Advice and options available
for patients diagnosed with Protastatic Carcinoma
under the care of Mr H Lewi, FRCS
As you know your protastatic biopsies have,
unfortunately, confirmed protastatic carcinoma. I would recommend
that treatment should be aimed towards providing a cure rather
than palliative treatment.
There are four options available to you as
1. We can do nothing
and merely observe your progress.
2. Commence some
form of anti-androgen (anti-testosterone) therapy which may
inhibit the prostate cancer for a period of time.
3. Radical radiotherapy
to the prostate itself with its inherent problems of developing
a small, contracted bladder, erectile failure and the possibility
that this may not completely eradicate the prostate tumour.
We would therefore have to carefully monitor your progress.
4. Radical prostatectomy
which would be carried out as a curative procedure.
It should be noted that radical prostatectomy is associated with significant
incidence of erectile dysfunction following surgery and a 10% incidence
The way forward is to consider some form of
curative procedure and radical prostatectomy, although carrying
the post-operative problem of erectile dysfunction, is significant
as a curative operation. There are therapies available to
reverse and correct post-operative erectile failure.
Initially, further staging investigations would
be arranged, including an MRI scan and bone scan which are
part and parcel of the work up towards a radical prostatectomy.
These are specifically looking for changes in the skeletal
structure which can be altered by the prostate tumour.
If you wish to discuss the matter further at
any time, do not hesitate to contact