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User

Posted 19 Mar 2023 at 15:38

Many thanks Barry, I very much appreciate your help. I will discuss further when I can see the oncologist etc and try to get a better idea of the risks.

Tom

User

Posted 19 Mar 2023 at 17:23

I think when the MDT considers diagnostics and states a view about suitable options, they take many factors into account that we don't know here on the forum. For AS, T1 is fairly critical and members here are correct that, traditionally, any elements of G4 would rule AS out. However, it may be that you have a very small tumour well contained and with a very low % at G4. Your MDT knows your specific data - they wouldn't have suggested AS might be an option if your cores had all been 52% G3 and 48% G4

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 20 Mar 2023 at 15:07

My diagnosis was very similar to yours- but only 3 cores and all less than 5 % . I was on AS for around 18 months but went for surgery when it was restaged at T2. I didn't regret delaying and feel very lucky with the surgery outcomes. Side effects have been minimal. Good luck.

User

Posted 24 Mar 2023 at 23:59

Hi Tom

I recently had a similar diagnosis (3+4) and am wrestling with the same issues. I was diagnosed in Jan and still weighing up options but don't want to wait too long, for what it's worth I have somewhat ruled out AS (due to age concerns - 49) but equally have moved away from thinking about a surgery option. Still investigating, have recently seen that there is an electrolysis option ( I think this is nanoknife) which I've read is also available in some other countries (but I need to research).

Best regards,

Edited by member 25 Mar 2023 at 00:07 | Reason: error

User

Posted 25 Mar 2023 at 00:51

Nanoknife is going to present you with the same dilemma as HIFU, Fox - it is a focal treatment and may need to be repeated at some point.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 25 Mar 2023 at 00:55

Yes understood, however it doesn't seem that surgery is a 100% guarantee in any case but is likely to carry an enormously higher risk profile for side effects.

User

Posted 25 Mar 2023 at 11:36

Yes, a rock and a hard place. About 30% of men need salvage treatment at some point after RP.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Mar 2023 at 15:14

Hi Fox

I completely agree about surgery, although I am meeting with a surgeon in a week or so, but that is really just to ask a few questions and see whether it changes my mind (doubt it will). I am currently leaning toward Brachy or RT rather than AS. I recently discovered that a friend had Brachy 6 years ago and he has been very pleased with the decision. The higher risk of nasty side effects and possible salvage treatment, not to mention the long recovery time following RP make it for me an unattractive option.

I would like to get on with it too, but we have a big holiday planned for July/Aug and so am thinking to start treatment after that.

Edited by member 26 Mar 2023 at 15:17 | Reason: Not specified

User

Posted 22 Apr 2023 at 16:42

It's been nearly a month since my last post. In that time I have met with an oncologist, a surgeon and a Brachy specialist. My prior experiences with the NHS have not always been positive but, hats off to the venerable institution, this time it has knocked it out of the park.

In the meantime my staging has been increased to T2b N0 M0, from T1c. Not sure why but hey ho.

I have decided on LDR Brachytherapy. The Urology centre I am using is one of the leaders in the field and I was very impressed. Happily I will not need any hormone treatment either (small prostate club member).

I am booked in for the procedure in August, a week after our return from holiday.

Tom

Edited by member 22 Apr 2023 at 16:51 | Reason: Typos

User

Posted 22 Apr 2023 at 17:23

Hi Tom,

It is very difficult to decide on what treatment path to take when you are offered more than one, I looked hard at Robotic removal and Brachytherpy in 2016 when i was diagnosed with PSA 2.19 Gleason 3+4=7 and for me i felt brachytherapy was a better choice for me with a possibility of less side affects.

Don't worry about the procedure as it is very quick with only a couple of hours in the theatre and great after care and release as soon as you can pass water I filled many containers over night that had to be checked with a Geiger counter to check for lost seeds.

All i needed was a cup of tea some food and a good nights sleep.I hope it goes well for you and please ask questions on anything.As you may or not know i am 6 years 7 months on and signed off by Specialist with PSA 0.04.

Regards John.

User

Posted 22 Apr 2023 at 17:27

Tom, you are in a similar situation I was. I had Brachytherapy five months ago ( no hormone treatment ) and personally I have no regrets. I am approaching my second I-125 “half life”. I am no longer on Tamsulosin and I can go about two hours without a pit stop, my bowel function is normal.

I still get a little bit tired and I am trying to build up my stamina by attending a NHS/ Council weekly HARP ( Healthy and Active Rehabilitation Programme ) course at my local sports centre.

Best of luck with your procedure.

Rgds

Dave.

User

Posted 23 Apr 2023 at 11:46

Thanks John and Dave for your responses, it is reassuring to hear positive stories about Brachy. It seems to be the less popular solution on here, or maybe it's just that fewer men are suitable for it. I am worried about the frequency of pit stops, especially during the night, but I understand (hope) that this is usually a temporary problem.

All the best

Tom

Edited by member 23 Apr 2023 at 11:47 | Reason: Not specified

User

Posted 23 Apr 2023 at 12:01

Originally Posted by: Online Community Member

...It seems to be the less popular solution on here, or maybe...

In general a forum attracts people with ongoing problems. Maybe people who have brachy have no problems and get on with their life.

Dave

User

Posted 23 Apr 2023 at 13:16

If my husband had been suitable, he would have gone with brachy in a heartbeat. Unfortunately it was ruled out for him but we have two close friends who have had it since and been very happy with their choice.

If you want to find more success stories on here, look up Johsan in the members list.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Apr 2023 at 13:58

also it's fair to say that many more men have Prostatectomy and EBRT than Brachytherapy Low or High Dose.

Barry

User

Posted 24 Aug 2023 at 15:47

Well I am one week on from the Brachy procedure. I was a little sore for a few days but apart from feeling a bit constipated and a little more tired than I would normally be all is pretty much as it was before.

On the big day I arrived at the hospital at 8.15am and was second on the list. As soon as I woke up afterwards I had a CT scan to check all was where it should be and then thankfully the catheter was removed as I urgently needed to pee. I nearly filled the nurses jug (she was getting worried). I am not convinced the catheter could keep up with the demand! Anyway she was pleased all was working so well and after a quick sarnie I was discharged at 1.30pm.

For the first four nights I was up twice a night to pee (this is more than normal for me), but for the last two nights I have slept through without any need for a trip to the bathroom.

I was very impressed by the Stokes Urology Centre at the Royal Surrey Hospital. I have been in a few private hospitals over my working years for various, mostly minor, things and this was as good, if not better, than any of them.

Anyway I am very pleased I took the Brachy option and the quick recovery time means I am looking forward to getting back out onto the golf course soon, hopefully next week.

Tom

PS - the cat though is extremely unhappy at having his lap privileges withdrawn.

PPS - You might be surprised at how long it took me to get the procedure done, but this was entirely at my request as we had a big holiday planned and didn't want anything to get in the way of that. The hospital said that the procedure could wait that long because of my circs.

Edited by member 24 Aug 2023 at 16:02 | Reason: Not specified

User

Posted 24 Aug 2023 at 21:56

Well done Tom!

It's certainly an easy enough procedure and I've only suffered from very mild side effects - the worst one probably being more tiredness than usual. I'm now just over 3 months post procedure and still try and slink off for a nap if no-ones looking!

User

Posted 25 Aug 2023 at 00:05

I too am leaning towards the Brachy choice once I'm ready to make the decision.

Had my first consultant appointment yesterday after learning I had PC a few weeks ago (T2 N0 M0 Gleason 3+4).

He gave me the AS, RP, RT and Brachy choices.

I have quite serious artery narrowing in the heart, and probably on the verge of the angina stage.

His opinion was that this significantly increases my risk in operations because of the anaesthetics. Whilst he wasn't saying RP was the wrong choice, the risk might not make it the obvious choice (if there is such a decision).

For now I've gone on AS whilst I digest all this and try to form some preference.

I suppose for me, the calcification could get me well before PC does. Quite a big dilemma.

Found this quite an interesting read:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10252630/

User

Posted 25 Aug 2023 at 12:03

Hi ohwow

Thanks for the response. I am sorry to hear that you have an extra complication to what is already a difficult decision to make. I think it is possible to have the Brachytherapy procedure under local anaesthetic.

Good luck with the decision, if you have any questions that I can help with regarding Brachy please let me know.

Also thanks for the link, that is an interesting article.

All the best

Tom

User

Posted 25 Aug 2023 at 12:14

Hi Tom, I am going for my first six month review ( nine months after procedure) on Monday. Three months after my brachytherapy my PSA fell from 8.6 to 0.8. The doctor said this was very unusual as that usually takes about nine months.

I still get very tired however I am beginning to think that might be due to something else ( apart from being bone idle!🤔 ). I will try and organise a generic blood test after my review.

All the best

Dave

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