Unexpected roadblock!

[Freddyboy]

I've only posted here a couple of times, mainly for info regarding surgeons in the US. This is a great forum and I've learned a lot from all the postings. I live in Canada and have been on a waitlist for a year for an implant. However after having a PSA test result recently of 19 and then a biopsy showing a Gleason score of 9 (4+5) I officially have high risk cancer. The stage will be determined after the results of a CT and a bone scan this week. So methinks I will be having the prostate out in short order. Anyway the reason I'm posting this time is cuz I don't see my uro till end of next week and i'm curious if anybody knows how much time might have to elapse after a prostatectomy before implant surgery can be done.
Thanks guys!

[RelievedofED1]

So sorry to hear that news. Having just gone through the implant I have also been battling with a rising PSA over the last few years and about to have a second prostate biopsy so may be headed for more urology surgery but with an implant in first. Most of the time men are advised to wait at least a year for an implant to see if ED will resolve after prostate surgery or radiation on its own. That is when the ED happened after prostate surgery or radiation. If ED was pre prostate treatment then there is nothing to wait for a return of so it would likely be much sooner than that. That said it would really depend on what you had done to treat the prostate cancer ie surgery or radiation or hormones etc and how you do with those. I wonder if your prostate surgeon could coordinate everything to avoid waiting on the implant as an option and on what kind of intervention to make them both happen as soon as safely possible. They will tell you the prostate cancer is the most important and frankly it is but make sure they consider both. Happy to be around for support even though I am a novice at the prostate cancer stuff beyond my own research. And dont feel guilty about speaking up for your penis while they focus on your prostate!!!!! someone will try to make you feel that way.

[Epsilon]

Freddyboy,

I believe you will discover there are lots of options. I have several friends who have managed this beast quite successfully. You will no doubt be scanning the internet for treatment information.

Don't overlook PROTON BEAM THERAPY. Many doctors are not yet familiar with this technology. This web site at Loma Linda University is worth a look.

http://www.protons.com/proton-therapy/index.page

They were the first with this technology. But in the last few years, Proton treatment centers (very expensive) have been opened in nearly ten cities including the Mayo Clinic in Rochester.

Two of my friends opted to avoid surgery after learning successful outcomes compared to surgical removal (and accompanying side effects) were on a par with Proton non surgical therapy.

Of course only a knowledgeable doctor can advise you but it may be a preferable treatment option -- one with no surgical side effects. Make sure you include an evaluation by a doctor knowledgeable in Proton Beam treatment. Best

[alibaba]

I do not know any form of radiation or pellet intervention that does not involve the high likelyhood of urethral strictures or impotency. I inquired with a number of professors of urologic surgery before my prostatectomy and all said the less invasive methods still lead to impotency and other issues but more likely a year to 3 years after the treatment rather than immediate like the prostatectomy but it definitely will happen. I don't think you can find many people who will truthfully tell you that you will regain potentcy after a prostatectomy no matter what load of crap you read on the net or in doctors ads about nerve sparing. Most doctors I find just plain don't tell you what will happen and you are left to pick up peices and do what you can with the aftermath. I have read stories of guys who had the implant and prostatectomy at the same time. I wish I had. would have save wasting years and countless doctors visits. That number and staging score are quite concerning numbers but there are new treatments on the horizon that make your bodies own immune system beat the prostate cancer. I am not trying to be a downer and sincerely hope my post did not upset you but having been through this and having friends who are wealthy enough to afford the best treatments in the world (I am the poor one of the bunch) have been through and seen them through at some of the best institutions in the U.S. this is where we all ended. Personally I know no-one who did not need an implant after any type of prostate treatment. with TURP, pellets and proton beam they needed urethral surgery and an artificial urinary sphinctor besides the implant. Best of wishes. Prayers and hugs your way. d

[Epsilon]

I do not know any form of radiation or pellet intervention that does not involve the high likelyhood of urethral strictures or impotency. I inquired with a number of professors of urologic surgery before my prostatectomy and all said the less invasive methods still lead to impotency and other issues but more likely a year to 3 years after the treatment rather than immediate like the prostatectomy but it definitely will happen. I don't think you can find many people who will truthfully tell you that you will regain potentcy after a prostatectomy no matter what load of crap you read on the net or in doctors ads about nerve sparing. Most doctors I find just plain don't tell you what will happen and you are left to pick up peices and do what you can with the aftermath. I have read stories of guys who had the implant and prostatectomy at the same time. I wish I had. would have save wasting years and countless doctors visits. That number and staging score are quite concerning numbers but there are new treatments on the horizon that make your bodies own immune system beat the prostate cancer. I am not trying to be a downer and sincerely hope my post did not upset you but having been through this and having friends who are wealthy enough to afford the best treatments in the world (I am the poor one of the bunch) have been through and seen them through at some of the best institutions in the U.S. this is where we all ended. Personally I know no-one who did not need an implant after any type of prostate treatment. with TURP, pellets and proton beam they needed urethral surgery and an artificial urinary sphinctor besides the implant. Best of wishes. Prayers and hugs your way. d

Alibaba,
Not to question your familiarity with Proton Beam treatment, but things have changed a lot in recent years. I have two friends who underwent Proton Therapy over 4 years ago. They're driving around town today cancer free with a smile and an erection. They both went to Loma Linda

http://www.protons.com/proton-therapy/i ... Aj5z8P8HAQ

Remember, there is NO prostatectomy to mess things up. You'll find several studies on the web addressing the question of ED and External Beam Proton treatment. It is a bloodless treatment. Mayo Clinic is reporting a study of 211 prostate cancer patients with a 99% survival rate five years after proton therapy. They've just started construction of their 2nd Proton Therapy center. I'm just suggesting if they tell you it is cancer, it may be premature to dismiss this as a load of crap. Unfortunately, most doctors are not going to be proponents because they don't know much about it. At least include one doc who is aware of it and scour the web.

[Woodicould]

There is a radiation treatment in Canada done by the Cleveland Clinic (not yet approved by the FDA, but done in many other countries).
Of course because it is in a private clinic it is on your dime.
http://my.clevelandclinic.org/canada/se ... ate-cancer
There are several good books out for guys with prostate cancer.
One is "Prostate Cancer: Asking the Right Questions" by Thomas J. Leih, PhD
another is "Saving Your Sex Life: A guide for men with prostate cancer" by John P. Mulhall, M.D.

Get these books, but if you go to Amazon you can see other books that you might find useful as well.
If you are a man of faith, google for John Piper's "Don't Waste Your Cancer".
All the best to you,

[alibaba]

I hope they have made progress with proton beam as it has been around forever. I consulted @ mayo, and Washington University in 2009 with professors of urology. surgery was done by a professor from Brigham. All told me that the radiation works by causing necrosis( killing tissue) and eventually, usually in about 3 years, impotency develops as well as strictures ( narrow places in the urethra). stricture repair from radiation treatment is supposed to be Dr. Milam's specialty. Every urologist I have ever had except one has been a professor of urology or assistant professor. I read a million ( exagerated number) of pretty smiling picture ads about how the DaVinci prostatectomy was so easy, fast recovery, nerve sparing, erections spared, no incontinence issues and was fed this load of crap from the doctors too. Those issues are only in a small number of cases they say. I have not met 1 person who had the rosey happy everything is normal after treatment bit like in the link you sent. They sell the same story no matter what type of therapy is used. After the treatment then they tell you , everybody needs an implant. Never do they tell you that before. I'm glad your friends can drive around town with an erection. Probably does make driving difficult though.

[Freddyboy]

Thanks to all for the responses and the information. I had heard about the Cleveland Clinic in Toronto. I believe its basically high energy focussed ultrasound as opposed to ionizing radiation so less damaging to adjacent tissues. It sounds promising but sounds expensive too. I’ll mention it to my Uro next week to get his take on it. Regarding proton beam therapy, that’s new to me. Obviously I have a lot of “homework” to do! I did get a book from my Uro, called ‘The Intelligent Patient Guide to Prostate Cancer'. Full of good information. I also came across information on some urologist's website regarding combined prostatectomy and implant surgery. He does the "combo" but only places the implant reservoir at the time of the prostate surgery. Then a few months later he puts in the cylinders and the pump and hooks it all up. Less traumatic and less chance of infection I believe. Anyway thanks again for the responses and I’ll keep my fingers (and toes) crossed for not-too-bad scan results.

[alibaba]

Sounds like you have your head on straight. I like the implant at prostatectomy idea. Wish I could have had that. Wanted the nerve graft at prostatectomy time but that is considered experimental by the insurance company. Hopefully it is confined within the a well defined margin and you will be good. Prayers for you. d