Decision Time. Help wanted.

When my dad was treated, the doctors believed the cancer had spread outside the prostate and recommended brachy and external beam. That was over 10 years ago, but I believe similar thinking still exist today. It was too late for him as the cancer was aggressive, he did experience side effects too, although the beam radiation today is better.

@ Overthepond. Hi Susan. Nice to hear from you again. I did make a comment in one of my old threads about the fact that Jeff had his treatment in Guildford and that I knew the area well, not sure if you saw it before that thread disappeared into the weeds.

I don’t have a problem with reduced ejaculation, but not being able to achieve an erection would be a major issue for me. I have had a flow problem for the last couple of years and have been taking daily tamsulosin to fix the problem. My brachy uro was concerned about this and made me take a fresh flow test before he would confirm treatment. He said it was ok, but could be better.

Fortunately, or unfortunately I no longer work, so taking some time out as you suggest would not be a problem. I sold my business in 2003 because I could no longer deal with the pressure after losing my son, wife, granddaughter and mother within 12 months. I now live of the proceeds but miss my old working life style, but at the time I was losing money because I was in such a state I could not even go into the office..........Very dark and sad days. Jeff is doing pretty good if he is still plastering at 65, it is a very demanding job.

My good wishes to you both.

@ Tudpock18. Thanks Jim, this was just the kind of information I was hoping for. Looks like your side effects are pretty much the same as others who have commented. Yooper in particular. If I can get results like that I will be a very happy man. It is just the flow issue that could pose a problem, but my uro appears to be happy about that.

@ Michael_T. Thanks Michael. The two differences as I understand between LDR and HDR is the fact that your body is not left radiated after treatment and that HDR is much stronger so reaches outside the margins further than LDR. I am hoping that my cancer is contained so that LDR will do the trick, if I go that rout. I have not yet ruled out HDR mono. To be honest, any side effects would not bother me that much, as long as I knew it was short term. There is no way I want anything to do with HT. My state of mind just wont take it, that is why if I went with HDR it would have to be the mono trials.

@ Squirm. Sorry to hear about your dad. I lost my father last year and still miss him badly, but you are right, treatment has come a long way in the last ten years. Just a shame it was not here for your dad.

@ Goodlife. At last, a surgery guy. Like you I think I would also go the surgery rout, it would defiantly help my flow problem, but the one thing that bothered me is my surgeons comment that he would have to cut wide on the right side, so could not offer nerve sparing in that area. That would cause ED problems for sure and if the nerves were cut away then there is nothing to heal in the future. That is the only reason I am not comfortable with surgery.


This is the type of information I have been looking for. Any more of you guys that would like to add there treatment reasons and experiences please. It will honestly help me in deciding treatment.

Thanks to all of you that have taken the time to comment so far.

Casper,

I would add a point about sex. When we first got married at 21, that was all we thought about. Unfortunately, many times my dear wife was left wondering what happened, as I rolled over and fell asleep.

It is so different now. My goal is to insure that my wife is able to achieve an "O". It actually is very satisfying for me. In general, many older women lose I interest in the actual sex. It can become painful, and just not like it was when we were 21.

They want the attention. I am sure that whatever treatment you choose that may cause ED immediately, or a couple of years down the road, that you will be able to find a lovely companion who will say that she wants a good man who cares about her and loves her. Actual sex will not be an issue when you meet the right one.

Living a good life is what is important. Oh, I gave away my handle.

Goodlife

Thanks Samster for your reply. Nice to have some input from the surgery side of the table.

Our numbers are pretty much the same and your results are just what I would be looking for myself. But as you may see from my surgeons letter, he has said he would have to cut wide on the right margin, therefore ED would be inevitable. Not something I want if I can avoid it. The only thing that has not made me rule out surgery completely is his comments on my flow rate. I am still thinking hard about that and will be calling his nurse again for more information before I pull the trigger on my chosen treatment.

@njs, when I met with Dr Ash Tewari, he told me 10% chance of PSM. I thought that was his overall rate, but maybe it's specific to me , due to the fact that I have one core in the right Apex. Although i notice in your signature block that you were also an apex positive core.

Tewari has done over 6000 RALPs, and is considered one of the best.

njs, thanks I will respond in a new thread, i dont want to hijack Caspars thread, its important he get the information he needs so this thread should remain focused on him, my bad.

Hi njs. Sorry I must of missed your post yesterday.

Funny you should say that, because that is something that has been playing on my mind. The surgeon is a pretty young guy, but has a phd in prostate cancer obtained from a Cambridge university. That said I am not sure how many procedures he has carried out. The brachy guy has done 300+ procedures and heads the team at my hospital for that kind of treatment. He certainly knows what he is talking about and willing to answer all questions in great detail.

The problem with our free health care system is that all the top doctors tend to move into the private sector where the big money is, leaving the less experienced to work for our NHS. They do not pay the top doctors enough money so you cant blame them for only working on private patients. Although a few of them do a bit of both.

Your comment is oh so true. The treatment is only as good as the person carrying out the procedure. That is where you guys are so lucky, as you have some of the top doctors in the world.

Thanks very much for you post, I found it very thought invoking.

Casper,
Like Yoop, I am extremely biased. Not only do I never question the choice that I made, but I am thankful every day that I made it. LDR made the most sense to me then and now: I was back to work in 2 days; back to the gym in 1 week; my sex life has never been better; continence is great; and the oncologist uses the 'cure' word. Yeah, I'm a very happy camper.
I can't comment on HDR, but it sounds like that group is a happy lot as well.
Best to you, Brother.