PROSTATECTOMY QUESTION....

[DaveKell]

For you guys who've had one I have a concern. Yesterday I talked to a very old friend (we were university roommates) who owns a large ranch in northeastern Utah in the middle of the Uinta mountains. He sounded very dejected as he told me he was preparing to go to Salt Lake City for two months of daily radiation therapy. It was the first I had heard he had prostate cancer.

He told me he had nerve sparing surgery, whatever that means, but that they didn't get all the cancer. He has to do radiation now. I brought up the implant in the discussion and he said he had already been told about that. He also said there was some concern about him achieving a 2 year mark without a return of the cancer and he didn't know if he could be implanted before then. He still has the lean, muscled body he had over 40 years ago due to a lifetime of hard labor on his ranch. He also has a natural blonde wife who survived breast cancer. I have no way of knowing but I'd assume given their fit looks that sex is still a big part of their life.

My question is this. Given what I've said about the current condition he is in, does anybody have a similar story that can shed some light for me as to what my friend may be facing long term right now? I worked with a guy in his 60s a few years back who was diagnosed with PC and died from it within 6 months of its detection. I thought it was supposed to be extremely survivable?

[bldoink]

I'm no expert on this.

My understanding is that if it is caught early and while still contained totally within the prostate, the long term survival rate is excellent. Once out of the prostate things get worse. Mine was what they call "in the margins". Meaning they couldn't guarantee it hadn't escaped elsewhere into the body, starting with the bladder. The doctor told me he thought he got it all but there were doubts.

In your friends case it sounds like the cancer has definitely escaped the prostate. The "Nerve Sparing" is where they save the nerves that make the dick work, erection wise. These nerves are wrapped around the prostate. I suspect they may have gone into surgery expecting to do nerve sparing but I doubt they were able to. Often, if not actually usually, the nerves are so pissed off from the procedure that they don't work even when "spared".

Your friends long term survival will also largely depend on just how aggressive his version of the cancer is. All hope is not lost because if the radiation is successful and it hasn't spread elsewhere things can go very well. Even if it has, hormone therapy can greatly slow it for years. Your friends robust health is certainly a positive influence on his outcome.

There are also new treatments in the works that are very encouraging. I'd be looking into those. I predict it won't be too many years before the Radical Prostatectomy is a thing of the past.

It he is wanting to remain sexually active it sounds like injections are currently his best option if they work for him.

I certainly feel for your friend as the poor guy sure is going through a stressful time in his life.

[David_R]

I thought it was supposed to be extremely survivable?

It is still true that as many men die from prostate cancer as women who die from breast cancer. (The reason seems to be that there are more funds for more research on breast cancer, than what there are for research on prostate cancer.)

[williamb]

I was diagnosed with Prostate Cancer in August 2014, surgery in October 2014. They did nerve sparing surgery which left me unable to acheive an erection at all without injections. The cancer had penetrated the lining of the prostate and was out side the prostate. It has been 3 years and so far my PSA has stayed at zero. So the getting rid of cancer looks like it has been successful, while the nerve sparing surgery was a total failure, in fact I believe the doctors just tell you "nerve sparing" to give you some hope and delay the onset of depression.
I am thankful for the success with getting all of the cancer and my implant revision but wish that I had better pre-surgery counciling and knew what questions to ask.
Life is good if you work on making it good.
Dave

[Ahappigui]

I think the responses to David's post have been excellent. It appears to me David's friend is in need of support and counselling. To be facing two months of daily radiation is sufficient to scare anybody, but he needs assurance there is light at the end of that tunnel. Many men have had a prostactomy followed by radiation and lived for years afterward. The fact he is going for radiation is an indication there's hope for him to return to a fairly normal life. The survival rate from prostate cancer is totally the result of the stage the cancer is diagnosed initially.

[bldoink]

in fact I believe the doctors just tell you "nerve sparing" to give you some hope and delay the onset of depression.

It seems like that may be the case. They do seem to promise more hope in the dick function department than seems warranted based on what I've heard or experienced. I suppose there may be some giant mass of silent men out there that are missing prostates yet have fully functioning natural dicks, but I'm skeptical that's the case.

It appears to me David's friend is in need of support and counselling.

Yeah, and the sooner the better. An online support group would be a start. You can't count on your doctor to help in that department. Mine sure didn't.

[Arnoldloveslife]

in fact I believe the doctors just tell you "nerve sparing" to give you some hope and delay the onset of depression.

It seems like that may be the case. They do seem to promise more hope in the dick function department than seems warranted based on what I've heard or experienced. I suppose there may be some giant mass of silent men out there that are missing prostates yet have fully functioning natural dicks, but I'm skeptical that's the case.

It appears to me David's friend is in need of support and counselling.

Yeah, and the sooner the better. An online support group would be a start. You can't count on your doctor to help in that department. Mine sure didn't.

Exactly

[David_R]

Years ago in a prostate cancer support group that I was in, a doctor explained that the surface of the prostate is like the surface of an orange. When you remove the peel,* even if you do it very, very carefully, you are probably going to take at least just a bit of the orange pulp -- which in the prostate would be the nerves that everyone hopes can be "spared."


*in order to get to the tumor inside the prostate

[Greg1956]

I was diagnosed with Prostate Cancer in 2014. I was told mine was a very agressive form. While this type of cancer is often slow growing and many doctors take a “wait and watch” approach with their patients, I was told waiting really was not one of my options if I wanted to live. I had a robotic Prostatectomy soon after that. A lot of men do die from Prostate Cancer because it was not caught early enough.

My wife has a friend whose husband had to go through the two months of daily radiation treatments, but he chose that in leui of Surgery. My dentist had Prostate Cancer at the same time I did and his had spread outside the Prostate. He is doing great three years later, with good PSA test results every few months.

[tarheelgwb]

my story: i was diagnosed in Sept, 2014, RP nerve sparring in Mar 2015. all PSA have been less than 0.02 UNTIL this last one in Nov 2017. it now shows 0.05. which is more than doubled from July (the last PSA test). i am a bit concerned as to why the sudden increase. doc has a retest in Jan 2018 (8 weeks from last). i hope it drops or does not go up again. if so, i may be facing radiation.

anyone else have a rising Post-RP PSA?

PS my Gleason score was 6, all cancer was contained in the prostate, so the surgeon says and all margins were clear. it really baffles me then how cancer is there again, if that is the case. perhaps the left-over prostate cells are now cancerous? That's crappy!