I was 53 when diagnosed with PCa. My father (a retired surgeon) had PCa in his 70s. He was treated with external beam radiation and died of something else at 92. His younger brother also had it and chose external beam radiation. He was also in his 70s and is fine 4 years later. My older brother had a RP at age 57, 6 years ago. Because the cancer had escaped the prostate he was also later treated with external beam radiation. He just celebrated his 64th birthday and lives a full life, but does have to deal with some aspects of the radiation.
Because of my family history I was faithful with regular check ups with a urologist. When my PSA jumped from 1.89 to 2.69 in a year, he suggested a biopsy. He did not feel anything particular with the DRE (Digital Rectal Examination).
On June 26, 2010 I was given the news that 2 of 12 biopsies had cancer in approximately 10% of the specimen. It was rated a Gleason 3+3=6. My urologist simply said that given the results and my age and family history that I should have it treated.
I made an appointment at the Huntsman Cancer Institute with Dr. Robert Stephenson. I had their lab look at my biopsy slides. They confirmed the findings of the first lab.
All treatment options were explained to me at Huntsman. They were careful not to push any particular option and even said (when I asked) I could start an active watch program with them.
I spoke to several PCa survivors and did a lot of research. The stories on this site were tremendously helpful.
The bottom line, I chose robot assisted LRP. My age and current good health weighed heavy in the decision. I could have waited for awhile with little additional risk but concluded treatment in my future was inevitable and I wanted the best chance for a cure and surmised the younger and healthier I am at the time of treatment will only help in healing and in dealing with the side effects. In addition, I chose to "pay now" on the issue of side effects and have a fighting chance for improvement over time instead of potentially having increasing problems with continence and potency over time with radiation. This was a personal choice and I recognize everyone will weigh the numerous factors differently.
I am four days post surgery. The surgery went well. I have not heard the pathology yet. The doctor felt good and believes the disease was organ confined. I guess we'll see. He did a bilateral nerve sparing surgery.
I was released from the hospital 36 hours after surgery. We stayed in a nearby hotel one night and drove the 3 hours home the next day. I feel stronger each day and just completed my second half mile walk of the day.
The catheter is a pain in the butt, but is manageable. Don't forget to take the stool softener. I followed the advice of others on this site and am grateful.
I will update down the road.
I am 18 months post surgery. Last week I had a follow up with the urologist. My PSA is undetectable. I have no urinary leakage. My health is good. I don't have to go back for another year. I will continue to check my PSA every 6 months for awhile.
By the way. My initial biopsy Gleason score was 3+3, 6. The pathology of my resected prostate was a 3+4, 7. All in all I'm pleased I chose surgery when I did. My relatively young age and good health made a huge difference in my recovery.
The surgery was nerve sparing. It worked. I actually experienced a night erection with the catheter still in place. But, the experience is decidedly different post surgery. For awhile things have been a bit "hit and miss." I believe the emotional and mental roller coaster has played as big a role in my ability to have an erection when desired as did the surgery. Things have continued to improve over the 18 months post surgery. Today my performance is about 95% of pre-surgery.
I suspect there is no way to ever know if waiting and seeking alternative treatment would have been a "better" approach. For me, emotionally speaking, a conservative watchful waiting approach wasn't a good option. I have moved on. I am healthy and happy.
I am healthy, strong and with no noticeable side effects from treatment.
I believe, in my case, the emotional toll was more significant than the physical toll. I believe emotions had a bigger effect on my ability to perform sexually than did the surgery. Yes, it did take time for the nerves to recover fully post surgery and the improvement continued for more than 18 months. But, in retrospect, I was "feeling" few emotions for a long time. I have had to "allow" myself to feel again. I am almost 2 and1/2 years post surgery. Dealing with the diagnosis of cancer and the subsequent treatment aged me, I believe. I recommend having help, either family or professional (or both) to deal with the emotions- even if you think you are handling it well. I hadn't realized I had simpy "closed" down as a kind of protective reaction.
All that said, I am doing very well, and consider myself cured.
Almost 4 years post surgery. I am well. I have no side effects. My life has returned to "normal."
I almost never think about cancer now in regards to myself.
It's as if I never had cancer. I believe my performance sexually is as good as any healthy 58 year old. Yes, the experience is a little "different." I have no incontinence.
All is well.
Steve's e-mail address is: scarr AT prodigy.net (replace "AT" with "@")