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nervous after pc surgery

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Posted 1/26/2013 10:14 PM (GMT -5)
Started out in dec. ,11 with psa went from 3.23 to 5.7, 1 month later it was 7.5 and my free psa was 9, went for first biopsy march2012, one sample suspsious, another biopsy done by the surgeon in aug. 2012, came back 4 on one side of the prostrate  positive , 2 suspsious, on the other side 2 positive, 4 suspsious gleason score of 4+3=7, had a radical prosectomy on dec 4 2012.Got the patholigest report back on jan 2013 and found out that the cancer had penetrated the wall of the prostrate and uped my gleason score to 9 and uped my cancer to a high grade. My uro thought that the cancer had just penetrated the wall so i had the choice of starting radiation or waiting for my first psa in march, i,m waiting for my first psa in march .Also my lymp nodes were clear and they saved one nerve bundle, but after 7 weeks am still unable to get a erection. The doc put me on a half 100mg of viagra and uped it to the full 100mg but still no erection. The incontnence is inproving, have total control at nite and am farily good until around noon ,then some tribling , hope this will inprove as it has only been 7 weeks since surgery.Also alot of the time my penis will only be a couple of inches long and that also bother,s me will this come back, other times it is a normal size. Kind of a newbe just had to unload. I am also 66yr,s old and otherwise in good health

 

Post Edited (wingman63) : 1/26/2013 8:21:01 PM (GMT-7)

Posted 1/26/2013 11:43 PM (GMT -5)
Hello Wingman,

Welcome back. Sorry to hear that things haven't been going as well for you as we all hoped when you were here before.

If you look at my signature below you will see that my results look a lot like yours. I was a GS7 going into surgery and a GS9 with positive margins after my pathology report.

Have you seen a medical oncologist yet? With a Gleason score of 9 and positive margins you will probably want a team of doctors instead of just your urologist. I have three cancer docs -- my urologist who did my robotic prostatectomy, a radiation oncologist who handled my adjuvant radiation therapy, and a medical oncologist who handles the hormone therapy that we hope will make the surgery and radiation more effective.

When I was where you are now my doctors didn't want to wait to see what my PSA would do. A couple of weeks after my pathology report they put me on hormones (to keep any remaining cancer from growing) and they scheduled my follow-on (adjuvant) radiation (IMRT) for four months after my surgery. I am done with the radiation now (it wasn't bad, side effects were minimal) but I will remain on the hormones for another year and a half.

There is some disagreement among doctors about starting the radiation as soon as the patient has mostly healed from surgery or waiting to see what the PSA will do. All three of my doctors were all about hitting it as hard as possible as soon as possible for the best chance of a "durable remission" if not a cure. But there are other, equally qualified doctors who think you should wait to see what happens before you treat it. It is something to talk to your doctors about.

It sounds like you are doing better than I did with incontinence. It takes a long time sometimes. I am seven months out of surgery (and one month out of radiation) and I am finally making some progress. I am down to one pad a day and I *might* be dry at one year. The rule of thumb is that two men out of three are dry at three months and of the men who are not, two out of three of those men are dry at one year. That leaves one guy in nine with long-term problems. I'm trying not to be that guy.

As for your erection problems. Those are quite common but the usually get better. It can take up to two years sometimes (and it doesn't always happen) but there is no reason to give up. Since Viagra doesn't work for you you might ask your urologist about injections and/or a vacuum erection device (penis pump). I use both of them to keep my hydraulics working while I wait to see what will come back when I am done healing. The injections work for four out of five guys so the odds they will work for you are really good.

Keep us posted on your status. This thing can be beaten. Good luck.
Posted 1/27/2013 1:20 AM (GMT -5)
Indeed, I have read where it sometimes takes as long as THREE years before sexual function recovery is complete.

In my case, after 14 months since Mr DaVinci, natural erections are just now beginning to get firmer. My nerves were spared on both sides and it still has taken this long for some really encouraging developments to happen.

Thus, 7 weeks is really just the beginning of the healing curve for many patients.

So don't worry too much wingman63. It takes time and patience.

And, as PeterDisAbelard suggested, keep the "hydraulics" going through the motions in the meantime. Eventually things should show great improvement.

Take care,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-erections now happening 14 months post-op & getting stronger.
Posted 1/27/2013 12:02 PM (GMT -5)
Thank,s for the advice,i needed that. My uro is one of the top one,s in London, Ont,and i respect his opinion. He has done well over 1000 open prosectomy,s and seems like a very careing surgeon. He felt that the cancer had just penatated the wall of the prostrate and he told me it was a very small spot and gave me the choice of radiation right away or wait for March and see what my first psa will be. I decided to wait. I have also had a meeting with the Rad/onc if needed. After reading Dr Walsh,s books i shyed away from hormone therapy at this time because the way i understood it that it only works as long as you take the injections, but i might be wrong, Thanks again
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