Prostate Cancer - next step

[Negita43]

Just an update to my previous posts - my PSA now < 0.1. I am in the UK at the moment and out of interest just had my hormone injection over here it called prostap in Thailand it's called Enantone BUT both made by the same company (Takeda)

[Sheryl]

3 hours ago, Negita43 said:

Just an update to my previous posts - my PSA now < 0.1. I am in the UK at the moment and out of interest just had my hormone injection over here it called prostap in Thailand it's called Enantone BUT both made by the same company (Takeda)

 

What you are on is not actually "watchful waiting" then. You are receiving hormone therapy. There is a difference.

[Negita43]

18 hours ago, Sheryl said:

 

What you are on is not actually "watchful waiting" then. You are receiving hormone therapy. There is a difference.

If you read my previous posts I believe I said I had had a biopsy and  radiation therapy in Thailand before

[erectem]

On 4/3/2024 at 8:50 PM, Sheryl said:

Rezum does not treat prostate cancer, it is used for benign enlargement. Ditto aquablation which in case is nto available in Thailand.

 

If you opt to remove the prostate, should go for endoscopic robotic approach rather than TURP. Substantially less blood loss and less risk of long term incontinence etc.

 

With Gleason of 7 and assuming PSMA-PET scan is negative,  and prostate not that big, either robotic prostatectomy or radiation treatment could be considered and ultimately your choice. Radiation treatment  has a number of different approaches, brachytherapy (implantation of radiactive pellets directly into the prostate) having the advantage of doing less damage to healthy tissue and also requiring less hospital visits. Main disadvantage of this over robotic prostatectomy is that after some years the cancer may recur whereas prostatectomy is definitive (assuming cancer did not already spread).

 

If at all concerned about cost (as it sounds like you are) I would recommend instead Siriraj hospital's private wing, will be around 25% less than Bumrungrad for same or better quality. I suggest this doctor there:

 

Prof. Sittiporn Srinuluad

https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=246&medical_id=&day=&startTime=&endTime=

 

Prof. Sittiporn also has hours at Thonburi hospital (just 5 minutes away from Siriraj) and MedPark and Bumrungrad (the last 2 being in heart of Bangkok). It can be often be quicker/easier to see him at those places but if you want to go to only one hospital then Siriraj would be the one as some treatments are not available at the other places. Though it will also work fine to see him at differing hospitals, he will remember your case, I did it that way with a friend recently.

 

 

[erectem]

Sheryl, 

Many thanks for the reccomendation of Prof. Sittiporn Sirunulad.  (Siriaj) 

Underwent RARP Dec. 1 /25.  PSMA scan before surgery . No mets. Bx from 2 mos. previous GL 4+4 ,grade 4, left side only, psa 4.8

Post Rarp pathology upped to 4 + 5 Grade 5.  Two months after surgery psa 0.003. ...2.5 months post surgery still some incontinence but progressing well. I am 75 y.o. caucasian. 

Prof. Sittiporn is sharp. 

[Sheryl]

1 hour ago, erectem said:

Sheryl, 

Many thanks for the reccomendation of Prof. Sittiporn Sirunulad.  (Siriaj) 

Underwent RARP Dec. 1 /25.  PSMA scan before surgery . No mets. Bx from 2 mos. previous GL 4+4 ,grade 4, left side only, psa 4.8

Post Rarp pathology upped to 4 + 5 Grade 5.  Two months after surgery psa 0.003. ...2.5 months post surgery still some incontinence but progressing well. I am 75 y.o. caucasian. 

Prof. Sittiporn is sharp. 

Thanks for the update and glad all went well. Incontinence typically improves with time but may tske many months. 

 

Can I ask the total cost of the surgety?