Prostate cancer. A useful resource.

Speve it would be useful for you to understand what your oncologist means by RT as there are quite a few options, all with pros and cons.

I opted for Brachytherapy which to be fair, has had it's up and downs but I can see light at the end of the tunnel! I'm not sure if all trust offer this or if you meet the criteria but worth reading about.

Prostate Scotland had some great literature as I'm sure other organisations do.

The biggest 'take away' I learnt was that, in general, there is no difference in life longevity between any of the options but the main thing are the side effects and different people can react in different ways especially, where RT is concerned.
 
clanjones said:
Speve it would be useful for you to understand what your oncologist means by RT as there are quite a few options, all with pros and cons.

I opted for Brachytherapy which to be fair, has had it's up and downs but I can see light at the end of the tunnel! I'm not sure if all trust offer this or if you meet the criteria but worth reading about.

Prostate Scotland had some great literature as I'm sure other organisations do.

The biggest 'take away' I learnt was that, in general, there is no difference in life longevity between any of the options but the main thing are the side effects and different people can react in different ways especially, where RT is concerned.
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Everything mentioned here correct , well put . I think you can get too much info , i would only use the info given by your hospital and one ?? Uk site like prostrate uk , which i used or MacMillan site ,? Still its up to the individual
 
I am 76, have lived in France for 19 years and have had routine, annual, comprehensive blood tests since having a heart valve repaired 16 years ago. These blood tests included the PSA (even though they regard them as fallible) and last summer I noted that, whilst the number was always within acceptable limits, it had been climbing imperceptibly for a while. Never much different to the previous result but the trend was always slightly upwards. I pointed this out to my doctor and he started the protocol with a month on antibiotics to eliminate any question of infection but a PSA test showed another little uptick so I had an MRI which revealed that there was a lesion. I was referred to a urologist, confirmatory DRE performed, biopsies taken, PET and CAT scans were clear, now I'm having a final DEXA scan this week and a consultation is booked for the following week where my treatment options will be discussed. Because it has been caught early I expect HT, RT or a combination of the two. Removal never mentioned nor Brachytherapy. Senior consultants here are usually deferred to and, since he has forgotten more than I will ever know about PC, it will simply be a risk analysis from my viewpoint.
It is a slight complication not speaking colloquial or medical French but they are very careful to ensure I understand. My experience is not particularly pertinent to any of you guys but it is interesting to see how closely my experience mirrors yours. I will let you know how it goes. I am grateful to those who have described their experiences on here because I have used it as a rich vein of information during a period when I could have been rather lonely.
 
Well Brachytherapy was and still is rarely available in England* and since there are now much more refined radiotherapy treatments available and the more specialised radiologists and machinery to deliver it - I think it will disappear entirely as the original specialists age and retire. It was never suitable for all prostate cancers in the first place dependent on exactly where they were and their individual Gleason score. (ie the score that determines the exact type of cancer and how aggressive that cancer is)

Husband's in 2013/4 resulted in total prostatectomy robotically using Coventry hospital's fairly new then, Da Vinci Robot. Saw the surgeon not long ago cos he's helping evaluate another new machine, still alongside the still youthful Da Vinci which will be aged 11 in 2025. The new one helps evaluate whether a large enough margin surrounding the cancer has been excised, whilst the patient is still under anaesthetic and instruments in place so they don't sew him back up and then have to open him up again. Early days for the new machine though and it's only been released to those hospitals (not sure if only Europe or World wide) doing more than a certain number of total prostatectomies a week, so far too early to expect the majority of hospitals to have much if any info at all about it.

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sedge said:
Well Brachytherapy was and still is rarely available in England* and since there are now much more refined radiotherapy treatments available and the more specialised radiologists and machinery to deliver it - I think it will disappear entirely as the original specialists age and retire. It was never suitable for all prostate cancers in the first place dependent on exactly where they were and their individual Gleason score. (ie the score that determines the exact type of cancer and how aggressive that cancer is)

Husband's in 2013/4 resulted in total prostatectomy robotically using Coventry hospital's fairly new then, Da Vinci Robot. Saw the surgeon not long ago cos he's helping evaluate another new machine, still alongside the still youthful Da Vinci which will be aged 11 in 2025. The new one helps evaluate whether a large enough margin surrounding the cancer has been excised, whilst the patient is still under anaesthetic and instruments in place so they don't sew him back up and then have to open him up again. Early days for the new machine though and it's only been released to those hospitals (not sure if only Europe or World wide) doing more than a certain number of total prostatectomies a week, so far too early to expect the majority of hospitals to have much if any info at all about it.
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Brachytherapy is available in most NHS trusts in Scotland and England for localised prostate cancer. It’s also used in Cervical cancer plus other cancers so it’s use isn’t going to die out in the near future.
 
carolyn said:
Brachytherapy is available in most NHS trusts in Scotland and England for localised prostate cancer. It’s also used in Cervical cancer plus other cancers so it’s use isn’t going to die out in the near future.
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Is that the treatment where you have to stay away from kids for months ?
 
big bertha said:
Is that the treatment where you have to stay away from kids for months ?
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It’s close contact really with children and pregnant women for a couple of months. Not just passing them by. It’s one of those difficult to measure risks. Some people say that unless the child was a grandchild sitting on your lap regularly it would be fine. Difficult one I always think. Others are more cautious.
 
Gosh! There wasn't anywhere near Coventry offering it although we did know it was offered ooop North, may have been Leeds or somewhere equally distant. Hasn't even been mentioned by any of the chaps coming to our meetings (the more social ones where chaps share their stories with other members of the group I mean) for years.
 
sedge said:
Gosh! There wasn't anywhere near Coventry offering it although we did know it was offered ooop North, may have been Leeds or somewhere equally distant. Hasn't even been mentioned by any of the chaps coming to our meetings (the more social ones where chaps share their stories with other members of the group I mean) for years.
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I think the problem is that it’s only really suitable for truly localised prostate cancer and that in itself will mean that the numbers are much smaller.

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carolyn said:
I think the problem is that it’s only really suitable for truly localised prostate cancer and that in itself will mean that the numbers are much smaller.
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Well I said that Carolyn - still far too many unaware they have it until it's Stage 4 already.
 
You are right Brachytherapy will only be offered if you have a Gleason score of 7 (3+4), categorised as stage 2, have good urinary flow and a prostate size of 50 ml (don't quote me on that, could be more or less) and a PSA of between 10 and 15.

I was initially told I wasn't eligible as my PSA was 13 and the specialist nurse said the limit was 10. However the oncologist consultant didn't have a problem with my PSA level. So that was the route I chose.

Happy to talk offline with anyone considering it, I'm coming up for 6 Months post procedure.
 
I had my brachytherapy treatment in August 23. Localised cancer, stage T2,Gleason of7 and PSA of 3.7. I selected it due to relative ease of procedure, hopefully less chance of serious side effects and statistically the same outcome as other treatments. 18mths after have minimal side effects, water works and sexual function all working though not as before operation.
Agree on children, I wouldn’t have my grandchildren sitting on my lap whilst under treatment and I did set off the security scanners at the airport on a number of occasions!
 
carolyn said:
I think the problem is that it’s only really suitable for truly localised prostate cancer and that in itself will mean that the numbers are much smaller.
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If offered he will refuse as we have a granddaughter with us 2 days a week and she is never of his knee.

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big bertha said:
If offered he will refuse as we have a granddaughter with us 2 days a week and she is never of his knee.
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I can understand that. It’s such a dilemma but time with grandchildren is so very precious. It’s all about balancing pros and cons. It’s not as though one treatment is significantly better.
 
I think what is key to understand in your treatment route are the potential side effects and what you are happy living with. I guess though not everyone had the luxury of choices either because of their stage or hospital trust.

I'll be very open and say one of my biggest fears was urinary incontinence as our main sport is tandem riding. That is not an issue with Brachytherapy but there are other potential side effects and with any thing radiation based it is very subjective. My path hasn't been that easy particularly with urgency and frequency but things are getting there.

At the end of the day, in Scotland anyway, if you have options, you have to make the choice and that can be quite daunting. Initially I was going down the prostate removal but the waiting list and possible post urinary issues made me think again. However I know many people where that route had been a total success so it is quite a challenge to decide.

Anyway onwards and upwards, next Step second PSA check which will hopefully see a further reduction down from 1.5.
 
This morning I spoke to the nurse who removed my catheter following prostatectomy: part of regular check ups. She was pleased that I have gone from 5xL6 protection per day to 1xL2 over 5 months: I am now discharged from their process.
I still squirt a little bit, especially when twisting or lifting weights but I believe that pelvic floor exercises will eventually sort that.
The next step is a penis pump: appointment at the end of March 😳
 
I was prescribed 16 Tadalafil tablets per month just 2 months after my operation. Perhaps Norfolk is a caring health authority?

(One of my school friends was involved in the development of Viagra. He used to send them home for his Dad to test. After a couple of months his Mum suggested that they be shared with guys down at the Working Men's Club ;))

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As Treasurer of a Prostate Cancer Charity I have spoken to a lot of men regarding E D, and it's an all to familiar tale of very little or no advise regarding ED from Surgical or Radiography teams.

The help is there if requested but can be quite difficult knowing who to ask for a referral to the ED specialist (nurses) in my case. In fact when I mentioned this to the surgeon who carried out my radical prostatectomy both Jenny (Sedge) on here and myself got the distinct impression (perhaps we were wrong) that we should be grateful that I was still alive and not bothered about such things!

It's ten years this November since my operation so hopefully things have improved since that time, in this hospital area at least. Some men I have spoken to have said that as soon as they asked they were referred quite quickly, I do think that it's up to the patient to ask rather than the departments offering the advice in the first place. After all is said and done when first diagnosed men can be a bit swamped with all the information they are given at the time so it is possible that it could be overlooked initially.
 
clanjones said:
I think what is key to understand in your treatment route are the potential side effects and what you are happy living with. I guess though not everyone had the luxury of choices either because of their stage or hospital trust.

I'll be very open and say one of my biggest fears was urinary incontinence as our main sport is tandem riding. That is not an issue with Brachytherapy but there are other potential side effects and with any thing radiation based it is very subjective. My path hasn't been that easy particularly with urgency and frequency but things are getting there.

At the end of the day, in Scotland anyway, if you have options, you have to make the choice and that can be quite daunting. Initially I was going down the prostate removal but the waiting list and possible post urinary issues made me think again. However I know many people where that route had been a total success so it is quite a challenge to decide.

Anyway onwards and upwards, next Step second PSA check which will hopefully see a further reduction down from 1.5.
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Where in Scotland was your treatment?
 
The "Old Man's Problem" !

I was diagnosed with benign prostatic hyperplasia, many years ago, probably before I retired (I can no longer remember).

After the insertion of many digits in the anal orifice, much of which was enjoyed more by the perpetrators than it was by me, or so it seemed at the time, I was prescribed Finasteride (5mg) and Tamsulosin (400mcg), one of each, on a daily basis, for the rest of my miserable life.

They seem to be doing the business, and I would recommend any chap over the age of 45 to get tested.

The current PSA blood test is not a 100% satisfactory check, but it is better than nowt. It is rumoured that there is a much more reliable test in the offing ?

Getting an annual PSA test is the way to go, once overnight urinary problems set in.

Mine is due in about 10 day's time.

Many blokes swear by Saw Palm tablets ?

They may be worth a try for blokes with "Issues" around sticking unnatural chemicals into one's persona ?
 
big bertha I was treated at the Western General Edinburgh, as BillandHelen was, which I believe is a centre of excellence in Scotland.

They have all sorts of options available. I understand there are centres in England as well this being one of them.

Prostate brachytherapy

www.cuh.nhs.uk www.cuh.nhs.uk

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