Prostate Update

bob4894
bob4894 Member Posts: 23

It has been awhile since I have posted and I wanted to give everyone my current status.

My stats:

Age - 54

PSA History - PSA 2012=3.1, Feb 2013=2.76, Mar 2014=3.12, Jul 2014 3.5, Jan 2015=3.46

February 2015 - Biopsy at USC 1 of 12 cores Gleason 6 10%

March 2015 - 2nd opinion at UCLA 4 of 12 cores Gleason 6 (5% - 25%)

 

In March 2015 I consulted with Dr Leonard Marks at UCLA and decided to enroll in their Active Surveillance program.  Marks scheduled an mpMRI and biopsy in early June.  In early May 2015 I started having second thoughts about being on AS.  I couldn't shake the feeling that there might be a more aggressive cancer that was missed or if it was progressing. 

Late May 2015 met with Dr. Mihir Desai at USC to discuss RALP.  Decided on surgery after speaking to him.  Surgery was scheduled for June 8th. 

Had the surgery and now dealing with incontinence and haven't even begun to think about ED yet.

Pathology came back today and here are the results:

  • Gleason 6 in 5% of organ
  • Organ confined
  • EPE, SV, LN and Margins all negative

3 month PSA will be my next hurdle.

Comments

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    Dealing with surgery side effects, a non local support group

    Bob,

    I've listened to Dr. Desai lecture, and spoke with him on a few different occassions. He is widely published, and in my opinion an excellent surgeon, so I am hopeful that the side effects that you experience will be mimimal.

    Have you discussed with Dr. Desai, what the course of your therapy will be for Erectile Disfunction?

    It is fairly common to have incontinence directly  after surgery. How extensive is the incontinence that you are now experiencing?  How many pads? Have you done, and are doing phyiscal therapy for incontinence? 

    Are you drinking coffee and/ or alcohol?

    ....................

    Bob, I will be attending a support group at Long Beach Memorial by Dr. Barton Wachs on Tuesday, June 23 2105 starting at 6:30 PM at the Miller Children's Pavillion conference room A2   The subject will be ED, incontinence and Novel agents.   If you will be near the Long Beach area that day, you might wish to attend....let me know.

     

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Peace of mind

    From the status you describe, I would think that surgery has been successful in getting rid of the cancer. You do not need to wait three months to verify successes. The typical PSA at the three-weeks time (after RP) can provide you peace of mind. Typical remissions are PSA lower than 0.06 ng/ml.

    ED is "workable" and you should be active to avoid atrophy. Viagra or similar pills, masturbation or pumping is the way to proceed. The problem with incontinence is more difficult to overcome because it depends on the skills of the surgeon. Too much cutting at the sphincter could cause a permanent night mare. Kegels are recommended to instruct other localized little muscles to "adapt" to functioning and substitute the ones dissected.

    Best wishes for improvements.

    VG

     

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    Wish you the best.

    Bob: Sorry to hear that you gave up on AS so soon. 

    Given the pathology results, it looks like you would have been an excellent long-term candidate for it.

    You should find out in about 3-6 months if incontinence is going to be a problem for you or not.  On the other hand, it can take up 12-18 months to find out if your erectile function will return or not.

    Hope that these problems are resolved for you well before then.  Good luck!

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,803 Member
    Post-Surgery

     

    Bob,

    I'm thankful your surgery went well. Since you had no positive margins, the likelihood that your surgery was curative is very high.

    After cath removal, I only wore Attends two days. I still use a liner, but usually do not need it. Relatively complete bladder control came very fast in my case.

    ED is post-surgically a problem, often for a year or more.  Last month I started using TRIMIX injections (I give myself a shot in the side of the penis, which is not painful), and have had relatively normal sex since, but the injection is required.  I do not have spontaneous erections at all at this point, even with Cialis.

    TRIMIX is successful, even when Viagra has no effect at all.  You will regain sex and continence. There are so many treatements available.

    max

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member

    Post-Surgery

     

    Bob,

    I'm thankful your surgery went well. Since you had no positive margins, the likelihood that your surgery was curative is very high.

    After cath removal, I only wore Attends two days. I still use a liner, but usually do not need it. Relatively complete bladder control came very fast in my case.

    ED is post-surgically a problem, often for a year or more.  Last month I started using TRIMIX injections (I give myself a shot in the side of the penis, which is not painful), and have had relatively normal sex since, but the injection is required.  I do not have spontaneous erections at all at this point, even with Cialis.

    TRIMIX is successful, even when Viagra has no effect at all.  You will regain sex and continence. There are so many treatements available.

    max

    Many do not regain sex and continence after PCa surgery

    Athough 30 to 60% of men who undergo surgery for PCa achieve Erectile function comparable to pre treatment after 2 years, the remaining men do not. Successful results is based on the age of the patient, and expertise of the surgeon.

    A site

    http://www.pcf.org/site/c.leJRIROrEpH/b.5836625/k.75D7/Erectile_Dysfunction.htm

     

    Also many men , after the operation, never achieve continence.....of course, there are several successful cases of intervention by a physical therapy (mainly kegels) and /or a specialized surgery to counter act incontinence....however, still  many men remain incontinent.