RP pre-op and post-op care advice

This seems to be a forum that is a bit more open-minded in terms of what is allowed in posts. However I apologize upfront if I am posting this in the wrong location or violating a rule (I did my best to read the sticky posts and "Before you post" posts).

I'm here on behalf of my father who was recently diagnosed with aggressive prostate cancer. His biopsy showed Gleason scores of 9/10 in all 12 samples. The good news was that his bone scan was clean and the doctors believe it has not spread and is isolated to his prostate. I believe his PSA was 13. I understand that his gleason score puts him at a higher risk of a cancer reoccurrence. Early next month he will go in for a bladder biopsy to make sure it hasn't spread there along with more imaging for the surgeon and potentially for the radiotherapy on nearby lymph nodes although scans currently show no cancer in the lymph nodes.

He is currently waiting a month for surgery after which he will have a RP. I have been doing a ton of research on prostate cancer and have learned that there is no proven causes of prostate cancer and there are a lot of different diets, lifestyle changes, treatments etc that some people swear by and people can get pretty defensive regarding treatment options and other personal choices. I've personally arrived at the conclusion that an "all-of-the-above" approach seems to work the best along with a strong will to live. My dad is in good spirits and coping with this by putting it out of his mind until the day of the surgery. However, I have read that there are some steps he can be taking pre-op that could help him with his recovery along with some steps he can take post-op that will give him the best odds of healing quickly and completely.

I am in a situation where I will be cooking and caring for him for his first week outside the hospital post surgery. They say he will need to be in the hospital for 3 days after surgery and he will not be in my care during this time. I have read some compelling studies and research regarding the ketogenic diet's effectiveness of combatting cancer as well as the benefits of healthy-sourced paleo foods but have already resolved not to put him through a super-intense diet post surgery (I'm not going to put him through the keto-flu) and let him decide if that is something he would like to do later on for himself. My understanding is that post surgery the first bowel movement is key and I want to make sure I help him with that in the best way possible. I have read that certain foods that produce gas should be off limits (broccoli, beans et. al.) and to slowly increase his fiber intake (not too much fiber to begin with). I've also read that the pain medicines can exacerbate constipation and prolong a bowel movement.

I would greatly appreciate any advice or experiences from people have experience with an RP in regards to what worked, what didn't work and/or things they wish they had done differently or had known ahead of time. Any advice relating to exercises, resting positions, diet, pain drugs, follow up treatments or something that may not even be on my radar both pre and post operation are what I am looking for.

Some more information that may be helpful to my specific situation is that my father is likely pre-diabetic but doesn't officially have any comorbidity. He has chewed tobacco for most of his life but has quit since his diagnosis. He is slightly obese (not morbidly) he is 59 and is otherwise reasonably active and feels fine.

I want to preemptively thank anyone who offers me info based on personal experience and again I am very sorry if this post is offensive or somehow breaks forum rules or standard procedures.

The period before RP is psicologically trying, but surgery day will come and go and recovery is relatively smooth for most people. My approach was a bit different from your plans since I decided to change my habits before surgery as little as possible. But any approach is good as far as you are happy with it. I also walked a lot after the catheter was out and it certainly helps.
It is possible that incontinence will be an issue but it is also probable that it will be solved in a few months. I had a list of many other possible difficulties, some trivial, other more cumbersome, but actually I was free from most of them. I guess every one in particular has one or two small problems from that long list. Fiber and fruit prevent constipation, I was lucky to avoid it though I was three days in the hospital with a lot of rice in my meals.
After reading recommendations from this forum I decided to explore different options, not only surgery. I talked to a couple of radiation oncologists before I made my final choice. Radiation is a highly recomended option for cases as your fathers and I hope you have considered it as well.

I'm pretty sure you did not offend anyone. Welcome to the forum. I think you are on the right track about not eating foods that produce flatulence. It's also good to avoid opioid pain-killers since they result in dreaded post-operative constipation. Colace helps a lot! Your dad will be very tired after the surgery. There is no reason to fight that, except that walking after surgery is very helpful in a number of ways. It helps get the intestines working again, for one thing.

There have been some heated discussions on this board about the merits of surgery versus radiation for primary treatment of prostate cancer. Since I've had both, I consider myself a relatively neutral party. Did your father meet with a radiation oncologist before deciding on surgery? He should, if only so that he gets a clear picture of the treatment options available. The problem with surgery for someone with a Gleason 9 cancer is that he will quite likley need radiation too. Some people think it's a better idea for G-9 patients to go straight to radiation and skip surgery and thus avoid accumulating the side effects of both treatments. That is a decision that he must make, but he should make it well informed. Whatever you and he decide, the folks on this forum will support you and provide advice to the best of our abilities.

Binxter,

There are several different ways to treat prostate cancer with radiation. One way is to use radiation after surgery to try to mop up any cancer in the surrounding tissues that may have escaped before the prostate was removed. The other is to treat everything with radiation without removing the prostate -- just zap it in place and, at the same time, treat the surrounding tissues with a lower dose. It sounds like your dad's doctors focused on that first option (surgery followed by radiation) but didn't particularly think about the other. This is often the way things go when a surgeon calls in a radiation oncologist for a consult. The radiation guys who the surgeon works with specialize in radiation as an adjunct to surgery -- perfectly natural... but sometimes unfortunate.

While surgery plus radiation sounds like a more aggressive treatment it doesn't always have the best results in disease control (especially for higher-risk men like your dad) and it has more side effects than radiation as the primary treatment. You might re-contact the radiation oncologist and ask him about radiation as a primary treatment. If you tell us where your dad lives (nearest big city is enough info) then we might be able to suggest a doctor he could consult.

As for his diet, I don't think it will make a lot of difference at this point, with only a month to go. If he is overweight any weight he might lose before surgery will be a good thing. Thinner patients tend to recover more quickly from abdominal surgery. But don't make him miserable with an extreme diet. The amount of weight he will lose in a month won't make that big a difference.

I will second the suggestion for a recliner. After surgery he will need to walk around to help his organs settle into their new configuration and when he isn't walking he should get more-or-less horizontal to keep things from swelling. A recliner will help him get up to walk and recline when he is done walking. It's easier to get into and out of than a flat bed and staring at the ceiling gets boring pretty quick. (I happen to know).

You might want to click on the link at the bottom of my signature below. It is my story of surgery. You will learn some of the mistakes I made. I also cover things I did right.

Search around on this site, as there are many threads on the topics you're interested in.

Good luck.