Optimal treatment

[Graemeb]

Dear Sir / Madam,

I am writing on behalf of my Father, who is a 71 year old white British male in otherwise excellent health (other minor ailments are limited to a mildly underactive thyroid gland and mily hypertension which he has had for 10 and 30 years respectively).  He is extremely fit for his age, indeed he was putting a new roof on his house this summer.  Non smoker for 30 years, very light drinker.

In October of this year my Father was diagnosed with PC as a result of his PSA rising from 4.2 to 5.8 in 14 months.  Previously his PSA had fluctuated between 3.9 and 4.2 over the past five years.

A DRE was described as marginal, and he was referred for biopsy.  Biopsy results showed adenocarcinoma in 25% of cores in one half of the prostate, with only benign disease in the other half (i.e. 2/16 cores postive in total).  Gleason score was 4+3 with tertiary pattern 5.

Bone scan was normal and MRI suggests the tumour remains contained within the prostate.

My Father has been given two treatment options on the British NHS - Surgery or Radiotherapy, possibly with hormone therapy running alongside.

Of these two options, which is likely to provide the best long term outcome for a man in my Father's situation, and should hormone therapy be initiated immediately?

Many thanks,

Graeme

[Oil_Man_Bob]

From what I know, either radio or surgery are options.  I guess it depends on yr Dad's individual circumstances which is better for him.

I think you really need Dr T.  to answer this one.

Good luck,

Bob

[Graemeb]

Dear Sir,

Further to my earlier post, firstly please accept my apologies for my earlier salutation of 'Dear Sir/Madam', I had not realised that the only Expert on this forum was a man, and as such the salutation was incorrect.

Further to my earlier post, my father is now inclined to opt towards surgery, however his rationale in doing so is a belief that if the gland is removed, this must be more effective than blasting the tumour with radation.  The NHS dont want to influence his decision either way.

Please Sir, in your oppinion, which of the two options being presented to my father is likely to be most suitable in the long term.

Also, as I can now presume that I myself am at increased risk of PCa in the future, at what age should I begin regular screening?  (I am currently 30 years old, have no symptoms, and have had two DREs in the past twelve months - one as part of an insurance medical, and one as a pre-cursor to a colonoscopy for what turned out to be internal haemorhoids).

Your advise is greatly appreciated,

Graeme