Hi. Thanks for allowing me into the forum. I was diagnosed on Monday that I have 2 anterior tumours. My PSA scores were 9.92 & 10.42. Gleason score of 7 (3 + 4) T3a. No cancer seen in the Lymph nodes. 7 in 11 cores , 5 out of 6 sites with maximum 90% core involvement. It is breaking into the outer casing. My bone scan has come back all clear. I have an appointment in Kendal hospital tomorrow to find out about the radiotherapy treatment. Needless to say I'm very anxious. I had an appointment in Blackburn hospital yesterday (7th May) & they offered surgery to remove the prostate. A friend of mine had the surgery in 2013 and he is fine, he reccommends having the surgery. Robin Weston did his operation and my friend speaks highly of him. My brother went down the route of external beam radiotherapy and Zolodex hormone treatment/ implants. He had to give up work as he is not strong enough to continue. He gets tired easily & stomach pains from the implants when he's in bed , which affects his sleep pattern. His face looks bloated also. I am 64 & reasonably fit. I go hill walking & play in 4 different bowling leagues each week, I also practice on several days. I have a gym programme that I try to do 3 times per week. This is some cardiovascular and machines / weights. Thanks for reading.
Newly Diagnosed : Hi. Thanks for... - Prostate Cancer N...
Newly Diagnosed
While your anxiety is understandable, a few months more or less probably won't make a difference.
prostatecancer.news/2016/08...
The penetration of the capsule puts you in the high risk category. Radiation seems to have superior results to surgery for high risk patients.
In the UK, my top choice would be Peter Hoskin at Mt. Vernon Hospital in Northwood.
all the very best to you. This is the scariest time. Tall Allen gives good advice. Take care with your choices. There is much to think about. You didn’t tell your psa score. I understand the nhs doesn’t do surgery with a psa of 20 or more.
My PSA scores are 9.92 & repeat was 10.42.
Looks like you’re getting valuable advice in this forum. I live in Australia. One thing that is a challenge, no matter where you live, is navigating your health system. The Americans talk about the challenges of their insurance coverage, the British about the nhs. Here we have our own maze through Medicare. Getting help and support is so important in the journey. Consider a counsellor- I found having someone to talk to about my fears and experience was a real bonus. I also collected a Physio specialising in urinary challenges and a sexual health doctor. It all helped keeping me in control. Best of luck friend.
Wishing you all the best on the start of a journey many of us here have been on for a long time. Make sure you are fully informed of your options and the consequences of the treatment route you choose.
The NHS were woefully short on informing me of all the consequences of the treatment route I chose. Plus you have to Police them at times as they can be slow in responding or getting back to you.
Had several run ins with them, do not be afraid to ask questions, take names and make notes so you can quote them if you have to. Don't get me wrong, I have a great relationship with my Urology Team at my hospital, but the administration systems around them are slow at times. So chase them if you are worried.
All the very best - Brian.
TallAllen has good advice about the radiation. You might ask your doctor whether he intends to radiate the pelvic area as a whole as well as the prostate. Seems appropriate, though we know very little from what you have told us.
If your bone scan is clean you are in a very close situation to mine(G3+4, t3a very high risk, tumor in seminal vesicle). Science is showing that the most effective treatment is HDR brachytherapy with ADT and external beam radiation. That is the path I chose and has worked out quite well. Almost 6 years with no recurrence, very low side effects. TA is correct, no need to rush to judgement. I had to wait 5 months while on ADT so my 95cc prostate shrunk down to the size where they could perform the HDR procedure
Agree with TA and tsim. I was Gleason 4+5, confined to 2 lesions in prostate, PSA 7. ADT for 18 months (though good evidence 12 would do), EBRT, and Brachy. 2 yrs later feeling pretty dang good, last check PSA at 0.21. And yea, try and relax a bit, you have time to talk to professionals, read up, and make your treatment decisions. Best of luck.
I'm also on the HD brachy, ADT, IMRT path. I did a lot of research and this appears to be a favorable treatment. Gleason 4+3, HD brachy last November and 16 IMRT sessions. I stopped Lupron after 6 months - I'll roll the dice. Now hoping my PSA stays low and testosterone climbs. Fingers crossed.
All this is very good information as at the moment I don't have a clue . I'm very grateful for every response. Thanks.
You did not mention the specific methods of imaging. Nine years ago during my diagnosis and primary treatment selection phase, I found multi parametric MRI imaging, genomic testing and many consultations critical to my decision making; all also helped me manage my anxieties. Today, based on my experiences, I would also be getting a PSMA PET and blood biopsy (I have had them since).
When I consult in England I always receive written consultation reports. I received excellent consultations (and still do) from the Royal Marsden on radiation-they recommended surgery for my primary treatment based on imaging and other findings. I consulted with Professor Mark Emberton, University College, on HIFU-he too recommended surgery. And I received excellent guidance from New Victoria Hospital. (When I had a business in Dorking, Surrey, I provided my staff with private health insurance for flexibility outside of NHS). All the best!
You may want to consider getting a Decipher test done. It will estimate your risk of developing metastasis.
Welcome. This is a good place. Lots of caring info. I'm far from an expert but your cancer not dissimilar to mine and I was able to get surgery with a good outcome cancerwise. Good luck.
Where did you have your surgery done & how are the side effects.
NYU. Dr. Taneja. A good doc, but side effects were incontinence and impotence. I was over 70 and on my way to impotence already, so that wasn't so bad. The incontinence required an AUD (Artificial Urinary Device) to be implanted. Some bumps in the road getting that installed. The good news is no recurrence of the cancer. Eyes on the prize. I'm in the minority with the side effects, and don't blame anybody. Luck of the draw. But do as you're doing, -- looking around, asking questions -- and you'll find the right answers for yourself.
Fairway
It seems you got great advice and encouragement. I did IMRT + ADT for 2years. An exercise program helped me out a lot both physically and emotionally . I started that a few weeks before my radiation sessions. My PSA was 10 and my Gleason was 4+3 . Best of luck. .
Here is a good website to compare odds of cure for the major treatment paths. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrence). So if you are intermediate, pull up the intermediate chart and you can see the odds of 10-20 yr survival, etc. based on the treatment you pick.
prostatecancerfree.org/comp...
It is best viewed on computer or just print it on paper. Not so viewable on phone.
To make the graphs easier to read, i drew a dot on the endpoints of the elipses, and then drew a line through the dots. This turns the elipses into lines.
Also be aware the the graphs don’t show any salvage radiation benefit. This would boost the surgery odds up a bit.
After reviewing the data above, attempt to strangle anyone that pushes you toward RP.