Prospective -perspective

User

Posted 28 Dec 2016 at 22:01

My husband is scheduled for da Vinci assisted prostatectomy 11th January and our journey to this point started mid September with a 'slightly raised PSA of 4.9. For context he is 63, annual PSA tests following a history of BPH diagnosed 12 years ago during which time he has had two TURP procedures, he has a large prostate and PSA has always hovered between 3 4. The raised result led to further investigation with the urologist suggesting it was precautionary rather than having an expectation of Pca.

Results in and 12 biopsies some targeted and some random 2 positive (4%) 3+3 and 3+4. Original staging 1c. urologist suggested nothing to lose sleep over!!!

Bone scan was OK but MDT upgraded staging to 2c as the 2nd radiologist suggests a suspicious area (inflammation?) on the other lobe - biopsies negative.

Confined to prostate.

We have been through all the emotions and fears expressed by others and have had our consults with oncologist and surgeon - large prostate means no brachiotherapy and the preferred choice is surgery but suddenly I am overwhelmed with concern and fear. I want to be strong and rational and I guess I'm posting for a little bit of reassurance. Because of the TURP surgeon feels surgery is still preferred option but more complicated (scar tissue etc and as a result possibly a longer procedure and catheter in for longer. I am so concerned about incontinence - we have been together for 37 years, I think they were suggesting long term erectile dysfunction, we can deal with that but I am obsessing on the incontinence.

I know we won't know until we know (histology) It just seems to be such a rollercoaster and I want to be the best support I can for him, he is more pragmatic, doesn't want to involve himself in forums at this point but I think I need the virtual support so comments and advice ahead of our pre op meeting next week welcome.

User

Posted 29 Dec 2016 at 10:21

Hi Sue

Forum generally quiet, however I'm sure someone with rp following turp will respond. I'm in a similar position advising my brother who lives in Australia. Do see my profile first. He is 69 and has been advised rt. Again not sure if this is because of previous turp 2 years ago. He is making his decision February 17. A couple of things has the surgeon or hubby got full medical details of turps. I assume there were different methods. I know my brother was laser and again not sure of the extent , as although I know a little medically my brother knows very little. From my understanding the bladder neck reconstruction / reconnection and the associated network of nerves is complex. Incontenence seems totally unpredictable, in my case dry after 48 hrs and catheter in 7 days. You could ask more questions around who is the surgeon and his experience . Is robotic the best option ? Ie I have no idea if open gives better outcomes in your husband case. The cancer is low to intermediate risk so yes, good news there. I'm sure others will post and add far more relevant detail. I didn't find this very positive and informative forum until after my op. I assume I had a skilled surgeon who took his time. All the best to you both.

PS You could ask about nerve sparing options and lymph node sampling ? Ie what exactly is the surgeons intentions .

Edited by member 29 Dec 2016 at 11:51 | Reason: Not specified

User

Posted 29 Dec 2016 at 10:56

Hello Sue,

Can't give advice but you'll know by now that

"but I think I need the virtual support so comments and advice ahead of our pre op meeting next week welcome."

you'll have support and advice along your way. As robgsr says it's a bit quiet at the moment but you will get help from others who've been there and done that.

We can't control the winds - but we can adjust our sails

User

Posted 29 Dec 2016 at 17:53

Hi Sue

I'm similar age to your husband, and at the same stage - contained PCa 3+4, and considering RP. Major difference being I don't have an enlarged prostate, no BPH and subsequent TURPs. The side-effects concern all of us and it's worth reading various threads on post op - some are dry very quickly post catheter removal, others struggling for much longer.

I haven't read anything that would indicate how you can stack the odds in your favour re: avoiding long term incontinence, but others will hopefully chime in. I did attend an afternoon session at the hospital do those considering / scheduled for RP, and the stats quoted were very encouraging - just note that the NHS view "Dry" as one day pad per day (from memory).

You have to have faith in your surgeon and make sure your husband is doing his PFEs - various apps to help him with those and keep track. Then stay positive.

As you probably already know, there is a wealth of information here from people who have gone through it, and it's a very supportive community.

Good luck.

Chris

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