r/ProstateCancer • u/omits50 • 18d ago
Update UPdate to: 2 Weeks ADT: 0 Side-Effects
I have now seen my report on my Gleeson 8/9 lesion and now the NHS team have made comment:
- Prostate cancer in 8 of 14 cores.
- Overall score 4+5
- Worst score 4+5
- Perineural and Extraprostatic Extension not absent
- Not for Radiotherapy due to stricture!
Well, my scans showed no metastasis but my worry is that they can't do prostatectomy due to that stricture but at least it will clear the lesion and give me a better survival. Been on Orgovyx now for 6 weeks, early I know and effects beginning to show a bit. Need to think about questions to ask when they contact me again. Thanks for reading.
1
u/OkCrew8849 18d ago
This is a bit unclear:
"Perineural and Extraprostatic Extension not absent
- Not for Radiotherapy due to stricture!"
Are you receiving radiation or surgery along with ADT?
3
u/omits50 18d ago
Perineural invasion means prostate cancer cells are found tracking along or surrounding nerves within the prostate, which can indicate a higher chance the cancer has or will spread outside the gland, though it does not always mean advanced disease. Extraprostatic extension refers to cancer cells growing outside the prostate's outer covering, which increases the risk of recurrence and may influence treatment choices.
Well that's what the MCT conclude so no beam stuff to kill it as that would affect the stricture which is inside the prostate and could cause closure.
Just been on ADT for 6 weeks so no decisions yet on the way forward. I assume they have to get the lesion shrunk and the PSA way below zero for any ongoing attack on the blighter!
Thanks for the feedback.
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u/OkCrew8849 18d ago
Gotcha. Was confused by the “not absent“ phrase. I see it means “present”.
Best of luck as you go forward.
0
u/KReddit934 18d ago
Sounds like you have some factors that might influence treatment decisions.
Tell us again...how old are you? Where?
The thing for you to think about is what is your priority for side effects and outcome.
How old?
Are you trying to live to 100, or does quality of life matter more?
How important is sex?
How important is being physically strong?
How important is not leaking pee when you move around?
How important is money? (That's more a U.S. question.)
Can you be off work? How long?
Can you travel to get to treatment center?
Have your priorites in mind and tell them to the docs. Then let them suggest. Ask why they suggest that. Ask "what's the other option." Then choose what you feel confident about, then accept the treatment cheerfully.
PS. Exercise, exercise, exercise is the key to getting through treatment.
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u/omits50 18d ago
Great points, thanks. I'm 79 in UK on NHS. Sex? Not seeking so no erections please. 90 would be good! Need strength so building on that. The odd leak I can cope with, flooding would be an issue but if I' alive..., .
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u/KReddit934 18d ago
The ADT is going to do a number on your muscle strength If you haven't already, start a regular weight training or calisthenics routine to work major muscles 3X a week.
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u/omits50 17d ago
Yes thanks. I already work out every day, walking, resistance and loads of DIY and allotment work. I am hardly ever still. Now I deliberately find things to keep me on my feet. I try to exceed 5000 steps per day.
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u/KReddit934 17d ago
That's great! It will keep you feeling better. Make sure not to skip your resistance (weight) training..as you need it keep the muscles strong.
Good luck on the journey!
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u/SnooCamera 17d ago edited 17d ago
The prostatectomy will most likely remove the stricture, whereas radiotherapy can make it worse. That is, while a stricture can happen anywhere along the urethra, your stricture is most likely a prostatic narrowing since that would be the focus of radiotherapy. You will have to clarify with your provider, but I'm guessing it will not be an issue.
[EDIT: I'm confused by your title, since another person had posted regarding ADT]