I had prostate cancer back in 2010. It was removed surgically and my PSA has been <0.1 ever since. I'm not a doctor and I have no medical training. However, I am an active member of my local prostate cancer group.
I'm definitely not qualified to make these calls, but that's never stopped me before.
I would suggest that treatment should definitely be chosen if one or more of these circumstances apply:
- The man is less than 65 and is in otherwise good health, because there is too much lifetime for the cancer to become aggressive and life limiting.
- The cancer is anything other than 3+3. If there are any Gleeson 4 or 5 cells found in the biopsy sample then the cancer has already started to become aggressive.
- The PSA is above some threshold, say 20 or 30.
If none of these apply (say the man is aged 68, Gleeson 3+3, and PSA under 10) then it's down to a personal decision, but there is probably no need to make a decision in a hurry.
Again, I emphasise that I'm not a doctor and I have no medical qualifications.
In my own case, I was diagnosed at age 56, my PSA was 5.7, and the Gleeson score on biopsy was 3+4, although when the organ was removed, it was downgraded to 3+3. As you can see, I fit two of my own criteria for treatment and hence I made the right decision to have surgery.
If you want or need to talk further, then we're here to help.
Hi. Thank you for replying. My husband is 65 and his gleeson score is 3+3. His PSA is 5.5 I think. It did go up to 7 on one blood test but back down on the next one . He was told that there's no hurry to make a decision but think he will worry all the time unless he gets rid of it through surgery. He is worried about being incontinent afterwards tho.i know it has to be his decision but good to hear other people's opinions and experiences . Jean
Personally, the only treatment I would have is surgery - BUT ONLY if it is being performed robotically at a large centre where each surgical team does a minimum of 100 such surgeries each year.
I think radio-active beads and HIFU are too experimental, and conventional radiotherapy prevents later surgery. With surgery, the removed organ can be examined in the lab and the true extent of the cancer found. With surgery, if it works the PSA should drop to <0.1 within weeks and if it doesn't you know immediately that further treatment is needed. With surgery, there are no worrying PSA bounces after treatment - you have the blood test and you are either immediately reassured, or you know you need further treatment. And the further treatment has a very high cure rate.
I was fortunate that my surgery was carried out by one of the country's top prostate surgeons; but because of my initial 3+4 diagnosis, I could only have nerve sparing on one side.
After surgery, once the catheter is removed there is always a miserable period of incontinece, but after 3 months I was 99% continent, after 6 months I was 99.99% continent, and after 9 months I went on a day trip to London not wearing any protection at all. Unfortunately the unilateral nerve sparing affected my erections, but even that wasn't as bad as I feared, since my orgasms have improved amazingly since the surgery! Go figure that for side effects.
With your husband's values, it's looking good for him and he has lots of time to consider his options, but the window for surgery will probably close when he reaches 70. Surgeons are unwilling to operate after that age.
I must again emphasise that I'm not a doctor, and this is my own personal view as someone who went through it all back in 2010.
My son age 62 diagnosed prostate cancer February 1918. He was T 3. PSA 47 His local surgeon said too far gone to operate. Just take Hormone Therapy folowed later be Radiotherapy. My husband had been diagnosed 12 years earlier ( not as advanced PSA 7).. We were able to pay privately to have it surgically removed by the most experienced prostate surgeon. We managed to engage this surgeon for our son and In May 1918, had his prostate removed. Unfortunately the cancer had spread to some of the lymph nodes' His PSA had risen to 0.5 and despite having had a CT scan which didn,t highlight anything it is suggested that he still has cancer some where, and the oncologist wants him to start Hormone Treatment. Being aware of the unpleasant side effects my son does not want to take them and is relying on a diet of fruit and veg plus other "other things" he has researched to cure cancer. I would appreciate any comments relating to this He did not become incontinent. after the operation.
Sorry about your son. Hope they find any remaining cancer and are able to treat it. My husband was also advised by the doctor to eat certain types of food but think an operation is the way to go in his case .
I remind you that I'm not doctor, just a prostate cancer patient who was lucky that it was caught early.
I was very sorry to hear of your son's diagnosis. The T3 means that the cancer is "locally advanced" - in other words it had already spread out from the prostate at the time of diagnosis.
You can find out more about Locally Advanced Prostate Cancer by clicking here.
To the best of my knowledge, surgery isn't always recommended in such cases because it's simply shutting the stable door after the horse has bolted. Treatment options usually involve a mixture of hormone therapy and radiotherapy. Hormone therapy can shrink tumours but on its own can't cure them. Radiotherapy can cure some prostate cancers even though they've spread. Often patients are put on a protocol of several months hormone treatment, then a course of radiotherapy, then many more months of hormone therapy. The aim is to effect a cure, but even when this doesn't happen, the patient's lifespan can be extended for years and the onset of more severe symptoms delayed.
Unfortunately, there are absolutely NO foods that can cure cancer. If there were then the NHS would not need to spend thousands of pounds on every patient, but could simply prescribe each patient their own diet. Sadly, there are any number of quacks and too much wrong, ineffective and dangerous information on the internet.
Being brutal, I think your son is acting unwisely by refusing treatment. I fear he will end up dramatically shortening his life. It's his decision of course, but it's not the way I would go.
Hi Jeanp. Surgery is a reasonable option in your husband's case. However, do you know where the operation will be performed and who would do it? It is important to get referred to a centre where they have the robots, and teams who have the skill and experience to use them. The best results are when each team is doing about 100 operations a year (or around 2 per week).
Note: it is against the forum's policies to name individual doctors and consultants, so don't mention any names or hospitals in your answer.
Don't know exactly where he would have the opperation but googled the best 10 surgeons and one was at the Sheffield hospital where he's been having his tests. Don't know if we get a choice as it would be NHS. It's something we can discuss when we let them know he's decided on surgery tho . Going to make an appointment today.
Looks like your husband is going to be in good (robotic) hands at Sheffield.
Just for information, if you don't like the surgeon you've been assigned, speak to your doctor who can refer you to a different hospital, but you go to the back of the queue. This would probably not be a problem in your husband's case.
But the best laid plans can go wrong. On the day of my surgery, the surgeon assigned to do it (and in whom I have 100% confidence) was lying desperately ill in another hospital. I could hear the nurses on my ward talking about his, and they were really worried for him. So a different surgeon extended his list to ensure everyone got their ops. Fortunately, the sick surgeon made a full recovery and his skills are making lives better for many people.
