prostate cancer

[PeterCurzon48 (imported)]

I have recently been diagnosed with Stage 2 prostate cancer and placed on Active Surveillance. To my mind this isn't going to cure anything and just kicks the can down the road accompanied by frequent PSA tests, MRI scans and Interperineal biopsies. I'm going to request that my treatment be changed to a Simple Orchidectomy followed later by a Radical Prostatectomy. Does anyone have any helpful comments regarding my treatment preferences.

[Midnightworker (imported)]

It Is better to do a Radical prostatectomy first. Becouse when it comes back then you have another choice. when you take the hormonal route first, then an operation is possible but no use anymore. when you choose for radiation, then an operation is not an option anymore becouse there is to much scarring. best way is radical prostacetomy, then orchidectomy and the last radiation. But it is your body and it are youre choices. Grtz

[PeterCurzon48 (imported)]

Thanks Midnightworker. I really need all the help I can get.

[Cseriess (imported)]

Depending on the cancer it may or may not be T dependent. If it isn't, then orchiectomy won't do anything. If it's really slow moving then you may well die of something else and have prostate cancer like many, many men. I have found there are so many different routes with different effects and side effects. Look carefully at your cancer, get several opinions. When I brought up prostatectomy to my urologist, she thought I was insane! She thought the side effects were far worse than other options at the time. Good luck!

[cutnbulls2ox (imported)]

You d be best served to get multiple drs opinions before you do anything radical. And research your different options in great depth

But if castration is your goal, this might be your chance to get steered.

[TopManFL (imported)]

I have recently been diagnosed with Stage 2 prostate cancer and placed on Active Surveillance. To my mind this isn't going to cure anything and just kicks the can down the road accompanied by frequent PSA tests, MRI scans and Interperineal biopsies. I'm going to request that my treatment be changed to a Simple Orchidectomy followed later by a Radical Prostatectomy. Does anyone have any helpful comments regarding my treatment preferences.

I am not a doctor. So, take what I say with that in mind.

Active Surveillance is a form of treatment. It does seem as if it is just kicking the can down the road and from having a different cancer, I know the deep desire to "just cut this shit out of me - who the hell wants cancer!"

However, prostatectomy causes harm. If the pathologist report comes back that the cancer was nonaggressive and slow-growing, you most likely would be sorry you'd had your prostate removed.

Since the introduction of the PSA test, the number of prostate biopsies has gone up dramatically. Of course, the number of core samples showing cancer has also gone up. As a result, the number of prostatectomies has risen as well.

However (and this is a big issue), the number of prostate cancer deaths has remained the same. So, the aggressive intervention hasn't lowered prostate cancer deaths.

That is not to say that PSA tests that result in the detection of cancer via biopsy don't lower death rates. It means that the overall death rate has not fallen. The numbers are confusing. Plus, studies are normally paid for by the makers of the test kits.

"PSA testing reduces deaths from prostate cancer, studies say. Unfortunately, the trials provided confusion rather than clarity. The U.S. trial reported no benefit of PSA testing..." https://www.upi.com/Health_News/2017/09 ... 504616877/

Of course, if we routinely took out the prostate of every man over 50, overall prostate cancer rates would drop to almost zero. Needless to say, the harm to benefit ratio would never support such an approach.

All of this to say, do not think that active surveillance is kicking the can down the road. You could be saving yourself from urinary incontinence and impotence. As for castration as a treatment, that only works on certain kinds of cancer and carries its own set of problems.

Good luck and keep us informed.

[PeterCurzon48 (imported)]

As you say there seem to be multiple options. I'm currently seeing an NHS surgeon so getting other opinions is probably beyond my finances. Orchidectomy is one of the NHS options along with other Hormone therapies. Thanks for your advice !

[PeterCurzon48 (imported)]

Much research is in progress. I doubt castration will be offered, and it isn't my goal. But if it is offered ... I'll take it.

[PeterCurzon48 (imported)]

It Is better to do a Radical prostatectomy first. Becouse when it comes back then you have another choice. when you take the hormonal route first, then an operation is possible but no use anymore. when you choose for radiation, then an operation is not an option anymore becouse there is to much scarring. best way is radical prostacetomy, then orchidectomy and the last radiation. But it is your body and it are youre choices. Grtz

Sensible advice Midnight worker ... taken on board. Thanks

[Chesleyt (imported)]

I have precancerous prostate cells and am on watchful waiting and get my PSA checked every 6 months. I've already had 2 prostate biopsies done after the last one I was told not to have another one unless my numbers drastically increase.I am already an eunuch and have chosen to stop testosterone therapy because of the mental health problems it caused

me. So hopefully that will keep it in check. Good luck.