Decisions Decisions for best treament

That is not supported by the stats - open is still slightly more precise with slightly lower error rate - the main attraction of keyhole and robotic keyhole are that they are quicker tecovery and therefore cheaper to the nation. Hospitals that have already invested in the equipment need to get their money's worth and Some NHS trusts that may have been saving up to buy a Da Vinci have changed plans because the benefit isn't enough to justify the spend. 

Hello John, 

I did not think too much of your earlier question, but have now been reflecting on the TRUS  biopsy that I had in July. 

This was not a pleasant experience, and I wish there had been an alternative available.  

Apart from the discomfort, I sensed that this was not medically sound. What if cancerous cells can be carried out of the prostate by the needles to surrounding tissue eg. 

I did ask the question to the surgeon/ specialist yesterday, but the method was robustly defended  - stating that extensive studies had shown no correlation. 

Still, having found out that the tumour(s) are located at the posterior of the prostate - closest to the rectum. I am not suggesting that it has developed there due to the biopsy, but it does seem like an uncomfortable coincidence.  

Maybe old Kierkegaard was on to something.....

Cheers, 

Ian

Hello again, 

re-read your profile. You seemed to manage to get more detailed information on your condition that I am getting.

Met with surgeon/specialist yesterday, Her consultative manner can best be described as 'brisk'   Some questions almost seemed like an affront. 

I did get some news though - see updated profile. One point of interest for yourself - I asked what is the possibility or recurrence - I was told 15% - (but somehow I never did get the timespan) This was based on the information she has on me. That seemed a bit better than what you were told - and from a woman who does not pull her punches.

i want to speak to an oncologist next- but that meeting has to be arranged - more waiting!

Ian

Hi Ian,

If you really want to be bothered about your statistical chances of surviving PCa (I do, being of an inquisitive nature) you can check out this Nomogram which is one of the ones oncologists use.

I have a 96% chance of surviving prostate cancer for fifteen years, by which time I will be much more likely to have died of something else. Am I bovvered? No, but at least I know the forecast which is about as reliable as the Met Office.

https://www.mskcc.org/nomograms/prostate

Edited by member 13 Oct 2018 at 18:06  | Reason: Not specified

Heizenburgh again,  

thanks to all who have responded to my original post. I have found most of the posts very helpful and have learned a lot.

I now just want to put this thought out there and gauge the reaction.

Recently I revisited an NHS publication ' Localised Prostate Cancer - which was written in 2010.

What I found interesting was a table at the back entitled: 'Comparing the pros and cons of treatment for localised prostate cancer'

Under the heading: How well the treatment works, were the following sets of data:

                                                                                           Surgery             EBR                 Brachytherapy        Watchful Waiting                     

No more treatment needed within 5 x years                            75/100 (cases) 75/100               75/100                         Not known

Prostate cancer does not spread to bones within 10 years         85/100           Not known           Not known                     75/100

You do not die from PCa within 10 years                                  90/100           90/100                 90/100                         85/100  

Looking at these figures, the odds do not appear to be greatly shortened by watchful waiting. I wonder if others have pondered this and decided to pull back from any form of treatment and the associated side effects, and decided just to maintain or even boost their general health.

This is more than an idle thought. I am sure my GP even mentioned this in what was a throwaway remark the last time I visited.

Would we very interested in hearing any views on this,

Best regards to all,

Ian

 I did read this article - in fact I read it a number of times to get some clarity.

What was mostly inferred was that active surveillance was more appropriate for low risk men.  With me being Gleason 3:4 and a PSA of >10 I do not consider myself low risk.

The warnings were there for men with intermediate risk: - increased risk of clinical progression / the development of metastatsis -  Usually around 4 x greater risk than low risk men (Gleason3:3) This was from the Sunnybrook Hospital (Toronto) 15year Pca mortality rate study.

A similar study at Royal Marsden hospital UK seemed to back up these figures.

Seemingly at odds with these studies was the one conducted in Sweden - which involved over 4,000 men. It showed that the mortality rate were pretty close between AS, surgery and radiotherapy treatments. Frustratingly it did not mention over what time period.

All these figures are open to interpretation. Not sure if I got much comfort from it. Not enough to convince myself that I could go on AS for a significant period of time anyway.

I would be interested to know what others made of that paper's content

Ian

Hello Tykey, 

I wonder if you are still logging in?  Good positive news on your RT treatment. 

Did you get Hormone therapy before/ during/after the RT.  It seems that this treatment can have significant side effects as well. Did you experience any? 

Met an oncologist a few days ago to discuss potential radiotherapy. He said I would be on HT for 3 x months, have 20 x sessions (fractions) of RT over a 4 x week period, and 3 x months HT after RT - all of which did not seem too arduous. 

Tending towards this treatment rather than surgery now. My GP has recommended same.

I did put myself on the waiting list for surgery a month ago, which is scheduled for December, and  I said I would be available for cancellations.

It is time I made up my mind!

Hope you are enjoying life post treatment

Ian