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BRONZE

Edward Rush and Barbara live in Virginia, USA . He was 70 when he was diagnosed in March, 2008. His initial PSA was 7.72 ng/ml, his Gleason Score 3+3 was and he was staged T1a. His choice of treatment was radical prostatectomy. Here is his story.

Having a father that died from prostate cancer and two younger siblings diagnosed with PCa (one choosing RP, the other in denial), and after reading this blog and doing much research, I reached the decision to have a RP (radical prostatectomy) at Johns Hopkins two months after my biopsy results - 1 positive hit in 12 with <10%. Good thing, because my after surgery pathology report showed the PC was much wider spread, had reached the capsule, but the margins were clear! Surgeon Dr. Edward Schaeffer spared both nerve bundles.

Post op was not that unpleasant, with only mild pain in the rectum area that was easily controlled with strong aspirin. Catheter was the real inconvenience for two weeks. Had the good fortune to be able to collect short term disability for 3 months, but was up and engaged around the home within 2 weeks, still wearing the catheter, however.

At the nine month mark, all PSA results have come back negative, but realize that I'm not out of the woods for another couple of years. Given my age and initial diagnosis, the advice from my urologists and oncologists - at Kaiser and Johns Hopkins was "watchful waiting". But my family history and reading of the blogs and literature, and my own concern that cancer was present and growing by the minute, and the fact that my otherwise good health could deteriorate over the course of the next few years, convinced me that I wanted the damn thing removed asap. I opted for the "gold standard" rather than the radiation pellets or Da Vinci; didn't like the fact that if the radiation didn't work, then I was facing "salvage surgery". The Da Vinci seemed at first the way to go, but in talking with several surgeons, including a couple who were skilled in the Da Vinci machine, both said that they would opt for the RP because they liked the fact that they could "feel" what was going on, which also provided more info on whether or not to spare the nerve bundles.

Looking back, I made the right choice for me. Have two high school friends in Los Angeles that had their prostates treated with in a year of my surgery--one had the radiation pellets, the other a RP. After a year, both are showing negative PSA; but, as you will read, it takes a couple of years for any remaining little bastards to multiply enough to start registering in the PSA results.

As for incontinence, that's still a frustration. No problem sleeping through the night without leakage after 4 months; but still use a couple of pads during the day, after 2PM, I start loosing a little control, especially when making sudden movements.

As for sexual action; well, I'm 71 and don't have much of a craving, and if I did, I couldn't do much anyway since most of the lead in my pencil is missing--but my wife and I have high hopes.

Happy to answer any questions. Will attempt to report back every six months or so with my post op progress.

 

UPDATED

August 2010

 

 

August 4, 2010: its been two years and a couple of months since my radical prostatectomy at Johns Hopkins Brady Center for PC.

As is usually the case, my pathology report was worse than the earlier biopsy report: [this is not a correct statement: although in many cases pathology reports after surgery show higher grade or more widespread disease, an almost equal number show lower grade - and in some cases, no can cer at all] went into surgery with one hit in twelve showing <5% PC with a Gleason of 3+3. Post op report showed extensive PC throughout the gland and had progressed through the capsule; however, my margins were clear, which validated my decision to get rid of the dam thing ASAP.

My recovery went as the doctor said it would; but I was surprised by the lack of pain and discomfort, although wearing a catheter for three weeks was the low point. All PSA tests (six month intervals), including my last at the 2 year mark (an important benchmark) have been <1%. That's the good news.

On the downside, I still struggle with stress incontinence, especially in the afternoon and evening. One to two pads a day are minimum. I still practice the Kegel exercise, but am resigned and OK with it, given my age. Not a big deal!

Sex is not what it used to be; seems that surgery, although my nerves were spared, did some damage and there isn't much of a electrical connection between my thought processes and my equipment. There has been some improvement recently and hopefully I will continue to see some "growth" in this arena. If not, so be it; I do have a future to spend with my seven grandchildren, and my beautiful wife.

 

UPDATED

January 2012

 

Almost at the four year mark since removal of my diseased prostate at Johns Hopkins (May, 2008).

No recordable sign of PSA in latest test. Health remains good, except for creeping arthritis, but can't/won't complain since I can still work f/t, garden, travel, and enjoy my extended family. There are consequences from choosing the radical prostatetomy route. Continence is still an issue when I cough or work out strenuously; so, I routinely wear a pad to keep safe 24/7. Efforts to strengthen my ...........have helped, but can't control the odd cough or sudden exertion.

ED is a fact even though the surgeon said the nerves were spared. I maybe can generate 50% erection with some creative action and thought, but "liftoff" seems a fond memory; but, at 74 and my wife at 70, we both feel comfortable just hugging and snuggling. We are content with the situation, and honestly, I feel kind of relieved from the pressure to perform. Not a big deal, really.

My two younger brothers both diagnosed with PC; one had a radical prostatechomy 11 years ago (showed it had spread to the lymph nodes), but he has no detectable PSA and is healthy otherwise--no incontinence, but full ED. My other brother also has lung cancer and deems the PC secondary to his current situation. Bottom line, despite the latest harangue over PSA testing and excessive treatment of PC, I would do the same all over again and at Johns Hopkins or another top teaching hospital. My thought at the time was that "watchful waiting" at my age (70) and with a family history of PC, that delaying treatment too much of a gamble, I didn't see much of a downside. And good that I did go through with the surgery, which showed that the cancer was wide-spread and had breached the capsule.

Regards, Ed.

Edward's e-mail address is: elrush@aol.com