As part of a routine evaluate, a PSA was drawn. Interesting in view of the current disagreement over whether PSA screenings are worthwhile. My PSA had risen from 3 to 9.1 in one year. As with most, I felt panicked. I spent hours on the Internet as most do which cause as much confusion as enlightenment.
I arranged an appointment with a urologist who was great. He spent time explaining various approaches after the exam was normal We discussed following,evaluating free PSA, course of antibiotics, etc In the end , I opted for biopsy which was done the same day. If you go this route, it not very painful and is brief. Of note, I did pass quite a bit of blood in the urine for the next week.
The biopsy came back with 6 of 12 positive and graded as Gleason 7 (3+4). Again now what to do. In view of my young age, I opted for prostatectomy. Then you have to decide on robotic vs retropubic. Again results vary. I'll save you some time. Neither can guarantee 100% cure or 0% complications. As this site tells you, discuss it with your surgeon as national statistics are meaningless. The cancer free rates and complications are similar in good hands. Robotic is associated with less bleeding but I didn't bank any blood as my surgeon told me has not had to transfuse anyone in years. Also, for the majority the robotic procedure takes longer.
The operation went well and was home soon. THe catheter is no fun and it is true with the robotic method it comes out quicker. Mine came out after 3 weeks and I had to use pull ups at night and pads for about 4 weeks. Not a lot of leakage but when you have to go there isn't much holding possible. Recovery has been unremarkable. No incontinence or flow problems.
In regards to the impotence, that does take a while. Initially not much interest. When desire returned the function didn't at first. Eventually used the injections. Worked great but initially had to adjust the dose as prolonged erections sound impressive but are quite uncomfortable. Have now progressed to daily Cialis with good results.
It's been 1-1/2 years since the surgery. My wife has been very understanding and supportive.The PSA remains undetectible but you still worry a little with each recheck. Of the web sites, YANA now was most accurate and helpful. I thank all the contributors. When making decisions, remember the goal of all therapies should be cancer elimination and thus should be the key to selecting treatment in your area.
Good luck to everyone, and personally I'm glad screening PSA was done.
It 's been 3 years. PSA remains undetectable and no leakage issues. Doing well. Sexual function continues to gradually improve. Erections are now possible without medications though at times Cialis does appear to help. Over the shock but still a little nervous waiting for my annual PSA result . I'm glad I chose retropubic prostatectomy. Lot's of controversy with PSA measurements but I feel fortunate as the diagnosis at a relatively young age logically tells me chances of spred much greater in my lifetime. Also know several people post radiation and currently on hormonal therapy. Though they may not die of prostate cancer, the side affects of the medicines are multiple. Keep up the fight!
Good news. Last visit PSA remains undetectable. Only issue is mild ED but not sure if disease or age related. Glad I chose retro pubic, know several treated with robotic and already have recurrence. May be their disease was more progressive at diagnosis. As with all surgery heavily operator dependent so if considering ask your surgeon what their margin free rate is with the surgery they perform. Lots getting on the DaVinci bandwagon but I feel there is a significant learning curve.
James's e-mail address is: james AT aol.com (replace "AT" with "@")