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Surgery vs Hormone therapy/radiation - struggling to decide

Posted , 14 users are following.

bobbyk
bobbyk

I have been diagnosed with Gleason 7 PSA 9 prostate cancer.

Biopsy showed cancer was in entire prostate and towards the edge but no evidence it had gone outside.

Bone scan normal.

Age 60. Generally healthy.

I have been advised surgery or hormone therapy for three years together with radiation.

The surgeon preferred surgery as did the consultant who would have been in charge of hormone therapy.

I think their logic was that surgery gave the greatest chance of 100% cure.

However I am very apprehensive about surgery and really struggling to make up my mind....

Please could you help me in thinking through some of the pros and cons and your experiences in particular to help me decide...

Every few hours I keep changing my mind. ...

2 likes, 24 replies

24 Replies

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  • Kombi_Cruiser
    Kombi_Cruiser bobbyk

    Posted

    bobbyk...welcome to the fotum... I was faced with a similar decision as yours and at the time I didn't hesitate to have surgery... you can read about me by clicking on the Kombi... During discussions with my Radiation Oncologist just a two weeks ago I was advised that in all likelyhood my Prostate Cancer probably had already spread but test at that time didn't pick anything up...it was only following a PSAM Scan I had done that they could confirm this...had I had known that at the time I probably may have opted for Hormone Treatment rather than the surgery as I think I can handle the side effects of the hormone injections better than the surgery... I will never know if the outcome would have changed or varied in time...

    I wish you the very best of luck whichever decision you make...

    • bobbyk
      bobbyk Kombi_Cruiser

      Posted

      Thanks.

      When you say "already spread" what do you mean?

      Did you go ahead with the surgery? Did this work for you?

    • Kombi_Cruiser
      Kombi_Cruiser bobbyk

      Posted

      bobbyk...unfortunately my Prostate Cancer had already spread to a bunch of different lymph nodes and in a rib (metastatic cancer)... Yes I'd had the surgery before I knew about the spreading... As a 51 year old being told that the surgery would leave me totally impotent was something I put lots of thought into but at the time I really saw no alternative... Prior to surgery I was told that my Prostate Cancer was still contained within the prostate but following surgery I was told that it had already burst out in several places... Your G7 score indicates a much less aggressive cancer than mine as i have rated both G9 & G10 on seperate occassions...

      bobbyk during my first Oncology appointment round table discussions I soon realised that I was entering a space on the unknown and was destined to become a part of the same big experiment that we are all apart of... Nobody can tell me anything outside of what has been tried and what has worked for others...the biggest thing to remember is that you are an individual and your PCa is just as individual as you and therefore all treatments etc. and outcomes in others are just their individual outcomes...no two are the same...

       

    • bobbyk
      bobbyk Kombi_Cruiser

      Posted

      So basically when I have been told that there is no evidence that it has gone out of the prostate... that's an estimate?

      Ie it could have gone outside but they just can't tell?

      That's quite worrying for me as I have been relieved that it I have been informed that it is contained at this stage.

      Did you know before surgery that there was a high risk it had spread even though it didn't show up on an MRI?

    • Kombi_Cruiser
      Kombi_Cruiser bobbyk

      Posted

      bobbyk...no I had no idea that such a thing was possible back then... from original suspicion through blood testing, scans, biopsy to decision making time was only a matter of 6 - 8 weeks...being told that it was still localised made surgery the option chosen...

      Check out the option of having a PSMA scan done as that will give you the best picture of you overall... I'm in Australia and I was told such a scan was relatively new...gave me a pretty clear picture of where I stood...without that they'd probably be still doing other scans etc...

      I'd certainly be asking the question...!!! 

    • worriedformydad
      worriedformydad bobbyk

      Posted

      Hi Bobby,

      I started a blog on here when my dad was diagnosed with Prostrate Cancer. He has a Gleason score of 7 (3+4) and a PSA of 7.

      My dad is otherwise fit and healthy, walking several miles daily to keep fit, he has very positive in attitude. We think his cancer is contained in his prostrate we are still waiting MRI scan results from approx 6/7 weeks ago. My understanding is that these are usually accurate.

      My dad is older than you, just turned 80 but has been told he has the fitness levels of a 65 year old and can opt for surgery if he wishes. He does not want this as he wishes to avoid the post operative risks. He has opted for hormone therapy followed by radiotherapy. He is on oral hormone therapy (Bicalutamide). He has experienced low energy/tiredness but continues to go walks and lead an active life. He has had no other effects. He will remain on hormone therapy until the end of the year then will be tested January 2016 to see how treatment has faired. He commences 7 weeks of radiotherapy on October 5th. He is having IMRT (Intensity Modulated Radio Therapy) which targets cancer more intensely and precisiely. There are several types of radiotherapy.

      It is a personal decision that you have to make. I came onto this blog for discussions with like minded others going through what my dad is experiencing and found this very valuable and useful. The personal experience of cancer is very individual, you can hear the horror stories out there that frightens you and the stories of recovery that are uplifting. It is a roller coaster ride. My dad reads these blogs but does not partake (technology is alien to him). 

       I found discussions I have had and will continue to have as my dad recovers very helpful.

      Make an informed decision for you, gather the information that is apropriate to you, but don't get involved in what might happen. Dont over consult to a point where you end up full of fear.Keep to legitimate sources of information. I've had my own health scares and have become lost in fearing what might happen and have stopped myself doing this currently re my much loved dad. My dad doesn't talk about what might be, he gets on with life and has the same great sense of humour he has always had.

      Remember to do all the things you normally do, have fun and live. Positive attitude aids recovery as well as the right treatment. I hope you manage to find an informed decision in regard to your decision re treat ment that is right for you. Talking with others including this blog and the great people that come on here who have helped me greatly to feel positive about my dad.

        I wish you well Bobby. 

       

  • raymond77603
    raymond77603 bobbyk

    Posted

    Due to the fact that I had already been treated for BPH with hormones I had a quite enlarged prostate. I was Gleeson 7 (3+4) with a PSA of 9. The only option open to me was surgery. There was no spread beyond the capsule nor had it metasised anywhere. The hospital seems to have forgotten about the 3 monthly checks but I now get regular blood tests at my GP surgery. There are side effects following the operation but through time I should regain erectile function. I had concerns about the prospect of surgery and requested a second opinion before consenting. I also spoke to a person from the prostate cancer charity Men United. Get as much information as possible before you proceed but don't delay.
  • glamour
    glamour bobbyk

    Posted

    Hi Bobby,

    I can advise you but based on my own experience.I was diagnosed at 64 years with P.C. with PSA of 11 and Gleason 9. That was in Dec 2004. I underwent hormone therapy from earlyJan 2005 until Aug 2005. I started radiotherapy in mid April 2005 until mid June 2005. At the end of Aug 2005 my PSA was 0.2. It remained at 0.2 for almost 8 years without any intervention of any kind but then began to increase.By March 2015 it was 13.1.

    I was put back on zoladex March 2015. By June 2015 my PSA was 0.1 described as undetectable. The worse periods for me were from the beginning of June 2005 when i was being microwaved and the three or so weeks after the treatment was completed.However,by Oct 2005 I did a 6 weeks bricklayers course at the local tech.Just for fun! 

    Over the past 10 years I am told that I am very healthy for a almost 75 year old man. I have always gone to the Gym to exercise except for the period April 2005 until Dec 2005. I was advised not to exercise at this time.

    I can understand your reticence for the operation. I was not offered that and my circumstances were not that different from yours. Once you have undertaken radiotherapy, surgeons I am informed, are reluctant to take on an operation should the disease return as the tissue around the bladder, lower colon and prostate are scared and difficult to handle.

    I hope my story is of some help to you. In your position I would seek a second opinion. Your G.P. can arrange that for you.

    If you wish, you can contact me at any time, I will be happy to listen and offer support.

    Good Luck, the fight is always worth the effort.

    cheers

  • supercargo
    supercargo bobbyk

    Posted

    Hi bobbyk

    Sorry for late post - new on the site.

    Like you I had the choice of surgey or RT.

    August 2013 diagnosed with locally advanced Prostate Cancer.

    Gleeson 7

    PSA 6

    Staging T3b

    Decided on RT. Had 37 sessions 14/1/14 to 7/3/14 no problems.

    On final Zoladex next month.

    Last month due bleeding when cleaning the rear end, went for a Colonoscopy, and Radiation Proctopathy diagnosed.

    Only other negative are the hot flushes and night sweats caused by the Zoladex injections.

    Talking to others - seems the RT route causes less problems to surgery (ED etc).

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