Radical Prostatectomy Question

icemantoo said:

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I am waitng for a date from Dr. Patel in Orlando who has done oner 10.000 RPs. I am 76 and have a Gleeson 5 plus 3. I had to sign an ackbowledgfmant that I will no longer be able to fathwr children. So far my 2 chuldren in their 50's and wife who will be 75 in 3 weeks are taking thhis as well as can be expected.

 

 

 

 

icemantoo

I am 68 and my wife is 67.  We two came to the conclusion that our baby making years are in the past and our only child (48) agreed.  Good luck on your journey.

Hi there,

Yes that is normal, I had quite an advanced tumour and my prostatectomy was non nerve sparing, the surgeon fished out the prostate and all the associated tissue.
I have no problems with urinary continence as the bladder neck, etc was spared but obviously I can no longer have an erection.
You may or may not have urinary problems afterwards but I doubt that you will be able to get an erection.
You may also be looking at post RP radiation plus six months or more of hormone therapy if it turns out that some cancer cells have escaped and are hiding in the bed of the prostate, etc.

Best wishes,

Georges

Steve,

I do not intent to create worries to anyone when posting my opinions. In fact I am careful on what I write and try to make it sure that all is correct. I do not touch in sensitive matters but like to alert the poster on the issues he may consider and give a though. Exchanging experiences and knowhow from researches is the motto of forums like this. I believe that there are more benefits in knowing the details behind the facts than just from a solidarity comment.
I also was careful in my answers to you (threads and CSN-mail) as I know that you surfer from the fears in having still prostate cancer in your body, in spite of the present successful results from your radiotherapy. Those fears may have been initiated from too much knowledge and information you gathered while in the period of the decision process and thereafter. I think it to be the reason for your indignation on very informative posts.

However, as the years pass by, we see more and more information readily available to those who inquire. It will be difficult to turn a blind eye on the facts. The mystic apes of Japan who pretend to "see no evil, hear no evil, speak no evil" will have a hard time in keeping their commitments.

I take the chance here in congratulating your last PSA of 2.5 ng/ml down from the previous 4.0.

Best,

VG 

It's been a while since I've been on line here, but had to reply to your thread.  My husband was diagnosed with Gleason 9 in fall of 2017.  My husband's main concern was being cancer free but also side affects from the surgery.     He had robotic procedure January of 2018.  His surgeon was Dr. Behfar Edhaie with Memorial Sloan Kettering in NYC.  I cannot say enough great things about MSK and the doctors that treated my husband.  Dr. Edhaie knew my husband's concerns, and what should have been a 2-3 hour procedure was an 8 hour procedure to go ml by ml to preserve the nerve bundles. My husband went through a protocol 4 months before surgery to increase blood flow to key areas to help in preservation of nerve bundles.  This included losing weight, walking, exercising. Not only did this help physically - it helped mentally.  Facing prostate cancer is tough especially with diagnosis at a young age.    He also met with MSK's ED specialist (known as one of the top in the world) to discuss ED issues pre-surgery and post surgery.  He started taking generic Viagra for 3 months pre surgery to incresae blood flow to that area.  He knew the vast array of options that were available if he had ED issues post surgery.   He met with MSK's bladder oncologist to talk about ways to improve continence post surgery.  This included physical therapy post surgery.  I can't stress this enough.  We should have started PT before surgery to get baselines on where he was before, and to make sure the Kegels were being done properly.  In my opinion, PT is the key to success in getting the nerves awake and working after surgery for both incontinence and ED. 

Today, my husband is cancer free after a Gleason 9 diagnosis.  He was very lucky in that his lymph nodes were not involved, and all margins were clear.  He is in the best physical shape of his life, and has continued his path to being healthy.  His oncologist/surgeon and the other two specialists at MSK who helped are absolutely amazing.  We are at MSK in NYC every 6 months for testing.  He won't go anywhere else and will not let our local doctors do any testing.  We live in the SE, so it's a stretch to do this every 6 months but it's worth it.    If something does happen with cancer again, he's in the MSK network for their state of the art protocols to help in deciding what to do to keep him cancer free.   The ED and incontinence issues - there really aren't any.  ED issues were quickest to improve.  Incontinence took a little longer, but he did great after physical therapy.  We went on a vacation 4 months post surgery exploring 7 countries in Europe.  Walking 10-15 miles a day.  He traveled 2 weeks after surgery to client meetings about 2 hours away from home as well as attending our daughter's weekend volleyball tournament in another state.  He walked 2 miles the night of surgery.  As you can tell, post surgery, he faced Prostate Cancer like a warrior.  Before surgery, he worried himself sick over the "what if's". 

Stay positive.  Find the best surgeon you can - and I believe MSK has some of the best in the world.  Take your time to find the best options.  Get in the warrior mode before surgery, and tackle every obstacle that comes your way.  Lean on your family, and your faith.  Best of luck to you. 

Gray Cloud

You will get through this

GrayCloud (Patti)

Thanks for sharing your experience. It is great to know that all runs in your favor. Many reading your post will like to know that your husband's treatment comes from a risk case with an initial high PSA of 9.5. Your story is in here;

https://csn.cancer.org/node/314285

Best wishes for continued success.

VG

lighterwood67 said:

Folks Need to Know

Yes, folks need to know.  Just like you so vividly describe your treatment side effects.  I remember telling you about my journey and exchanging CSN-mail.  At the time, you wanted to know as much as possible from folks who have experienced radiation and surgery as treatments for PC.  Most of the folks on this site use it to tell their stories and so they do.  That is what this forum is about. Front line experiences with their prostate cancer treatments.  With that said, stay positive my friend with a common enemy.  My gut feeling is that you have better days coming.

Steve,

Exactly as Lighter replied, YES, all patients need to hear it all.  They did not come here for 'safe space' or to be coddled.   They need hard information, to make life-saving decisions. Of course responses should be thoughtful and with no hysteria, but Vasco and the others responses were perfect in tone and content.

max

ufknkidding said:

Consider Everything

Treatment decisions are very individual so please consider everything.  Age is a factor, family history is a factor, bone scans are a factor, etc. etc.  (Even race may be a factor as some studies are beginning to find). So one case can't speak to another case but can help with the decision making process.  However, commonalities across cases can help with decision making.  Quality of life is a HUGE factor for the individual and differs for all.  Some things matter more than others for everyone and we can't judge or criticize where another person places value.  I think lighterwood67 comments about radiation if the cancer is outside the gland versus removal if limited to the gland is consistent with current treatment protocols for gleasons 7 or higher.  I agree with VascodaGama you should only choose a treatment you are comfortable with = quality of life.  Hope everything works out well.

You can follow my (Sept 2019) story at https://csn.cancer.org/node/320408

When I was diagnosed two years ago, my Uro, who is also a surgeon, suggested that he would take the nerve bundle on one side.   He performed open surgery.  The reason was the 3T MRI showed one of the tumors to be right up near/against the wall.    He said to play it safe he would take the nerve bundle, most important factor to him, get all the cancer.    Surgeon # 2, Robotic, stated he would "go wide" to be safe, but didn't think he'd take the entire nerve bundle on that side.    Surgeon #3, Robotic, told me he would make the decision on full nerve sparing when he was inside and got a better look.

I went with surgeon #3, for other reasons as well.  Specifically a surgical process study.    I ended up with a positive margin of <.1 cm.   So yes, it was right up against the wall.   My pathology was also downgraded from 4+3 to 3+4, so I call it a wash.   Uro and I decided radiation would be over treatment at that time (3 month follow up), with the margin so small.     ED has not been an issue.