That is incredibly sad news; he was always an interesting and watchable actor, not necessarily mainstream. 71 is still too early an age to pass of prostate cancer in my mind.
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Paul,
I reckon I am at a similar stage to you; confirmed diagnosis about 6 weeks ago and a Gleason 7 (3 + 4). Given âoptionsâ of prostatectomy or hormones and radiotherapy. I feel I have been shepherded towards radiotherapy and hormones (6 months of tablets and one month of radiotherapy) rather than robotic prostatectomy because I have had previous stomach/groin surgery. At the moment the oncologist is giving me two weeks âto think about itâ.
You may have found yourself pointed in the direction of the NHS website Predict Prostate but if not I found it useful. Other peopleâs âjourneyâ anecdotes are (mostly) reassuring and helpful, but this site is evidence based.
Good luck,
Jonty1
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One general pointer about preparing for surgery is the need to exercise the pelvic floor muscles. Incontinence after surgery can be much reduced if those muscles and your brain are prepared for what is needed.
On a related subject anything that can be done to re-educate the bladder towards its youthful high capacity will help. Again pelvic floor assists with this.
Phil
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thanks Phil, again useful to know!
Many thanks for posting Jonty and interesting to hear about the direction you are pondering; good luck with your choice and hope all works out well. Thanks also for the website pointer.
Thanks to all who have replied and provided their journeys, thoughts and kind words; these have been both reassuring and reaffirming.
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I think it is important to remember that over 50% of all people with cancer live over 5 years now and for some cancers, the survival rate is much higher. Prostate cancer has a 10-year survival rate of 78% according to Cancer Research UK.
Cancer is not the death sentence it once was. Also, whilst some cancers are still not curable, they are treatable and modern treatments can keep lots of people alive with a good quality of life for many years. When I got my diagnosis for advanced cancer of the tonsils, that had spread throughout my neck, two main tumours and numerous small tumours, the prognosis was not brilliant (in fact it was pretty dire as I had advanced and very spread cancer) but I was determined that I would get through this. I deliberately took an optimistic view of my outcome, knowing from my previous work as a therapist that there was strong evidence that proved to be optimistic improved cancer patientsâ outcomes. I knew that the overall survival rate for my cancer could be well over 50% maybe 80% if caught early, I ignored the if caught early bit and just held on to that higher figure. So I was convinced I would become clear and apparently, 7 years on I am. If anyone is interested in reading about my journey, there is a link on my profile.
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Yikes. Cancer has a way of coming back, so the preferred treatment may depend on your age. The Da Vinci is not associated with better outcomes than non-robotic surgery, but recovery may be fasterâmy brother was up and walking the next day, with 4 1- or 2-inch scars to show for his ordeal.
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Agree with this - although worth bearing in mind that many people who are positive and optimistic unfortunately have their optimism proven wrong. Succumbing isnât a marker of a lack of will-power or positive thinking (I know youâre not saying it is).
I think all these decisions are easier the younger you are.
Urology would like to burrow into my bladder to rectify a small residual problem they discovered when I had the todger-o-scope nearly two years ago. File lost/covid delaysâŚwhatever.
Daughterâs partner is a surgical nurse practitioner and I obviously raised the problem with her over tea and cake.
Does it cause you problems? No
Does it hurt? No
How old are you? 82.
Leave it alone.
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Unfortunately, you are right being positive doesnât always mean you survive and one of the most optimistic people I have ever known didnât make it. Being positive just swings the odds in your favour slightly and as a cancer patient, every percentage point is eagerly grabbed.
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There are possibly differences. At one time the surgeon had to be able to sense the boundary between the cancerous tissue and the healthy by touch. Some surgeons were very good, and if this preserved the nerves which surround the two sides there was a greater chance of preserving ***ile function. With the the Da Vinci, the scalpel is replaced with a cauterising device, which helps with bleeding and also kills potentially cancerous cells.
How the surgeon proceeds ideally is informed by MRI which should reveal more about the extent of the cancerous tissue. Many urology departments include MRI as standard at some point. Mine happened before the biopsy and therefore informed the procedure. As it happened the cancer was everywhere in the prostate rather than being a small mono-lateral growth or several bilateral growths. He could hardly miss. Other things that MRI helps with are: the position of the growth relative to the bladder - growth at the side is better than near the bladder; it can also detect spread to the nearby lymph nodes and sperm ducts. Therefore, MRI is very beneficial for informing the decision on surgery or radiotherapy.
Hope this helps. Even though I started learning about the subject nearly 5 years ago it is still fairly fresh in the memory. Music and gardening were my escape.
Phil
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@PaulM , I had a radical prostatectomy performed in January 2017.
I had a consult visit with the surgeon who performed the surgery using the computer guided robot. I also had a consult with an oncologist who reviewed the radiation therapy option with me. Both were viable options but for me I preferred going the surgical route. I checked into the hospital at 11:00AM day of the surgery that was scheduled for 1:00 PM. The surgery was delayed and did not start until some time after 5:00 PM. I was moved to the recovery room some time after 9:00 PM and moved to my inpatient bed right after midnight. I was discharged from the hospital at 3:30 PM that afternoon with a catheter and a leg bag to wear for 10 days. Pathology reports were reviewed with my surgeon when I went and had by catheter removed which indicated that all the cancer was removed and none was found in samples they took outside the margins. I still have a PSA drawn which has been negative for the past five years.
My preference was to have surgery but I have know others that have gone the radiation route and have had success. I preferred getting it all done at one time instead of several weeks of treatment. The other reason was there was a drug treatment that went along with the radiation treatment that was know to cause depression and anxiety. I had an issue with this previously in my early 20âs after leaving the military while I was attending college. A chapter of my life I preferred not to experience again if I could avoid it.
It is nice to have options and belief that early treatment and taking action prior to the cancer spreading outside the prostrate was the best decision for me.
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Thanks for sharing Seakayaker. I appreciate knowing your rationale for choosing the route to take and how the day(s) went. Hopefully the path to recovery was straightforward. It is great to know that your PSA remains low long may this continue!
Your welcome Paul.
The surgery and recovery was straightforward.
I should mention that having the catheter inserted and wearing the leg bag for ten days was a royal pain in the arse. âŚbut a small price to pay in the grand scheme of things.
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I had to make a similar choice a couple of years ago when my PSA reached 11 and my Gleason score reached 3+4. Based on my assessment of the long-term side effects of each treatment, I opted for radiotherapy. In my case, my doctors told me that my odds of long-term survival were about the same for each treatment, so it wasnât a factor in my decision. I was also able to ask a friend who had similar treatment 15 years previously about his experiences. One factor in my decision was that the possibility of impotence was lower with radiotherapy than with surgery.
My treatment (I live in California) consisted of hormone suppression therapy in preparation for an out-patient brachytherapy procedure performed under sedation with an epidural, followed by 20 sessions of external beam radiation therapy. Fortunately, I didnât suffer too badly from night sweats during hormone suppression therapy. The staff at the clinic were wonderful and made each session feel like a visit to the spa and going out for a couple of hours each morning during the initial CVOID-19 lockdown wasnât too much of an inconvenience for me. I donât recall anything that was particularly unpleasant or painful about the treatment. Some of the associated diagnostic techniques before and after were much worse in that respect. The prostate MRI probe and the todger-o-scope spring to mind here.
After almost a couple of years, the only side effect I have had (apart from the obvious result of my prostate having been fried alive) is occasionally an increased sense of urgency in the need to pass water. I have my PSA checked every six months and so far it has remained near zero.
About the best advice I can give is to be as fully informed as you can about the pros and cons of each treatment and decide which is likely to suit you better given your unique preferences and medical history.
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Thanks for providing great detail about your choice & how it went Paul; this is very useful, especially around the longer term survival summation. I think most of the radiotherapy examples kindly provided by folk look to focus on a longer. period of treatment; what is offered to me is a much shorter term treatment so I need to research some more on the cases where this was followed. I totally understand about the probing and scoping in comparison! Thank you also for the advice which ties in with that of others; it is more research time and all the great feedback that I am getting here is all part of this. I am really pleased to hear that this has been successful for you and long may that continue to be the case!
Slightly late to reply. A close friend of mine was diagnosed with prostate cancer 5 years ago. He opted for Da Vinci surgery at a London Hospital and the surgeon was Declan Cahill. Outcome was very successful. Annual checkups now show PSA still low and clear of cancer. He had minimal side effects. Iâm waiting for results of my biopsy next week so fingers crossed âŚâŚâŚ
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I went for removal because my cancer was at 4 and I had only just got over Pancreatic cancer. I had a full Whipple for that and a lot of chemo. I really did not fancy going through that again but as I recall my Urologist said I needed to go for removal rather than Radiotherapy. I was worried about having incontinence issues post surgery but they only lasted about 8 - 10 weeks. No problem now.
All the best with whatever decision you make.
SteveT
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Thanks t-o-t-r, definitely fingers crossed for your results.
Paul