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Prostate Cancer

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 The New NickB 06 Mar 2019

My Dad has had a Prostate Cancer diagnosis today. Something that has been a possibility for a few weeks following a PSA test and a biopsy.

Its a Gleason Score of 7 (3:4) which I understand makes it a grade 2 cancer. He is having a bone scan next week, following this recommendations will be made for treatment, likely either surgery or hormone and radiology treatment.

Just wondering if anyone had any experience of similar. 

 DNS 06 Mar 2019
In reply to The New NickB:

Two close associates, both now in their 60's, with similar - if not more severe - initial results. Both went through chemo and radiotherapy, not the easiest time, but both apparently getting on with life 5 and 9 years on and being as big a pain in the arse as ever.

Both fairly bloody-minded and physically robust when diagnosed.

 DNS 06 Mar 2019
In reply to The New NickB:

Just remembered another, mid 60's when diagnosed. Always a passive chap and prone to melancholy. Had hormone treatment. Don't know severity at time of diagnosis. Died quietly within months.

 gribble 06 Mar 2019
In reply to The New NickB:

I'm in that club. Your dad has grade 4,though probably stage 2. On those details, eminently workable with  pending bone scans. It's a very slow moving cancer, so don't panic about slow moving medics! 

For further (and good) info, check out Prostate Cancer UK  

Removed User 06 Mar 2019
In reply to The New NickB:

Can't answer your question Nick but my experience is that in these situations the not knowing is the worst of it. We all want certainty but unfortunately that's the thing you won't find.

Sending you a hug. Be strong for your Dad.

 Andrew Holden 06 Mar 2019
In reply to The New NickB:

My dad had the same diagnosis in September 2017. He’s had hormone, radio and chemotherapy and so far so good. He is just about back to his old self now. Fingers crossed it stays away. 

Be there as much as you can during treatment.if you can take him to and from the hospital from treatment that will make things so much easier for him.  If he has radio make sure he drinks plenty of water. This helped both my dad and my mum during radiotherapy. 

Stay strong during this difficult time there is light at the end of the tunnel. 

 Neil R 06 Mar 2019
In reply to The New NickB:

I had 3+3 and treatment was Brachytherapy. I was fortunate to live in Leeds which was one of the main centres for Brachytherapy at the time. Looking elsewhere some people with score of 3+4 also seem to have had similar treatment. Of all the treatments offered this seemed to have the least side effects and I was back to work in a few days, with no subsequent recurrence in seven years.

Clauso 07 Mar 2019
In reply to Neil R:

>... treatment was Brachytherapy.

My dad had much the same situation, and treatment, as you did. He received fantastic treatment at The Christie, Manchester and has been clear for the last dozen years. 

 Trangia 07 Mar 2019
In reply to The New NickB:

Yes, I had surgery  7 years ago, when I was 68. I had the choice of radiotherapy or surgery. The Consultant told me that in my case, if I opted for surgery and it didn't  succeed then I would still have the option of falling back onto radiotherapy. However the converse wouldn't apply, so it was really a no brainer. In my case brachytherapy wasn't an option because of the close proximity of the cancer to my bladder and poor flow rate.

I am pleased to say that when my prostate was removed they found the cancer was still within the gland ad hadn't spread, which was good news. For a year after the op I had PSA tests every month, then every 3 months for a a couple of years then reducing to once a year up to he present time. The PSA Level had dropped to and remains at 0.03, and so long as this remains the case, I am clear.

The op was  radical out carried out by keyhole surgery, and recovery was pretty fast . I was walking around the hospital corridors two days afterwards with my catheta in tow on a trolley, that was removed after 2 weeks - slightly longer than usual, walking up to two or three miles after a month, and climbing again (easy routes involving no strain) after 3 months, and the 5 scars from the surgery have healed so well I can hardly see them. 

Yes, there are side effects but they can be controlled and managed, and gradually reduced during the year following surgery and have been nothing like as unpleasant as I had feared.

1
Deadeye 07 Mar 2019
In reply to The New NickB:

> My Dad has had a Prostate Cancer diagnosis today. Something that has been a possibility for a few weeks following a PSA test and a biopsy.

> Its a Gleason Score of 7 (3:4) which I understand makes it a grade 2 cancer. He is having a bone scan next week, following this recommendations will be made for treatment, likely either surgery or hormone and radiology treatment.

> Just wondering if anyone had any experience of similar. 

Well, I have prostate cancer - and, unfortunately, that's *after* both surgery and radiotherapy.  I'm in my early 50s.

The Gleason is a marker of how aggressive the cancer is.  Mine was 7.  The other improtant things are whether the biopsies suggested the cancerous cells have crossed the margins of the prostate (not all biopsy methids show this), and his PSA level.  A very high PSA would raise the likelihood of it having escaped the prostate.

If it's contained, and with modest PSA then there is an excellent chance that first line therapy will be completely successful.

In terms of treatment, the first line if bone scans are clear is either surgery to remove the gland, or brachytherapy (radiotherapy from implanted "seeds").  I went with surgery, although it's a fairly horrible operation.

If that doesn't reduce PSA to undetectable, then there are cells that have spread, probably to the pelvic floor as in my case.  The treatment is then salvage radiotherapy... unfortunately that has also failed in my case.

If the above fails, or if the cancer has already turned up in the bones, then you are into hormone therapy.  This is not curative, and carries side effects.  I have elected to delay - I would rather have fewer years overall but higher quality for longer.  The cancer eventually becomes unresponsive to the hormone treatment.  At that stage there are a couple of chemotherapy agents, but these add a few months at best and carry some poor side effects.

Someone has suggested one of the support websites.  Be very careful with the forums on these - there's quite a lot of, at best, well-meaning misinformation and, at worst, snake oil pushing.

If you want more info, by all means pm me.

In reply to The New NickB:

My Dad was diagnosed at 62 (18 years ago) and we are celebrating his 80th this weekend. He had radio therapy at the time which was effective. It has recently come back which was confirmed from elevated PSA and MRI scans, he is going onto hormone therapy next week.

One thing to consider yourself is that you are personally in a higher risk group if your father gets prostate cancer at a relatively young age.  I am 46 and have started this year within my annual medical a PSA test and prostate examination. The doctor explained to me that monitoring the PSA levels over a long period of time can be useful and informative if it suddenly spikes, or even just starts creeping up.

Best wishes to your father and for successful treatment.

OP The New NickB 07 Mar 2019
In reply to The New NickB:

Thanks everyone for your comments. Obviously it's pretty early and he is waiting on further tests and advice on the appropriate course of treatment, but he seems pretty positive.

vancian 07 Mar 2019
In reply to The New NickB:

Gleason 7 (3+4) is a pretty good starting point. Depending on further investigations on size and PSA score, etc or older patients the recommendation might be do nothing

As a radiotherapist I'm bound to recommend it, even 10 years ago when I started the 3 options of surgery, external radiotherapy or brachytherapy were all highly likely to cure you if it hadn't spread. They had varying sorts of side effects and inconveniences to decide between. These days, due to various advances, external radiotherapy takes 4 weeks rather than 7 1/2 where I am and the side effects have reduced from moderate to mild levels generally.

 lansa 07 Mar 2019
In reply to The New NickB:

I was diagnosed with advanced prostrate cancer (ie it had spread to my bones) just over 12 months ago and am now on a regular 3-month hormone injection which 'closes down' the cancer and its spread and certainly works - along with menopausal type symptoms (hot flushes et al!). I'm in my early 80's and still climbing on very low grades, with plenty of attention to safety - which is probably while I can still do it at my age. The GP wanted me to stop climbing, but to keep walking - apparently, both cancer and hormone treatment can lead to brittle bones, hence his concern. I explained to him the level of safety that can be achieved, and that my greatest danger of a fall would be walking back from the crag in failing light at the end of a day on the rocks. I have received a lot of anecdotal reports of men living long active lives on the jab. Thank God and Aneurin Bevan for the NHS!

 desmondo1 07 Mar 2019
In reply to The New NickB:

There is always hope. I was one of the youngest people diagnosed and had radical surgery 15 years ago. Of course there are changes in my life but still climbing plenty of hills. Only way ahead is to look forward positively.


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