FrankTalk.org

Per the subject line:
I had a radical robotic proctectomy 2.5 years ago. Surgery went very well but ED got worse. Pills no longer worked for me after surgery. VED helped but needed more help so tried Trimix and that has been working very well for me for the past 15 months. However; I am about to start my 2nd prostate cancer chapter. They have caught some bio-chemical recurrence at a very early stage. I have just begun a new 6 month treatment plan that includes ADT Hormone Therapy, plus 2months of radiation midway thru the ADT. I know that unless I am proactive I would experience shrinkage (and a further ED hit) during the next 6 months.

So my plan is as follows:
1) continue daily use of the VED
2) I have an appointment with Dr. Levin in Chicago next month for two reasons, A- to get his advice on a regimen for penile health for the next 6 months, and B- start the discussions on an implant once this next treatment period is complete.

2024 may be the year I join the bionic brotherhood. Frank Talk has been an excellent resource for me and I welcome any/all comments

Dr Levine is my urologist and he's fantastic.

I also can't get my implant this year. In my case I'm completing and online degree and dealing with health issues of my elderly mother all while working full time.

I'm hoping 2025 will be my year, but he may be retired by then. Even if he is I'll get a recommendation from him

It's good youre making plans. This place is the best resource for making plans. Because of what I learned from this place I know I want

a)AMS CX
b)penoscrotal surgery
c) a plan for pain management explicitly strategized before surgery
d) a plan for infection prevention explicitly strategized for surgery
e) jock straps, baby socks etc purchased before surgery

You'll get a lot of good info here

I have been extensively researching prostate cancer ever since my diagnosis in April 2023. Biopsy found cancer extensively throutout my prostate and seminal vesicles with perineural invasion but PET scan showed no metastasis in lymph nodes or elsewhere.

What I have learned that I feel compelled to share with you is this: Radation inevitably affects healthy tissue as well as killing off cancerous tissue. So much so that surgeries (such as prostatectomy) after radiation are generally difficult to do (because healing of previously irradiated tissues is compromised and the tissues are more fragile). I can only suppose that implant surgery has a certain risk which is elevated after radiation. Of course, the implant surgery is further away from the radiation field, so may be less problematic than I am imagining.

The upshot of my post is my suggestion that you discuss getting the implant before the radiation therapy.

I am not a medical professional, so that second paragraph's assertions should be verified with your medical care team.

@mark1974 @Lost Sheep
Thank You both!

LS, sorry to hear that you are diagnosed with Prostate cancer. I hope you recover very soon. Did you or your doctor consider the robotic surgery over the radiation?

CuzznClark wrote:Per the subject line:
I had a radical robotic proctectomy 2.5 years ago. Surgery went very well but ED got worse. Pills no longer worked for me after surgery. VED helped but needed more help so tried Trimix and that has been working very well for me for the past 15 months. However; I am about to start my 2nd prostate cancer chapter. They have caught some bio-chemical recurrence at a very early stage. I have just begun a new 6 month treatment plan that includes ADT Hormone Therapy, plus 2months of radiation midway thru the ADT. I know that unless I am proactive I would experience shrinkage (and a further ED hit) during the next 6 months.

So my plan is as follows:
1) continue daily use of the VED
2) I have an appointment with Dr. Levin in Chicago next month for two reasons, A- to get his advice on a regimen for penile health for the next 6 months, and B- start the discussions on an implant once this next treatment period is complete.

2024 may be the year I join the bionic brotherhood. Frank Talk has been an excellent resource for me and I welcome any/all comments

I also think getting the implant before the radiation is a better option to avoid size loss. Implant will preserve the size while you are in another treatment.

FinallyBionic,

To answer your questions:

After getting x3 2nd opinions (including a radiation oncologist) opinions were unanimous that I was an excellent candidate for robotic surgery. Even though I now need some follow-up treatment - I still feel good about the initial decision for surgery.

I understand the logic for implant first and radiation later. However the wheels are already in motion I have already started ADT and radiation will begin in early August (I'm sure implanters are booked out many more months in advance)

CuzznClark wrote:(edited for brevity)
I understand the logic for implant first and radiation later. However the wheels are already in motion I have already started ADT and radiation will begin in early August (I'm sure implanters are booked out many more months in advance)

Then I advise therapeutic vacuum erection device use. Apply vacuum to induce blood flow into your penis (to oxygenate tissues and expand/stretch tissues) twice a day for 30 minutes per session. Vacuum for a minute, then release (no use of constriction ring). This emulates the dailly (usually nocturnal) erections than intact men usually have that keeps penile tissues healthy, elastic and full-size.

And hope for a cancellation in the surgical schedule if you can manage that before the cancer treatments.

Good luck.

CuzznClark wrote:FinallyBionic,

To answer your questions:

After getting x3 2nd opinions (including a radiation oncologist) opinions were unanimous that I was an excellent candidate for robotic surgery. Even though I now need some follow-up treatment - I still feel good about the initial decision for surgery.

I understand the logic for implant first and radiation later. However the wheels are already in motion I have already started ADT and radiation will begin in early August (I'm sure implanters are booked out many more months in advance)

Of course, cancer treatment is a top priority. We can't always manage things as how want them to be. And yes, VED and/or traction device will help you maintain your size. All the best!

Mark1974 wrote:Dr Levine is my urologist and he's fantastic.

I also can't get my implant this year. In my case I'm completing and online degree and dealing with health issues of my elderly mother all while working full time.

I'm hoping 2025 will be my year, but he may be retired by then. Even if he is I'll get a recommendation from him

It's good youre making plans. This place is the best resource for making plans. Because of what I learned from this place I know I want

a)AMS CX
b)penoscrotal surgery
c) a plan for pain management explicitly strategized before surgery
d) a plan for infection prevention explicitly strategized for surgery
e) jock straps, baby socks etc purchased before surgery

You'll get a lot of good info here

LOL!
I found my Doctor here in FrankTalk.

This place and it's posters have been an incredible asset to me.