Which treatment to choose?

Hi,

It's a tough decision and even when you've taken it you can wonder if it was right.   It's very rare for anyone to say they took the wrong treatment.

Anything with a 4 in it is probably worth treatment.  If it becomes inoperable you will say you took the wrong treatment.

As far as hearing bad things.   You could look up the surgeon in the https://www.baus.org.uk/   to see what his record it like.   Number of operations, what type etc.   In general it's considered better if they do a lot of operations which you might say is at least 1 a week for several years, although some would prefer more.  They all have to start somewhere though.

You might let us know more about the bad things you've heard.   My immediate thought is some people like complaining and you might be better ignoring them.   That said there are risks to potency and continence and even the best surgeon might not get it right every time.   The nerves for erection are very delicate a bit like undoing a spiders web on a ball.  They can do it but sometimes they deliberately cut them if there's a risk of them being effected.   He cut mine on one side and told me he would.  Although I think he damaged the other side as well as it isn't as good as he said.  For me getting rid of the cancer was an Everest next to a few hills.  The real choices are few.

All the best, Peter

I don’t know anyone on here that’s tried harder than me to regain function after nerve sparing surgery but it still took 2 1/2 yrs to be totally spontaneous, and even then I need daily Tadalafil and usually a cock ring.

Good luck ok

Linz

Bear in mind I used a surgeon with a very good reputation who specialises in nerve sparing prostectomys. 

Erections are slightly less frequent and probably about 90% of what they were. I also still tend to use (not always) 50mg of viagra for events. Previously hadn't even needed to consider that. But we were able to resume penetrative sex at 4 weeks and haven't really looked back. I think in part there is some reassurance with the viagra (for me) but to be honest it doesn't detract from anything. 

Orgasms are dry (which I knew was an outcome) which is slightly odd but the experience/feeling is just the same. There is no wet patch LOL

At the same time as the weeks go by everything seems to be getting more and more back to normal. Spontaneous erections etc so I really don't have any concerns

I think a huge amount depends on your attitude (both you and your husbands) to the situation. Things will not be quite as good as they were but if you can communicate, if you can improvise a bit if its not going quite as planned and if you can retain an intimate relationship then its perfectly possible to be happy and fullfilled. 

I had a friend who had the same operation with the same surgeon 6 months before me. He had a similar outcome to the above and it was hugely reassuring to know that there was a good chance of a pretty decent recovery. And I've seen reports from people that have used this site that have been similar. 

Hope that helps. Ask away if you need more

We had a similar set of questions to you. We had excellent medical advice from the Epsom Hospital (which is affiliated to the Marsden). This community has an excellent toolkit that independently outlines all the options.

I was 60 in good health, grade T2. I spoke to many friends, I was surprised how many had prostate cancer but didn’t talk about it. I got great face to face feedback. I was torn between surgery and hormone and radio therapy. I finally opted for surgery.

I was operated on at the Marsden by one of UKs leading surgeons on the NHS (we spent time researching who would do the surgery and this man stood out based on numbers of successful ops).

That was 2 years 3 months ago, I have now had 6 undetectable PSA results.

No incontinence at all and I run half marathons now. Took time and patience but whilst I am not the same I can now have enjoyable sex. My penis is quite a bit shorter (no longer a show stopper in the change rooms) but so what, and my erection is about 80% now.

Recovery from surgery relies on good prep before surgery pelvic floor and core plus weight reduction (I lost 6kg). Post surgery follow instructions, patience over the first 6 weeks is key, continue with pelvic floor exercises when the doctors say so. Then wait for the ED to recover. It takes time and it’s very frustrating. I used ciallis and regular masterbation. You have to work on it to retrain the nerves. It took me 18 months before any true stirrings. Your man could feel very embarrassed and let down during this period, I did. But for me it did come back - it does for many men. I can not reinforce how important the process of surgeon selection is. It does comes down to the experience of the surgeon and what they find when they get in. BTW all the scars resulting from surgery are hardly visible.

My histology upgraded my cancer to T3B, G of 3+4+5. I was told it was particularly nasty and I was advised about 40% nerves spared - but in my mind now I am cancer free, relaxed and hardly think about it. I am now on yearly testing.

Was surgery MY best solution? I think so because some of my friends are still in treatment with lesser staging grade to me. But it’s a very personal choice.

I am conscious many men on here are in a bad way so I don’t want to give an impression it’s all easy - it isn’t. My key decision concerning surgery - who do I choose to do the op, don’t be afraid of second and third opinions and travelling to find the right surgeon. Someone in this forum once said not all plumbers are the same - same with urologists, even with the best of intentions.