CSN Login
Members Online: 7

You are here

Prostate cancer Please help

Jess4566
Posts: 15
Joined: Mar 2018

Hello, 

My dad has been diagnosed with stage one prostate cancer. He has a Gleason score of 7. We are looking at all our options and doing our research. One of our options is MRI Guided Focal Laser Ablation. Has anyone here have that done? If so, could you please tell me your experiences. Dates are important. How long ago did you have this operation? Have you experienced any major issues post op? Has the cancer recurred?

By the off chance, has anyone seen Dr. Sperling? What were your experienced with him?

hopeful and opt...
Posts: 2226
Joined: Apr 2009

I am sorry for your father's diagnosis.

MOre information is needed to provide best answers.

Was the Gleason found a 3+4=7 or a 4+3=7. There is more of the number mentioned first, so 3+4 is less aggressive than 4+3

Was the biopsy MRI guided, or random. How many cores were taken? HOw many were positive. What is the involvement in each of the cores that that were positive, that is what is the perecent of each core that was positive.

What is the PSA history for your father.

Any other diagnostic tests, image, etc.

Your fathers age and health issues if any?

I know about MRI Guided Focal Laser Ablation, and have heard of Dr. Sperling

Jess4566
Posts: 15
Joined: Mar 2018

Unfortunately, we are unsure of the order. We were all pretty shocked and unprepared for this. His biopsy was done by the needles. The doctor took for 10 samples and out of the 10, four tested postive for cancer. We don't know the aggressiveness of the cancer. It's localized in his right side. His psa has slowly climbed up over six years. I believe his last test of psa was an 8 or 9. He took the 4k score. My father is 58, he's healthy as a horse (doesn't smoke doesn't drink) and he never, still doesn't, showed signs of prostate cancer. We are in the process of getting a pet scan of the prostate. Right now, we are trying to find people who had this surgery for some time. We want to know what's the percentage of it recurring and whether or not this is a good option for him. He wants to take the best choice he can.

Old Salt
Posts: 720
Joined: Aug 2014

It's pretty normal to be in shock after a (prostate) cancer diagnosis. But since your Dad has stage 1 diseaeas with a Gleason score of 7, you and your Dad have time to study all the alternatives that are available for treatment. Although FLA is a possible therapy, it is NOT recommended by the American Urological Association (AUA):

Clinicians should inform low-risk prostate cancer patients who are considering focal therapy or high intensity focused ultrasound (HIFU) that these interventions are not standard care options because comparative outcome evidence is lacking. (Expert Opinion)

Moreover, in my (not so expert) opinion, when one has several cancerous loci, there are likely to be others that are currently not detectable, or that may develop over time. Those will need treatment at some point in time. Doesn't it make much more sense to treat the whole prostate with radiation and destroy all cancerous loci in one swoop, even the tiny ones? 

In a practical sense, I doubt that MRI guided FLA is covered by insurance because it is not Standard of Care. 

 

PS: I agree with Hopeful's advice of giving us more info regarding your Dad's cancerous prostate.

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Your father needs to have a copy of the results of all tests, which he will need as he speaks with various specialists, and discuss at this forum. Simply contact the uroogist office to obtain this informaton,; the pathology report, PSA history and the results of any other diagnostic tests.

I agree with Old Salt, prostate cancer can be multifocal, and the current technology is not advancedd enough to detect small cancer lesions.

The cost for MRI guided FLA runs about 25K. It is not covered by medical insurance.

Please post information from your fathers tests. We can help.

Please be advised that PCa is very slow growing, and your father will have time to research, so a decision can be made that he will be comfortable with.

We can answer most questions that you may wish to ask.

There are local support groups that you and he can attend that provide a wealth of information. Google ustoo....this organization sponsors local support groups worldwide, to find one near you.

Also family members are more likely to develop both prostate and breast cancers, so all need to eat heart healthy. The women in the family need to have those mamograms, and the men need to be monitored. A PSA at 35 as a benchmark, then regular monitoring by the GP at 40.

 

Jess4566
Posts: 15
Joined: Mar 2018

So far what we know is that it's stage one prostate cancer. He has a Gleason score of 7 but unsure of the order. He tested postive for cancer in 4 of the 10 samples. His PSA has slowly risen from a 1.9 to, over a course of six years, a 8.74. His free PSA tested 14%. At this moment, this is all we know  I know every surgey has its risks and quirks. Am I sure that this procedure will get all the cancer out? No. Even with radial surgery it has been proven you are still cancerous (based on the free psa that is still circulating in your system that was not, and can not, be removed from your body). But I believe it is best option (in terms of making sure he has all his functions). I also believe radial surgery should be the absolute last resort for any man who has prostate cancer. But thank you for the words, anything helps. I am looking at hifu as well. Has anyone heard of treatments that help strengthen your body's antibodies to fight the cancer?

 

tpelle
Posts: 184
Joined: Aug 2003

My radical open prostate surgery was over fifteen years ago. No further treatment.  I was age 71, now 86.  PSA was 3.6; Gleason was 4+3 or 7; Staged at T1-T2.  Decided on surgery without much research. (Don't remember the post-surgery readings).  One nerve bundle saved.  Results:  PSA has been <.1 ever since; 2.3 average Depends pads per day drippage the first ten years; issue solved with an AMS800, past five years; erectile disfunction without treatment. Primary goal was to get rid of the cancer.  Satisfied with my selected option.

hotstox
Posts: 4
Joined: Mar 2018

My situation iis similar to what yours was at 71.  I have a 4-4 targeted thus 2 hits on cancer out of 15.  PSA 4.5. Have decided to get the surgery done. Thank you for your input.

Jess4566
Posts: 15
Joined: Mar 2018

I am also looking for people outside of the USA who had this treatment done. I know laser ablation is relatively new here. But if I can collect data from other countries that had this treatment for longer than the USA would be great. I am unsure how to do that. I find very little on the net and I would prefer if I could talk to a person who had this surgery done many years ago. 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Jess, Is the pathology results available to you, or only your father? Will you have this information available to you?

In order for you to get an answer about focal treatment, more information is required. For example, of the cores that were positive for cancer, what is the involvement, that is what percent of the cores are cancerous.  The extent of cancer will affect the outcome. 

By the way MRI Focal laser ablation is not a surgery.

As far as HIFU, there is targeted HIFU and HIFU for total prostate, which has 100% chance of ED, and is generally done as a salvage treatment.

 

 

 

Clevelandguy
Posts: 470
Joined: Jun 2015

Hi,

Sorry to hear about your Dad's cancer but now is the time to start doing your homework.  You need to find out where the cancer is located in his Prostate(close to the edge or deep inside) and the grade(3+4 or 4+3).  Your doctor(s) should reccomend the tests to pinoint it's location.  This can lead you as to how much time you have to get treament and what kind of treament to choose.  Keep us informed on updates of info.  People on this board have had most if not all of the treaments that you may consider. Keep an open mind and study several of the successful treament options and their side effects.

Dave 3+4

Jess4566
Posts: 15
Joined: Mar 2018

Has anyone tried immune therapy to fight cancer?

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3325
Joined: May 2012

Jess,

I have read all of your posts and responses above. I too am sorry about your dad's diagnosis, but do be aware that early-stage PCa is probably the most treatable of any organ cancer.  And almost certainly the most indolent (slow-moving).  Survival long-term is the norm, and even advanced metastatic cases (which almost definitely your dad does NOT have) have men survivng often ten years or longer. Compared to many other cancers that kill in a few months, this is an eternity.

It seems to me that you are fixated on fringe therapies, modalities that are not mainstream.  You also speak of "researching" results from foreign countries.  Such a project would take even major biomedical research institutions with teams of PhDs and specialized computer systems many years to compile and properly analyze.  Ancedotal evidence, this or that man claiming this or that result, is not scientific in any manner, and counts for nothing statistically.

What IS known in American and international medical science to be curative (the ONLY two things) are radiation therapy (there are several forms of curative radiation dellivery) and surgery.  Nothing else.   

Against PCa (UN-like many other cancers), chemo and hormonal therapy (HT) are pallative only.  HT often dramatically extend life and also gives good quality of life in most cases, but is ordinarily only employed against metastatic disease.  Chemo is pallative also, but is harsh with severe side-effects, and seldom adds more than a year at best to metastatic patients.

PCa is among the most difficult to detect on any imaging system.  PET and CT are seldom of value in spotting PCa, but if the doctor recommends them, by all means go ahead. A negative PET and/or CT do not prove minor involvement, and do not even prove lack of metastasis.  Most cases of PCa, even metastatic, show NO SYMPTOMS, or if there are symptoms, they are the same as what enlarged prostate cause, and are often dismissed as such (frequent urination at night, difficulty in emptying the bladder, occasionally some sexual dysfunction). Even early Stage 4 PCa virtually never causes the patient any pain.

With a PSA approaching 10, and numerous cores positive for disease, he is probably not suited for Active Survellance (AS), but I am not well-read in that approach.  A few of the men here are, and share priceless information.

I would have you do what most men do, and what is almost universally recommended here and inmedical journals:  Speak to several doctors, including surgeons and radiation oncologists.  At some point a light will go off in your dad's head, he will bond with whichever doctor or treatment, and decide "This is right for me."  Confidence with the technique and the individual doctor decided upon yield serious peace of mind and confidence.   I wish you both good luck, but very likely, he can achieve full remission fairly readily,

max

Jess4566
Posts: 15
Joined: Mar 2018

My dad is 58 years old, he doesn't smoke and he doesn't  drink. He has shown no symptoms of prostate cancer expect for the increasing psa levels. Still doesn't. It is localized only to the left side of the prostate. 4 out of 10 cores tested postive. Of the 4, two scored a 3+4=7 and the other two scored a 3+3=6. We aren't set in stone as what we should do as of now. We have been talking to many doctors and getting their opinions. Another option, maybe, is doing immune therapy. Has anyone done this? What were your scores? Thank you for your words. I will continue updating as we travel down this horrible road. 

Magicsparkes's picture
Magicsparkes
Posts: 17
Joined: Mar 2018

Hi Jess,

I, too, am 58 and until a little over a week ago, I also had Gleason 7 (3+4) prostate cancer. After a lot of research, 4 different doctors, and even my qualifying for a Memorial Sloan-Kettering (MSK) trial study in NY and then having that taken away without much noitce, an old high school chum with similar prostate cancer turned me on to focal laser ablation in Houston with Dr. Karamanian. I have no measurable side effects. The procedure happend on a Tuesday and I returned to work this last Monday full time ... all my parts are working as normal. To be sure, focal laser ablation is not a magic solution. Not all men qualify, but my stage 2 cancer certainly did and I am praising God for how well he answered my prayers. For my own therapy I started blogging about the whole process last summer. You can find it by simply googling "magicsparkes wordpress" Note the small e in Sparkes. Also, the blogs are quite lengthy...nine blogs combined equal the size of a small novel. So, if you ever have insomnia, maybe peruse my blog to help you get to sleep! Peace and blesssings to you and your father. I'm thankful for your posting as I will pray for your father, you and your family.

Doug

Old Salt
Posts: 720
Joined: Aug 2014

Immune therapies are typically used for late-stage prostate cancer patients. Based on the data provided, I don't think your Dad would qualify. Moreover, immunotherapies are still rather 'experimental' with few long-term data.

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Your father needs to know where he stands. ...this is the first step...before determining various treatment choices.

What is the percent cancer in each of the cores that are 3+4=7

Recommend that your father obtain a second opinion by a world class pathologist...there is a difference between pathologist and equipment. Many men here use John Hopkins...without insurance the cost is about 250 dollars.

Highly recommend that your father have a T3 MRI, which can reveal if there is extracapsular extension, that is if outside the prostate, and the potential extent within the prostate; one lobe or two, possibleaggressiveness and volume within the prostate.

Read research. attend local support group(s) google ustoo. they sponsor local support groups worldwide.

come back with the percent cancer in each of the cores that are 3=4 and any other pertinent information from the pathology.

Jess4566
Posts: 15
Joined: Mar 2018

Ok guys, I have the pathology report. Tell me what you think. 

Left lateral base: Gleason score of 7 (3+4) grade 2. Less than 5 percent of tumor in core. Perineural invasion present. (How do they know they there is PNI? How do they see its tracking a nerve?) No ENE or lymphatic vascular invasion.

 

Left base: Gleason score of 7 (3+4) grade 2. Tumor involves approximately 20 percent of the core. PNI present. No ENE or lymphatic vascular invasion.

 

Left lateral mid prostate: Gleason of 6 (3+3). Group 1. Tumor involves 20 percent of the core. No ENE, PNI, or lymphatic vascular invasion present. 

 

Left mid prostate: Gleason score of 6 (3+3) group 1. Tumor involves less than five percent of core. No ENE, PNI, or lympharic vascular invasion.

 

The right side looks good, no tumors found. The left lateral and apex also have no tumors. All the tissue is white and soft. Is that good? Does that mean somewhat healthy?

The doctor discussed with him his options: active surveillance, radial prostatectomy, radiation therapy, cryoablation, and HIFU. My father is looking at laser ablation or the nanoknife. I know the doctor didn't say those...

Magicsparkes's picture
Magicsparkes
Posts: 17
Joined: Mar 2018

Hi Jess,

Crikey, your father and I are very similar with regards to prostate cancer. Last summer I talked with four prostate cancer experts, including a major Urology Professor at UCLA. They all said due to my young age (58 being relative) that I did not qualify for the radiation treatment (pellets or radiation bombardment). They all also shot down HIFU and cryoblation as being very unreliable ... The funny thing is not one mentioned laser ablation whatsoever. In my very jaded opinion, (hey, I can admit that I am jaded), the whole industry is bent on having men go through having a "Robotic Radical Prostatectomy." The pros is that this procedure will get rid of ALL of the prostate cancer and that is a good thing, but the con is all the side effects that come with it! Ah, don't get me started!!

Doug

Old Salt
Posts: 720
Joined: Aug 2014

The Nanoknife is never used for prostate cancer. But Stereotactic Body Radiation Therapy (SBRT) can be used to fight prostate cancer. We have several frequent posters on this forum, who have used SBRT (including me). The latter can be done with several instruments; the best known is CyberKnife. I do suggest that you and your Dad learn about this therapy.

ASAdvocate
Posts: 117
Joined: Apr 2017

https://www.mskcc.org/videos/irreversible-electroporation-nanoknife-treat-prostate-tumors

 

Old Salt
Posts: 720
Joined: Aug 2014

I guess I was too outspoken and should have written that the NanoKnife procedure is not routinely used in the USA to treat prostate cancer. From some casual reading, it appears to be 'early stage'. The company that makes the device writes on its website:

FDA: The NanoKnife is intended for the surgical ablation of soft tissue in the United States. The FDA has not cleared the NanoKnife System for the treatment of any specific disease state or condition.

Clearly (?) MSKCC must have gotten approval to treat prostate cancer patients.

PS: I copied the following from a 2016 paper by Wagstaff et al:

In theory, focal treatment in prostate cancer is a promising approach as current conventional therapies have a lot of limitations. Radical prostatectomy and radiotherapy both have poor functional outcomes, with high rates of urinary incontinence and erectile dysfunction. It is believed that IRE has the potential to overcome these side effects. However, to date, there is little evidence on oncological outcome and no long-term results of IRE in prostate cancer are available. To our knowledge, there is sufficient evidence to say that IRE is a safe and effective focal treatment modality in prostate cancer, but a large trial is needed to warrant its oncological efficacy.

Note: IRE is the academic term for the NanoKnife procedure

hopeful and opt...
Posts: 2226
Joined: Apr 2009

...look into Stereotactic Body Radiation Therapy (SBRT)

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679773/

Jess4566
Posts: 15
Joined: Mar 2018

What are the side effect from that?

hopeful and opt...
Posts: 2226
Joined: Apr 2009

The side effects are minimal. Basically one can be treated, and go about his business after each treatment. There are either four or five sessions depending on the doctor to administeer this radiation.

 

 

"They also report the following toxicity data:

  • Late rectal toxicity:
    • Grade 2: 4 percent
  • Late urinary toxicity:
    • Grade 2: 9.5 percent
    • Grade 3: 1.9 percent
    • Grade 2 or 3: 6.9 percent for the lower radiation dose vs. 13.2 percent for the higher dose.
  • Patient-reported bowel and urinary quality-of-life (based on EPIC questionnaire data) declined at 1 month then returned to baseline by 2 years; sexual quality-of-life declined by 29 percent at last follow-up.

These are clearly excellent results for any kind of radical therapy. The authors conclude:

These long-term results appear superior to standard IMRT with lower cost and are strikingly similar to HDR therapy."

STUDY RESULTS

https://prostatecancerinfolink.net/2016/01/06/nine-year-outcomes-after-treatment-with-sbrt/

Jess4566
Posts: 15
Joined: Mar 2018

Thank you, I am looking into this as well. If anyone has done this please post your experience 

Old Salt
Posts: 720
Joined: Aug 2014

Individual reports on an internet forum are just anecdotal. Please consult the original papers for 'real' data. Hopeful has posted data that are reliable. Go from there. 

You can also search PubMed for papers by Alan Katz; here is a link to a recent publication (230 patients; 10-year outcomes) by him:

https://www.ncbi.nlm.nih.gov/pubmed/29152425

graycloud
Posts: 38
Joined: Jan 2018

My husband (55) was diagnosed with prostate cancer October of 2017.  His initial pathology showed 4 +3.  He had two previous MRI guided biopsies before the big biopsy. We consulted with Dr. Joseph Busch in Chattanooga, TN for his MRI's, and Dr. Busch performed the guided biopsies.  At that time, we discussed possible ablation if Jim's biopsies came back with positive findings.  After his 3rd biopsy which took 14 core samples, it showed Gleason 7 (4+3) with two areas testing postiive.  A little more agressive than your dad's but still within guidelines for successful ablation. We talked with Dr. Busch's preferred ablation specialist in the Netherlands - Professor Jurgen Futterer.   His assistant's email is Solange.Estourgie@radboudumc.nl.  However, I would probably contact Dr. Busch for a consult -( jbusch1@epbfi.com.  423-622-7212 - Jeannie is his gatekeeper)  Everything is out of pocket for Netherlands procedure.   

There are two ablation study programs going on the US now.  One at Memorial Sloan Kettering in NYC, and one at Mayo in Rochester.  All paid for including expenses.  Contact for Memorial Sloan Kettering is Kathy - 1-646-497-9068.  The contact for Mayo is Deb 507-284-2511.   The doctor heading up the study at MSK is Dr. Behfar Edhaie.  He is an oncologist and surgeon.  The doctor heading up the study at Mayo is Dr. David Woodrum.

We actually went to MSK to apply for the study.  Was accepted.  They ran my husband's biopsies through their own labs, and his Gleason Score actually came out higher - 4 +5. Not what we wanted to hear. Sent pathology over to Johns Hopkins - they concurred with Gleason score of 9.

This put us out of the ablation program in the US.  We could sitll have it in the Netherlands, but the thoughts of a Gleason 9 and ablation just didn't add up for our choice. 

My husband did months of research, and all roads led us to Dr. Edhaie at Memorial Sloan Kettering for his treatment.  He is also a patient of Dr. Mullhall at MSK who is the leading ED specialist in the world.  He had nerve sparing robotic surgery on 1/30.  All lymph nodes removed, prostate removed.   We were blessed with excellent pathology report past surgery.  Downgraded his Gleason to a 7 - lymph nodes clean, nothing outside the prostate, margins clean.  I cannot say enough good things about our experience with Dr. Edhaie and his staff at MSK. 

You will have to weigh your options - which you have.  Just take your time.  Even with my husband's gleason score of 9, we didnt' rush to surgery.  He took time for healing after the biopsies which takes a minimum of 12 weeks.  This helped with nerve repair, and with the nerve sparing part of his surgery.  He lost 50 lbs, got in the best physical shape of his life (walking helps with bloodflow to key areas that are affected by surgery - 5-7 miles daily for us) and he is doing so good post surgery.  For him,  he will tell you he didn't have pain from the surgery.  Cathater was awful!  Recovering from surgery has been tougher emotionally than physically. 

We just returned from his follow up visits this weekend in NYC.  PSA is undetectable!   He's in the top 15% for recovery, ED issues are improving - in fact he's doing great there.  Bladder issues have finally turned for the good, and he's improving daily now.  It's a process that takes time, but he's so thankful for the skill of his surgeon. 

A friend of ours had ablation last July in Miami.  His latest followup test last month showed some areas that were missed.  PSA rising.  He's weighing options on what to do.  Thougth I would throw this out.  I would apply for ablation at either MSK in NYC or Netherlands if you dad's biopsies are confirmed to be a 3 + 4.    My opinion - Get your dad's biopsies reviewed at MSK and Johns Hopkins (Dr. Pollack) - Dr.Busch can help with coordinating these as well. 

That's my two cents worth on your question.  Good luck.  Just don't let fear direct your decisions.  Removing the prostate is a life changing event - but teaming with one of the best mdical groups in the world providing us with phenomenal outcomes.  We are lucky!

 

Thomas A
Posts: 1
Joined: Mar 2018

Hi,

Sorry about your father's prostate cancer diagnosis. His numbers are very close to mine. I was diagnosed five years ago with prostate cancer. My prostate was three times the normal size and the doctor had a hard time finding cancer. After three sets of biopsies in six years he finally found the cancer. First biopsy was 9 cores. The second was 16 cores. The third was 21 cores and done under anesthesia. My Gleason score was 7. 3+4.

I had the DiVinci procedure to remove it four and one half years ago. I have been going for PSA blood tests every three months since surgery. My last test was six months ago with a reading of .001 non detectable. The surgery took seven hours with very little side effects. This was a nerve spareing procedure and everything works a before but no prostate. The doctor that did my surgery was extremely skilled and was an expert with DiVinci.

Tom

 

Grinder
Posts: 442
Joined: Mar 2017

 "but he's so thankful for the skill of his surgeon. "

 "The doctor that did my surgery was extremely skilled and was an expert with DiVinci."

 Thank you, graycloud and Thomas for sharing your experiences. Regardless which treatment or procedure , the skill and experience are paramount. 

It is a very difficult venture, but the professional you choose is every bit as crucial as the treatment you choose. What Max said is so true... you have to feel at peace and "comfortable" with your professional. If you read far into these archives, the successful treatments  give credit to skilled and experienced professionals. The worst nightmare scenarios almost always involved novices or inexperienced professionals who are trying to overachieve or "bite off more than they can chew" .

Magicsparkes's picture
Magicsparkes
Posts: 17
Joined: Mar 2018

Aloha,

I just had the procedure, (focal laser ablation) performed March 20th 2018 in Houston (Dr. Karamanian Prostate Laser Center). I could not be happier with both the treatment and the results. Like your father, I too, had a Gleason of 3+4=7 That's the short and sweet. For all the details please see my blog. Simply google "magicsparkes wordpress" (note the e in Sparkes).

Peace and blessings to you and yours!

Doug

Jess4566
Posts: 15
Joined: Mar 2018

Thanks guys. For those of you who had the divinci procedure you experienced no urinary incontinence or sexual impotence? And they removed the prostate gland but spared the nerves? Is that correct? 

Old Salt
Posts: 720
Joined: Aug 2014

Urinary incontinence is common, but may get better over time. Same for Erectile Dysfunction, and some people never recover. But you need to look at the percentages of these side effects. Anecdotal reports (there are a lot of them on this forum) do not predict outcomes. One really needs to dig a bit deeper.

With respect to nerve sparing, most surgeons will try, but there main mission is to eradicate the cancer and in some cases, the nerves will be destroyed to get rid of all cancer. I think that one can ask the surgeon what the chances are for this to happen during the decision process. It will depend on the location of the cancerous loci within the prostate. And even when ;th nerves are spared, it may take a long time (a year or more) to recover sexual function.

graycloud
Posts: 38
Joined: Jan 2018

My husband had successful nerve sparing robotic surgery.

After my husband's surgery, he did have "temporary"  incontinence issues.  He's still wearing a light pad, but each day is getting better.  He is still healing internally, and it takes about 4-5 months for the internal stitches to dissolved completely.  He's dry all night, and literally dry most of the day.  You can tell when the bladder muscle gets tired about the same time every day after exercising, working and moving all day.  He's doing physical therapy twice a week to help with building up the pelvic floor muscles.  I can't say enough about incorporating physical therapy in to your pre-surgery plan and your post surgery plan.  The PT has been the best thing physically and mentally for him.  It's given him goals to work on at home, and positive reinforcement from the therapists.    The things that bother him now are getting in and out of the car, and heavy exercise/weight lifting.  But he's able to get in and out of bed at night, and make it to the bathroom!  He's able to hold it for over 2-3  hours during the day with no leakage.   He can cough and sneeze without leaking.  His surgeon told him it's a process, and it is. The first 3-4 weeks were hard - really hard.  But he is improving dramatically daily over the past 10 days.  (Surgery 1/30).  

His ED issues - it's a new normal now but we are both ok with the new normal.  Alot of men wait for several weeks to "heal" before starting back with intimacy - we waited 2 days post catheter removal.   He was able to get an erection post surgery even with the catheter in.    Now he's able to maintain for more than 10 minutes, size is much better, and sex is getting better every time.  Was he frustrated at first?  Yes.  But we knew his surgeon was successful with the nerve sparing part of his surgery.  We both had to work together.  Honestly, he doesn't need the "challenge dose" or regular does to get things going anymore. 

There are a number of things you can do pre-surgery to help with sideaffects.  Physical Therapy for pelvic floor muscles.  Viagra (generic Costco brand) every day pre surgery.  We started 45 days before surgery due to husband's diabetes and blood pressure issues.  We had sex every single day 45 days before surgery for increased blood flow.  Exercise every day (walking 5-7miles) for increased blood flow.  Losing weight - he lost 40 lbs pre surgery and anotehr 10 pounds post.  Healthy diet.

Research the best surgeons in the country.  Big Cities. I can't say this enough.  My husband is type A personality control freak.  This whole cancer process has been so hard on him.  A Gleason 9 score at 55 is enough to send anyone over the edge.  His doctor and team have been awesome in his care both pre/during/post surgery. 

Jess4566
Posts: 15
Joined: Mar 2018

Magic, thank you  I will definitely look into your blog!

Jess4566
Posts: 15
Joined: Mar 2018

Magic when did you do your ablation? How long ago? You scored only a Gleason 7? My dad is stage 1, were you?

Old Salt
Posts: 720
Joined: Aug 2014

Not my opinion, but a recommendation from an expert panel of urologists from the American Urological Association

Clinicians should inform low-risk prostate cancer patients who are considering focal therapy or high intensity focused ultrasound (HIFU) that these interventions are not standard care options because comparative outcome evidence is lacking. (Expert Opinion)

Jess4566
Posts: 15
Joined: Mar 2018

I see that any focal therapy isn't a guarantee. It's a hope that it works. Most will do the true and tried method-surgery or radiation. There is considerably more research on those than any of the new technology today. But if focal therapy doesn't work, it can be done again. And if it still doesn't work then, yes, the true and tried method. But no body is truly cured from this disease. Even with radial Prosectomy, there's still a chance the cancer can come back. This is backed from an oncologist whom we saw today. But we can't afraid of doing something new. At one point radiation was new and most people scoffed at that and would suggest just cutting it out. But we all have different opinions and I respect that. Sometimes it works. Sometimes it doesn't. We just have to try and keep fighting. 

Duo
Posts: 2
Joined: May 2018

your one special daughter and your daddy is one lucky guy. Keep that bond you have nothing can replace it. 

Subscribe to Comments for "Prostate cancer Please help"