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Howard Richmond and Anne live in Arizona, USA. He was 65 when he was diagnosed in December 2005. His initial PSA was 4.0 ng/ml, his Gleason Score was 3+3=6 and it seems he would have been staged T1c. His choice of treatment was Surgery. Here is his story.

December of 2005 I was diagnosed with prostate cancer. The purpose of this paper is not to discuss my diagnosis, or my decision to have the prostate removed surgically, but rather to discuss the events leading up to the surgery, the immediate aftermath of the surgery, and how I have recovered and the impact it has had on my life.

For background, my brother in law died from prostate cancer, which wasn't caught until it had spread and my neighbor took his own life after not being able to deal with the pain so I had a lot of incentive to deal aggressively with this disease. One of my challenges was being able to talk with men who had experienced this problem and getting an understanding of what might lay in my future. I did lots of reading of information on the Internet and my doctor was helpful with the information she provided, but I really had concerns over my future that I couldn't readily allay. These concerns have led me to write this paper to help other men get a perspective of what might lay in the future after an operation for prostate cancer.

My three main concerns were incontinence, impotence, and the short-term aftermath from the surgery. My primary concern was incontinence, since that could affect me 24 hours a day, every day. The next concern was impotence and the impact on my sexuality. The last concern was the surgery and its aftermath.

When I was diagnosed, my doctor told me that I was overweight and that might preclude minimally invasive surgery. I told her that I would go on a diet and a couple of months later astonished her by showing up after losing 25 pounds. There is nothing like surgery to give you the incentive to change your ways and lose weight.

In preparing for surgery we arranged for my wife to donate blood for me. The Red Cross in Tucson has a procedure to do this specified donation and there is a modest fee that is charged. It worked and the day before surgery I checked and the blood had indeed showed up at the hospital.

The day of the surgery was uneventful since I was asleep for most of it. In getting ready, everyone would ask me my name and the procedure I was going in for. This questioning is designed to catch any last minute errors and to ensure that if I was expecting a prostate operation I would not get a hip transplant instead.

Following the surgery I woke up to the big change in my life for the next few weeks, the catheter. A catheter is placed in the penis going up to the bladder in a small balloon, to keep it in place, and at the other end to a bag for urine. There are two bags that I was given, one small that I could "walk around" with and a large one for nighttime use.

There is nothing positive I can say about the catheter experience except that you have to just suck it up and deal with it. After two days I went home, as there wasn't much the hospital could do that I couldn't do at home. My wife went to Wal-Mart and bought a pair of very loose fitting, light weight cotton pants that were quite helpful in improving my comfort level. I didn't do much for the next two weeks as when I walked, the catheter irritated my penis and generally was a pain in the neck to deal with. The prospect of a few weeks to "freedom" kept me going.

I made a rope sling that I put over my shoulder and through the straps on the bag that kept pressure off me and that was a big help. At night I hooked up the large bag and placed it in a bucket by the bed, wedging myself with pillows to keep form turning over. Showers were fine, just being careful so I didn't tug anything. After about two weeks of so I went back to the hospital where they injected a dye through the catheter into the bladder and took x-rays to make sure there were no leaks around where the urethra enters the bladder. My doctor had done a good job on the stitching and there were no leaks so the next week I went to her office to have the catheter removed.

My wife had gotten me some adult diapers, which became very important for the next few days. My doctor injected some liquid through the catheter and into the bladder and then on the "count of three" removed the catheter as I sat up and urinated into a container. Words cannot describe how happy I felt having gotten rid of that device. For the next few days I wore the diapers, which were necessary, as I had no control of my urinary functions. My doctor gave me some exercises, which I did about ten times a day to strengthen my muscles. Slowly control returned and I graduated to feminine protection pads in my jockey shorts and then to panty shields in about a month. Within a couple of months I regained full control of my urinary functions. I never had a problem with control of my bowel movements, although I did drink prune juice daily to keep my movements loose and to eliminate strain on my lower abdomen.

Within six months I no longer needed additional protection and now consider my self back to where I was before the operation. Once in a while if I am putting a great strain on my lower abdomen I might lose a drop, but that really is all. My concerns over incontinence are well behind me.

Dealing with my sex life is a little different. There are, in my opinion, three aspects to sexuality. The first is desire, the second is erection, and the third is ejaculation. It has been nine months since surgery and my desire is just fine. My ability to get an erection is very limited and not sufficient for much, even with Viagra. I am optimistic that this problem will improve somewhat over time as the nerves heal. My ability to ejaculate is also fine, although since the prostate and one key muscle at the base of the bladder was removed with the prostate, the ejaculate is composed of urine. The pleasure remains the same. So two of the three aspects of sexuality remain and I continue to receive pleasure and a sense of intimacy with my wife. It is important to have a good and caring relationship with your partner.

In summary, I am happy with my progress and very happy to be rid of the cancer. I hope this paper gives you some understanding of what is ahead and I would be happy to discuss any aspect of my experience if you desire. Knowledge about what to expect is key to a good recovery in both body and spirit..

 

UPDATED

December 2008

 

 

My condition is unchanged. PSA is undetectable, I have no problems with continence.

I have ED but am able to enjoy sexual relations. All in all a good outcome considering the alternatives.

 

UPDATED

July 2010

 

 

I am doing fine. My PSA is 0

Howard.

Howard's e-mail address is: richmond@dakotacom.net