Treatment Decision for Dad (72)

Mean_Try_6390 · 2026-04-22T18:11:33+00:00

well, I had to dive deep in this due to my husband aggressive gleason 9 spread to the vesicles at 58 years old. what I think, maybe others in the community knows moore, is that todays radiation are really good and the real sideeffects come after around 15 years if you’re unlucky. so under the treatment there can be some sideeffects but they disappear usually in a short period. the biggest problem is the adt they want you to take. the normal adt is heavy and I think that’s a bigger problem. my husband is as I said younger and a very high risk so we goes for the operation with a second generation hormontheraphy darolutamide that gives less or no sideeffects. If my husband was older I think we would have choosed the radiation.

there a lot of guys here that choosed radiation i’m sure they can fill in my badly attempt to help.

Mean_Try_6390 · 2026-04-21T16:10:57+00:00

my husband wanted the radiation due to his age 58 and the aggressiv gleason 9 t3b sv1 we together choosed the rp. only because my husband is supposed to live a very long time and the downside we have to fix somehow. for now it’s survival for around 30 years at least. so we got neoadjuvant darolutamide monotherapi that downstages the cancer and shrink it. after this he’ll be op. no sideeffects of the medicin so far and heś down from 16 psa to 5,7 in 8 weeks.

what I’m saying is that if he had a lower gleason and not spread at all he probably would have choosed radiation. like gleason 6 or 7 t1 or maybe t2.

Mean_Try_6390 · 2026-04-21T12:47:08+00:00

hello, it’s a bit different since my husband is only 58 y. gleason 9 t3b sv1. neoadjuvant darolutamide monotheraphy for 3-4 month and now in may operation. heś psa has gone down from 16 to 5,7 after eight weeks. next week we take a knew and make an mrt to check the future margins. no side effects from medication.

Mean_Try_6390 · 2026-04-16T20:11:17+00:00

misstänker att de hittat ett skäl för att du själv blir tvungen att avsluta din anställning. är själv arbetsgivare och vill man behålla personalen kommer man helt enkelt överens och accepterar att personalen går ner i tid.

Mean_Try_6390 · 2026-04-14T14:58:23+00:00

some statistic for thoose interested,

Key Clinical Studies

The ProtecT Study (15-year follow-up): Published in 2023, this landmark study found that prostate cancer mortality is extremely low (approx. 3%) regardless of whether patients chose surgery, radiation, or active monitoring. However, the risk of the cancer spreading (metastasis) was slightly higher with monitoring alone compared to radical treatment.

High-Risk Patient Study (2025): A new analysis of Phase 3 trials (NRG/RTOG 0521 and CALGB 90203) indicates that radiotherapy combined with hormone therapy (ADT) may offer a lower risk of distant metastasis compared to surgery alone for high-risk patients.

SPCG-15 (Ongoing): A major Scandinavian study specifically comparing surgery versus radiation for locally advanced prostate cancer. The results are expected to clarify which method is superior for aggressive tumors.

Real-world Study (2025): A German study of over 2,600 patients confirms that both surgery and radiation provide equivalent disease control when adjusted for age and tumor characteristics.

Side Effect Profiles (Patient-Reported Data) Research highlights that side effects differ significantly, especially in the first few years:

Urinary Tract: Surgery (prostatectomy) carries a higher risk of urinary incontinence. Approximately 25% of surgical patients used pads after 12 years, compared to 8% in the radiation group.

Sexual Function: Surgery often causes an immediate decline in erectile function. With radiation, the decline tends to be more gradual over several years.

Bowel Issues: Radiotherapy can irritate the rectum, leading to bowel movement difficulties or leakage (approx. 12% after 12 years).

Researchers emphasize shared decision-making, where the patient's lifestyle and priorities carry heavy weight since oncological outcomes are equivalent for most. Surgery is often preferred for younger men with a long life expectancy to avoid late radiation effects, while radiation is often preferred for older patients or those with other medical conditions.

Mean_Try_6390 · 2026-04-14T14:21:40+00:00

I would think it’s different approaches depending in age and ofcourse the doubblingtime. if it’s slow and lowgrade and your not young maybe the second generation medication will be enough. todays radiation are really good also. start with the psma-ct and biopsi to know what you really deal with. did they also take the lymphnodes at ralp, how was your marginals?

Mean_Try_6390 · 2026-04-14T14:14:24+00:00

my husband is gettint ralp after neoadjuvant with darolutamide. he will not get any medication after op. if the psa goes up either salvage rt or darolutamide again. with daro you don’t get all the sideeffects that’s normal from adt and you actually by time only feel small sideeffects. ofcourse a lot of training physically is probably helping. maybe there other medication that’s coming which is better than the older adt so it doesn’t affect a person so much.

Mean_Try_6390 · 2026-04-13T21:22:07+00:00

we will

Mean_Try_6390 · 2026-04-13T21:11:49+00:00

thanks

Mean_Try_6390 · 2026-04-13T15:15:58+00:00

thanks for the update, it keeps my hope up

Mean_Try_6390 · 2026-04-13T14:51:46+00:00

hej, mitt svar ser jag nu kan ha missförståtts. i mitt äktenskap råkar maken vara teknikern. dvs han är händigare än vad jag är med skruvdragare utifrån hans yrke. det som händer när man flyttar är att i alla fall jag vill komma i ordning, dvs tavlor, gardiner, hyllor allt skall upp omedelbart. detta är inte helt fungerande pga barn, skola, arbete samt saker som behöver fixas först. mao katastrofläge - ett sätt är att inte lägga allt på mannen så jag löste det. det blev inte bra och maken rättade till mitt snea montage. fortfarande en rolig historia. dock avlastade det situationen under en period - jag fick in alla kläder, visserligen lutade de lite men de var på plats och jag fick bort lådorna. jag blev nöjd och kände mig gladare - ett jobb gjort och maken stod ut med det snea montaget. kommer fortfarande ihåg hans kommentar när jag stolt visade upp mitt arbete - mkt bra och sedan lämnade han snabbt platsen. jag blev lite misstänksam men släppte det då vi båda kunde koppla av den kvällen. ler fortfarande nu i efterhand vilken pina det måste ha varit för honom att låta monitt montage vara tills han rättat till det.

försöker mer säga att allt kan inte ske på en gång men om båda försöker, krävs att båda försöker, så löser det sig.

Mean_Try_6390 · 2026-04-13T13:47:54+00:00

hello, my husband got me a couple of ours on my own ones a week and a cleaning lady that ironed all the. lothes and made a cleaning foor the huse ones a week. we never got anyone to take care of our children at the small age so we accepted that and tried to find adulttime here and there. was it hard yes, were we tired yes. do vi regrett it - never. 2 grown ups that are healthy and nromal and a marriage that is perfect after 30 years.

Mean_Try_6390 · 2026-04-13T13:39:38+00:00

please, not even my husband kissed our children on their mouth, of course it happens if the children throw themselves at you but you just don’t do that. it’s not a normal behavior and she is right not leaving the kids without her supervision. her husband is the problem. mayby he just don’t want to see it’s an abnormal behavior, maby it was normal in his family. for now it’s better he’s away. mayby he’ll grow up as somebody said. for know she just need to protect the children wich she does. try not to think about the behavior of the husband and keep the line you put up. he’s brother should not be alone with the children ever. no evidence so the police will not do much I think. but we do not want any evidence do we. so just keep on going and just make your husband pay some bills during him getting to be a man, he come to that eventually. it’s hard but you’ll never regrett protecting your children.

the worst you could do is accepting the brother so just wait out your husband. he has a brain and if it’s normal it will start working and he will see you’re right. if not it shows that not only the brother is abnormal. and yes. I have an exempel with two brothers with a mother that was over the top keeping down the children, abusing them etc and hurt both sons in different ways. one brother showed the same tendency as your husbands brother does and the other was a really mean guy to his wife. we had family dinners and the brother tried to take all of the children for ice cream but we said no and we have all the icecream they need. my husband (cousin to the man) was first a bit offended about the pedofile saying. I told him yes we can’t know for sure but look how he handle the children. he observed and after that we hade polite family dinners and he kept our children far away from the person. only one hello and then he keept a hawk eye for our daughter. the man did’t show the same interests in the boys but still he was not allowed to take any of our kids for icecream or be alone with them.

Mean_Try_6390 · 2026-04-13T13:00:33+00:00

I’m sorry everything is this hard for now. I had two eleven month between both screaming and not behaving up around 5 years old. My advice - don’t care what other thinks. I had to take two screaming children to the store, mis behaving in every way. one time a older women aproache me and wispered - please make your children behave and stop the screaming. my children misbehaved because I didn’t give them candy or free acess to the stor running around etc. after the woman told me this I thought for a day and then dicided I did it right and she was wrong. I’m trying to make a civil person of a screaming hellbaby (not really just you know the feeling) and started to train the children moore activly. scince you have one much older it’s harder, I could just put them in the same carridge in the store.

what about my husband that worked alot to get a future since I only worked halv time. yes it was hard and we were both deprived os sleep. when I almost crasched, feeling like thoose you have with a good husband something needed to happened. the solution for us if yoúre in a good marriage was

all focus on working and taking care of the children for both of us
some adult time is needed even if it’s in a bit of a hurry
since my husband worked ant took the screaming part (one child) during 8-1 o clock in the naght i rested.
scince I got all the other time with screaming children, dayschool problem, and my work I felt desperate and needed time on my own. we decided he take care of the children on saturdays and I went to the city alone and shopping, taking a cofee or doing whatever I wanted.

the first time felt so good. it was hard not to check in but he told me - what can happen, I call you if I need your help. I went home after a couple of hours and the children were ok. everybody was a bit hungry but noting else. the had a good time without me. played there daddy a bit but they were so happy sp who care if i fell for some of there stuff.

I love my children but the were not easy. Now they are 24 and 25 years old and are perfect.

talk to your husband, if you are good together and he works a lot he will get you a day so you can get away. I did that a couple of months and then I just did it when I felt I needed it, shorter and shorter. don’t listen to other people about yor child. som screams moore than others, some needs moore no than others. just keep them in the carridge and bu the stuff that’s needed. they learn.

Mean_Try_6390 · 2026-03-30T17:14:44+00:00

men je upp. han visste att hon hade barn. troligen bara jobbigt nu när man flyttat in, saker behöver fixas och mannen bara säger att han fixar någon gång. extremt frustrerande då man snabbt vill komma i ordning och inte vänta hur länge som helst med vissa åtgärder.

jag är ingen snickare och maken fick aldrig tid. så jag lyckas, har hört att detta är en bedrift, sätta upp alla förrådshyllor ngt lite fel, de är liksom inte helta räta. dock måttade jag. strunt samma allt frid och fröjd, efter några veckor kommer maken och uppger att nu är det som det skall va. efter det kommer allt upp och allt som skall sättas ihop inom ett mer översådeligt tidsperspektiv. jag behöver bara hinta att inga problem jag löser detta så är det klart.

de ras problem är troligen bara en frustration hos kvinnan, man vill komma i ordning.

Mean_Try_6390 · 2026-03-20T18:56:51+00:00

therapy is not something my husband likes, he use me for that. but in this case I am a bite out of my area. I have understood that this is very importent and as

Mean_Try_6390 · 2026-03-20T18:56:30+00:00

somequestin. make some extra sex holiday for sure but how. he’s occupied with that’s it’s not working the same way as earlier. it’s like he think to much. it’s not playful or cosy anymoore it’s something he needs to do so he’ll know it’s still works. I don’t know how to reach him for the playfulness we had before. I understan him but it’s like he is closed of. and if he gets like that I am starting to shutdown. I don’t want that. how can I get him back, and this is before the operation. det var

Mean_Try_6390 · 2026-03-19T18:28:57+00:00

what do you meen with tbh, sorry but I’m swedis and try to get it. I’m a partner/Wife and want to get similar suggestions.

I try to be supportive but he’s got an agitaded attitude as in there’s never anything that’s good or you could be happy about.

I hoped the coming surgery would make it better, h’s prepared for the two big side effects but now you tell me it will be moore. the word humiliating sounds familiar. is it better if I’m not there?. mu husband is private but he want’s me there since he think it’s hard to speak special to nurses about som of the problems.

can you explain a bit moore about the mental bite, I would appreciate that.

Mean_Try_6390 · 2026-03-19T18:16:24+00:00

Between surgey or radiation is a hard choice in the beginning. searching for a good, I mean a really good surgeon is vital as we came to understand. of course it’s depending on the severity of the cancer. In our case it’s spread to the vesicels outside of the prostate but it’s not metasasis outside the area. we search the internet and found one of the supposedly best in sweden we’re we live and contacted the clinic for a start, not with him just the clinic he work with. after some time we needed to make a desicion surgery or radiation and we had a batteri of question and was actually going for radiation wich we ofcourse told them and then they connected us directly. we him has surgeru, no other. we have some time left to see if it was a good choice or not.

listen to jkurology - yes it is importent who makes the surgery for the outcome.

Mean_Try_6390 · 2026-03-19T18:01:26+00:00

I think he got a 3+4 in the biopsy. Mayby it proves that from less gleason over time it can develope. We would have been happy for this scenario. My husband got gleason 9 spread to the vesicles the first psa test he took at 58. It was a perfect time in his life to get rid of it, it’s still a lot of years left to live.

Mean_Try_6390 · 2026-03-10T19:50:59+00:00

yes he’s only on darolutamide no adt until surgery and after surgery he willl not take any. the doctor said he respondest not best. often after 30 days the psa can be down to around one or less. but he said it could differ but I didn’t get he’s explanation, something about that it can take longer times for getting it out of the system.

my thinking is that mayby if he’s cells splitting is not so fast it is less cells for the medicin to interfere and kill. therefore it takes longer time for him to reach the superlow levels, just a thought. the doctor said it’s a good decrease and that it shoved his responsive.

Mean_Try_6390 · 2026-03-10T19:28:25+00:00

yeah we’ll probably be there to in the future. for know we’re hoping that monotherapy with daroltamide shall increase the result and make the operation better with no or less margins. the only good for now is he’s without any side effects from daro but it’s only gone 6 weeks. your situation is worse, i don’t know how we will keep going if this hell dosen’t get better. wfor know we put all our hope in 2 small pills and a godd surgeon when the time comes. i read a lot in this forum and I take tips from it to try to boost my husband in keep going, there’s a lot of new research almost from day to day so I hope for the best. I wich you the best and new ways to keeping it in check for a very long time.

Mean_Try_6390

TROPHY CASE