) Side effects were told to be similar. Just that surgery you get them at once and you can recover whereas in RT the side effects can be experineced as time progresses and more difficult to turn around.

So above were my reasons bearing in mind all I read and advise I received from doctors and specialists. I had a big trouble at first to figure out that treatment is a decision of our own and not something a doctor tells us to do. But once I made up my mind I sticked to it and just live one day after the other. I usually wake up in worry, but later in the day I tend to say this is and will not be the end of the world to me and lay down feeling ok.

Of course afraid of the days after surgery...but as said, when the day comes I will worry more about it.

You take care and let me know if anything further you need from me.

Paulo

[btl258 in reply to Paulo1968]

I have similar numbers as you (46 yrs old, T3b N0M0, Gleason 8, PSA 32.2, scans all negative). For the same reasons that you list above, I'm looking at surgery and am in the process of meeting surgeons. My Dr. suggested open RP in order to be aggressive and do complete pathology for testing chemo pathways in case needed. I'm also seeing someone that specializes in robotic assist RP. Both Drs. have extensive experience. Good luck with your surgery.

[Paulo1968 in reply to btl258]

Thanks for your words. So young for this isnt't it btl258. Just a question, what do you mean with chemo pathways?

All the best with your decision and try be calm in the whole process.

You take care.

[btl258 in reply to Paulo1968]

Yes, too young.

My Dr. explained that if they remove the prostate and lymph nodes and perform a complete pathology, they will be able to study which drugs do best against the cells in my particular situation. He said that they would also save cells for in case current drugs are not successful but ones developed in future years are. All of this is hopefully not required, as the desire would be that PSA drops and remains below 0.1 (then no further treatment is necessary). However, if it starts to rise, it means it had spread and just was not visible on scans yet (need to have minimum size lesion or cluster of cells).

Best of luck to you too. Take care.