Radical prostatectomy or not ?

Posted , 11 users are following.

Hi, I think I am a healthy male aged 62 and attend gym classes regularly with a view to keeping fit.

I have looking to have a radical prostatectomy (complete removal of the prostate).

Having had a PSA test with a level of 12, followed by a 1.5T Multiparametric MRI scan at Bristol NHS hospital. (Would have liked a 3T scanner but unable to find a hospital with one).

Which came up with a possible cancer to the left side of my prostate.

Followed by a prostate biopsy (Tiverton NHS) which confirmed cancer to the left of my prostate with a Gleeson level of 3+4 in 70-90% of mean core volume, 50-60% of overall volume, which has not spread to any other areas. 

My main question is regarding incontinence and loss of erections that will probably follow.

Does anyone know if it could be a permanent result, my other option may be to just monitor the situation through regular scans.

Any advice appreciated, many thanks.

Barry

 

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    Barry,

    I faced the same decision in 2012. Don't want to go into a long discussion here, but I did a lot of research and met with several doctors who performed the various procedures. I eventually decided on HD Brachytherapy. Based on my studies it had the highest probability of success eradicating the cancer with the lowest side effects. I went in for two sessions in 2014. The only issue I had post op was prostate swelling from the radiation. I was unable to urinate on my own for 5 weeks and had to have a catheter - actually no big deal - got used to it. 

    One member of my extended family and one friend had the RRP that you are considering. Both had a really tough time in the months that followed. Basically, they weren't able to control their urination - severe incontinence. The family members cancer came back and he had to go in for radiation. I haven't spoken to my other friend in some time, but I do know his struggles lasted a very long time. 

    Looking back on my decision I would do the same thing again four years post procedure. My PSA is steady at 0.1. I get tested every 6 months and it's always the same. I can get an erection but it is soft, so there is some ED. I can urinate but have typical BPH symptoms unrelated to the radiation. 

    So, I don't want to be discouraging, but once you begin down this road there are going to be issues. It's likely that whatever procedure you choose will have side effects. ED is a likely outcome of anything you do, and incontinence issues can be another major issue in your life.

    Active Surveillance or "watchful waiting" is an option - I did it for a year and a half, but it caused anxiety - I was always concerned that the PCa was growing. Once I had my procedure that anxiety went away. 

    As prostate cancer is slow growing, you do have time to do your homework, which is why you are here on this forum. 

    My very best to you,

    Tom

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