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Which is best? Surgery or hormones and radiotherapy?

User
Posted 23 Mar 2019 at 08:43

Hi. first post so here goes. i was diagnosed on 4th Feb 2019. i was supposed to make a decision quite quickly but i am so indecisve at best of times. so just hoping for some advice/help. which is best option for maintaining a "normal" sex life? any opinions welcome. thanks

User
Posted 24 Mar 2019 at 19:11
DR, I must offer a small correction to your earlier posts about the effects of RT. It does result in dry orgasms (radiation destroys the prostate just as surgical removal does!), and I personally am currently experiencing the side-effect of having to urinate every hour during the night, which is pretty exhausting. I’m told that this is an extremely common side-effect during the later stages of RT, and that it should wear off within a few weeks of treatment ending. RT is perhaps “gentler” than surgery but it certainly isn’t free of side-effects!

Best wishes,

Chris

User
Posted 25 Mar 2019 at 06:45

It happens because the radiation irritates the bladder and makes you need to "go" a lot.

Regards,

Chris

Edited by member 25 Mar 2019 at 06:45  | Reason: Not specified

User
Posted 23 Mar 2019 at 10:02

Good Morning 

Sorry to read that your Diagnosis is prostate cancer. 

I dont have knowledge of prostate cancer related illness .I dont even know the terminology of prostrate RP.HT.RT,PSA level  etc numbers, ..but because of I Had prostate operation I know what is like afterwards of it.

 

Are you sure ...are you definitely sure you are diagnosed by cancer???are you 100% sure????

I was diagnosed with cancer last November. 

But the way I was told That I had a cancer it was so theatrical. It was a joke.yes I had to go ahead  stupidly with the operation 

But before that I was not suffering much even badly, all I said to my GP was SOMETIMES! I get feelings that I dont fully empty my bladder.that was it. (That could be because of I was consuming too much tea coffee red bull's)

Otherwise my sex life was great OVER THE MOON type of sex life night life I had.

my ex boss,s he owns 4 strips clubs so that can tell you something a bit.

I used to go to private house parts,clubs etc.(still I do but no actions)

So what I'm saying is yes had a great sex life but now its zero below,minus-50 !

What I'm saying is the RP operation is much different than what they told you, or Can tell you.or will tell you. Especially if your living on your own than that is so bad.

Yes they all say WE ALL DIFFERENT! but what they dont tell you is...if your a weak person,emotionally you can be find your self down

Down 

Down.

After 3 months RP operation I cannot even lift 2 shopping bags those as heavy as 10 kilogram. 

Try to cure your self with something else.

Remember Doctors ,GP, they are there because of us.without us they cannot get paid.bonus.

I'm not sure about RT.HT but after RP operation your life will change just like that over night you will became a different person.

I dont know how old your but as we get older our sex life gets change anyway so libido as you know.but after the RP surgery never mind the libido....everything will change. That is the reality. 

Saying that there are good people on here maybe they might advise you differently then my self.their knowledge is perfect and positive. I'm sure that some people might respond to me and say Please stop people putting off but they are entitlement to do so.

Good luck.

D.R

Ps: Are you sure you got cancer?

User
Posted 23 Mar 2019 at 10:02

Hi, A recent NHS tool which is in the Research topic on here says Radiotherapy is better for retaining sex life. Although I think it gives more benefit than is generally considered.  However your overall condition may be more significant and it can depend on the skill of your surgeon and how the surgery is performed,.  I'm sure others will give you their opinion which will fill out details. Good luck Peter

User
Posted 23 Mar 2019 at 10:29

Thanks for taking time to reply. yes i'm 100% sure. ive seen my mri scan of it. really sorry that your  treatment sounds so poor, but hopefully its still early days. i also hope you are getting some after care/counselling. good luck and thanks again

User
Posted 23 Mar 2019 at 10:35
There is no prostate cancer treatment that will let you retain a normal sex life, apart from active surveillance where you have no treatment but are closely monitored for any changes. If you were told that you needed to make a decision quickly then you may not be suitable for active surveillance. Having said that, PCa is not so rampant that it will be spreading while you weigh up the pros and cons ... it seems a bit unreasonable if that is the impression that doctors have given you and it is really important to have time to make the best decision you can.

The 'normal' things that you will lose whichever treatment you have:

- you will have dry orgasms - there is no ejaculate

- your penis is likely to get smaller

- you may need to use tablets, injections or a vacuum pump / cock rings to maintain an erection

The main difference between surgery and radiotherapy / hormone treatment is that with surgery, you are likely to have erectile dysfunction (ED) immediately but there is a good chance it will improve over time. With RT, the ED may emerge months or years later. If RT is given with hormones, there may be no mechanical ED but you are likely to have no libido so your brain will think / feel no sexy thoughts.

Your decision might be easier if you know the following:-

- will the surgery be nerve sparing or non-nerve sparing

- would the RT be with or without hormones

- if with hormones, how long would the HT be needed

- are you suitable for brachytherapy (ED seems to be less likely with brachy than with external RT)

If you don't know the answers to these questions, your allocated urology nurse should be able to give you the information.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Mar 2019 at 12:20
Chris, I was diagnosed with prostate cancer in May last year, have been on hormones since last August, and am just coming to the end of RT now. I've really not found the experience to be too bad at all. I had some side-effects from the hormone therapy in the first month or two (mainly feeling "foggy-headed") but that cleared up and I've now no side-effects at all other than the expected loss of libido. Be aware, though, that everyone has a different side of HT symptoms: I've not experienced things like hot flushes, but many men do. As far as RT goes, again it's not been too bad. The main side-effects have been difficulty in urinating (which has been treated with a drug called Tamsulosin; this is an extremely common side-effect, apparently) and the need to urinate frequently at night. I'm told that these side-effects should wear off within a few weeks of the end of treatment.

As far as sexual function goes, the HT has pretty much removed all "desire", but everything is still "functional". When I ejaculate it's now only a few drops of liquid, but the feeling is still the same. As Lyn says, ED can follow RT as a late side-effect years later.

I'm happy with the way that RT has gone for me.

Hope this is of some help,

Chris

User
Posted 23 Mar 2019 at 13:21
Hi Chris,

I had a radical prostatectomy last June. It seems to have been very successful inasmuch that I no longer have cancer, evidenced by my ‘undetectable’ PSA tests.

I have lost about 2” off my penis, and no longer have erections, despite nerve-sparing on one side and daily Cialis.

I still have dry orgasms, about a third of the intensity pre-op.

I am quite happy, nevertheless.

Cheers, John.

User
Posted 23 Mar 2019 at 16:41

Originally Posted by: Online Community Member
2 inches! Bloody hell i'm in trouble then! Have you tried a pump because the little I know so far they seem quite effective? I'm glad your cancers gone and also that your ok. Thanks

 

The pump is very effective for keeping the penis healthy but it is a rare man that finds it acceptable for penetrative sex. Many men can get the penis to engorge with the pump, and some can retain the engorgement using a ring as a tourniquet. However, the pubic area beyond the ring does not enforce so it is quite difficult to point the penis in a specific direction and some positions are not possible. Plus you must remove the ring after 30 mins so the sex has to be over quite quickly :-( 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Mar 2019 at 09:45

Good morning 

Please do not worry about 2 inch etc loss.

Yes after the operation your little soldier it will shrink..but dont worry dont get upset you will regain size of it .pump will help you to regain of it.

As what lynn says is very logical  and pump is useful but technical side is important. 

As Cheshire Chris say go ahead with RT at least you wont have any problems with having erections. Yes Chris says it will get hardened but no desire..well I wouldn't  care as long as you keep it up that's matter.

For me too late I have got the best pump on this planet but seems not working for me.

But might work for you?

Saying that Go ahead with Chris s suggestion. Mate ..at least less mess would be for you.

With RP they dont much mention about side effects...neither your medical staff will do as well.

Check out about HERNIA risks infection risks

Check out Becoming a impatient person 

Check out lonely,Emotional person you will become

As Lynn says you will have dry orgazm (that will take your pride away)

Pains over your tummy wont fade away for a long time.

But if you listen Chris Go ahead with RT

So less mess and you wont have the list that below listed. 

*Catheter 

*blood cloud risks

*pads & Nappy 

*dry orgazm 

*Night time Trips to Bathroom 

*pain all over your tummy

*Yes will have sexual desires but no hardened.

*become impatiens 

*depression 

*lonely planet feelings. 

 * financial lost

* to become pump technician  daily use of at least for 10 minutes 

* To become anti social 

Nobody takes me seriously on this website (cant blame them)

But I had my RP operation last December  I been going through most of the problems those noted above.

Thanks 

D.R

 

 

User
Posted 24 Mar 2019 at 15:18
It wasn't meant as a criticism. I hoped it read as supportive of your posts and your right to post. Genuinely was trying to help by saying that I eventually got help and wish I did so earlier. No offence intended. I find all the posts I've received so far helpful and yours was no different. No tigers here bud. Take care. Chris
User
Posted 24 Mar 2019 at 15:46

Dear Chris 

Thanks for your kind respond. All sorted mate. We are all on the same boat.no cold feelings. I can understand what you mean. 

Hope you wont be alone before and after your treatments. I know how hard it can be mate .

Keep in touch 

D.R

User
Posted 24 Mar 2019 at 19:23

Good Evening Chris 

Thanks for your kind explanation very nice of you.

Yes got you.what your saying is RT comes with price as well.not a free ride.

Yes could be less risky and painful than RP.

But still good to me really if I knew that RT was less messy than RP I would have chosen  RT treatment instead instead of RP.

I confess.I m a solid 100% idiot. I did not do my home work before the operation really.

All The medics were suggested to me RP even they arranged a private clinic for me to have a  RP operation than they cancelled it.

Never seen my Key worker/nurse more than once.

Anyway all my fault.

Saying that I do remember your advises everyday taking care of my body respect for it.I do have gentle walks every trying not to lift anything that is heavy. But still pains there  saying that I dont take pain killers anymore since early March.

Sex life is zero .

Once again Thank you.for your advisers before my operation and afterwards. 

Have a nice evening 

D.R

Show Most Thanked Posts
User
Posted 23 Mar 2019 at 10:02

Good Morning 

Sorry to read that your Diagnosis is prostate cancer. 

I dont have knowledge of prostate cancer related illness .I dont even know the terminology of prostrate RP.HT.RT,PSA level  etc numbers, ..but because of I Had prostate operation I know what is like afterwards of it.

 

Are you sure ...are you definitely sure you are diagnosed by cancer???are you 100% sure????

I was diagnosed with cancer last November. 

But the way I was told That I had a cancer it was so theatrical. It was a joke.yes I had to go ahead  stupidly with the operation 

But before that I was not suffering much even badly, all I said to my GP was SOMETIMES! I get feelings that I dont fully empty my bladder.that was it. (That could be because of I was consuming too much tea coffee red bull's)

Otherwise my sex life was great OVER THE MOON type of sex life night life I had.

my ex boss,s he owns 4 strips clubs so that can tell you something a bit.

I used to go to private house parts,clubs etc.(still I do but no actions)

So what I'm saying is yes had a great sex life but now its zero below,minus-50 !

What I'm saying is the RP operation is much different than what they told you, or Can tell you.or will tell you. Especially if your living on your own than that is so bad.

Yes they all say WE ALL DIFFERENT! but what they dont tell you is...if your a weak person,emotionally you can be find your self down

Down 

Down.

After 3 months RP operation I cannot even lift 2 shopping bags those as heavy as 10 kilogram. 

Try to cure your self with something else.

Remember Doctors ,GP, they are there because of us.without us they cannot get paid.bonus.

I'm not sure about RT.HT but after RP operation your life will change just like that over night you will became a different person.

I dont know how old your but as we get older our sex life gets change anyway so libido as you know.but after the RP surgery never mind the libido....everything will change. That is the reality. 

Saying that there are good people on here maybe they might advise you differently then my self.their knowledge is perfect and positive. I'm sure that some people might respond to me and say Please stop people putting off but they are entitlement to do so.

Good luck.

D.R

Ps: Are you sure you got cancer?

User
Posted 23 Mar 2019 at 10:02

Hi, A recent NHS tool which is in the Research topic on here says Radiotherapy is better for retaining sex life. Although I think it gives more benefit than is generally considered.  However your overall condition may be more significant and it can depend on the skill of your surgeon and how the surgery is performed,.  I'm sure others will give you their opinion which will fill out details. Good luck Peter

User
Posted 23 Mar 2019 at 10:29

Thanks for taking time to reply. yes i'm 100% sure. ive seen my mri scan of it. really sorry that your  treatment sounds so poor, but hopefully its still early days. i also hope you are getting some after care/counselling. good luck and thanks again

User
Posted 23 Mar 2019 at 10:35
There is no prostate cancer treatment that will let you retain a normal sex life, apart from active surveillance where you have no treatment but are closely monitored for any changes. If you were told that you needed to make a decision quickly then you may not be suitable for active surveillance. Having said that, PCa is not so rampant that it will be spreading while you weigh up the pros and cons ... it seems a bit unreasonable if that is the impression that doctors have given you and it is really important to have time to make the best decision you can.

The 'normal' things that you will lose whichever treatment you have:

- you will have dry orgasms - there is no ejaculate

- your penis is likely to get smaller

- you may need to use tablets, injections or a vacuum pump / cock rings to maintain an erection

The main difference between surgery and radiotherapy / hormone treatment is that with surgery, you are likely to have erectile dysfunction (ED) immediately but there is a good chance it will improve over time. With RT, the ED may emerge months or years later. If RT is given with hormones, there may be no mechanical ED but you are likely to have no libido so your brain will think / feel no sexy thoughts.

Your decision might be easier if you know the following:-

- will the surgery be nerve sparing or non-nerve sparing

- would the RT be with or without hormones

- if with hormones, how long would the HT be needed

- are you suitable for brachytherapy (ED seems to be less likely with brachy than with external RT)

If you don't know the answers to these questions, your allocated urology nurse should be able to give you the information.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Mar 2019 at 10:54

Yeah I knew normal was wrong term! As normal as can be would have been more accurate. Thanks for advice I found it very useful and will take it up with my key worker. ps certainly do have to have hormones and for two years. thanks again. chris

Edited by member 23 Mar 2019 at 10:57  | Reason: Not specified

User
Posted 23 Mar 2019 at 12:20
Chris, I was diagnosed with prostate cancer in May last year, have been on hormones since last August, and am just coming to the end of RT now. I've really not found the experience to be too bad at all. I had some side-effects from the hormone therapy in the first month or two (mainly feeling "foggy-headed") but that cleared up and I've now no side-effects at all other than the expected loss of libido. Be aware, though, that everyone has a different side of HT symptoms: I've not experienced things like hot flushes, but many men do. As far as RT goes, again it's not been too bad. The main side-effects have been difficulty in urinating (which has been treated with a drug called Tamsulosin; this is an extremely common side-effect, apparently) and the need to urinate frequently at night. I'm told that these side-effects should wear off within a few weeks of the end of treatment.

As far as sexual function goes, the HT has pretty much removed all "desire", but everything is still "functional". When I ejaculate it's now only a few drops of liquid, but the feeling is still the same. As Lyn says, ED can follow RT as a late side-effect years later.

I'm happy with the way that RT has gone for me.

Hope this is of some help,

Chris

User
Posted 23 Mar 2019 at 13:21
Hi Chris,

I had a radical prostatectomy last June. It seems to have been very successful inasmuch that I no longer have cancer, evidenced by my ‘undetectable’ PSA tests.

I have lost about 2” off my penis, and no longer have erections, despite nerve-sparing on one side and daily Cialis.

I still have dry orgasms, about a third of the intensity pre-op.

I am quite happy, nevertheless.

Cheers, John.

User
Posted 23 Mar 2019 at 14:20
2 inches! Bloody hell i'm in trouble then! Have you tried a pump because the little I know so far they seem quite effective? I'm glad your cancers gone and also that your ok. Thanks
User
Posted 23 Mar 2019 at 14:21

Thanks. yes thats very helpful. good luck in the future.

User
Posted 23 Mar 2019 at 16:41

Originally Posted by: Online Community Member
2 inches! Bloody hell i'm in trouble then! Have you tried a pump because the little I know so far they seem quite effective? I'm glad your cancers gone and also that your ok. Thanks

 

The pump is very effective for keeping the penis healthy but it is a rare man that finds it acceptable for penetrative sex. Many men can get the penis to engorge with the pump, and some can retain the engorgement using a ring as a tourniquet. However, the pubic area beyond the ring does not enforce so it is quite difficult to point the penis in a specific direction and some positions are not possible. Plus you must remove the ring after 30 mins so the sex has to be over quite quickly :-( 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Mar 2019 at 09:45

Good morning 

Please do not worry about 2 inch etc loss.

Yes after the operation your little soldier it will shrink..but dont worry dont get upset you will regain size of it .pump will help you to regain of it.

As what lynn says is very logical  and pump is useful but technical side is important. 

As Cheshire Chris say go ahead with RT at least you wont have any problems with having erections. Yes Chris says it will get hardened but no desire..well I wouldn't  care as long as you keep it up that's matter.

For me too late I have got the best pump on this planet but seems not working for me.

But might work for you?

Saying that Go ahead with Chris s suggestion. Mate ..at least less mess would be for you.

With RP they dont much mention about side effects...neither your medical staff will do as well.

Check out about HERNIA risks infection risks

Check out Becoming a impatient person 

Check out lonely,Emotional person you will become

As Lynn says you will have dry orgazm (that will take your pride away)

Pains over your tummy wont fade away for a long time.

But if you listen Chris Go ahead with RT

So less mess and you wont have the list that below listed. 

*Catheter 

*blood cloud risks

*pads & Nappy 

*dry orgazm 

*Night time Trips to Bathroom 

*pain all over your tummy

*Yes will have sexual desires but no hardened.

*become impatiens 

*depression 

*lonely planet feelings. 

 * financial lost

* to become pump technician  daily use of at least for 10 minutes 

* To become anti social 

Nobody takes me seriously on this website (cant blame them)

But I had my RP operation last December  I been going through most of the problems those noted above.

Thanks 

D.R

 

 

User
Posted 24 Mar 2019 at 09:53
Thought the point of this site was everyone is entitled to an opinion. It's not like your telling people NOT to get treatment. Sounds like you really need to get some professional support mate. Christ I know because I've totally screwed up my life by not asking for help when I needed it. Signed off last year after a breakdown and severe depression. Nobody knew cos I didn't tell. Talk to someone! I wish you well. Stay strong
User
Posted 24 Mar 2019 at 15:11

EASY TIGER!

You asked members opinion about the prostate related treatments you mentioned that your diagnosed with cancer. Other people given their opinions so my self. 

All I said to you that if I was you I would follow cheshire chris,  advise which is RT .

And mentioned to you about side effects of RP .

SO SORRY TO UPSET YOU but why so much anger?

Now days we all have mental issues anyway 

Smile ..summer is around the corner. 

User
Posted 24 Mar 2019 at 15:18
It wasn't meant as a criticism. I hoped it read as supportive of your posts and your right to post. Genuinely was trying to help by saying that I eventually got help and wish I did so earlier. No offence intended. I find all the posts I've received so far helpful and yours was no different. No tigers here bud. Take care. Chris
User
Posted 24 Mar 2019 at 15:46

Dear Chris 

Thanks for your kind respond. All sorted mate. We are all on the same boat.no cold feelings. I can understand what you mean. 

Hope you wont be alone before and after your treatments. I know how hard it can be mate .

Keep in touch 

D.R

User
Posted 24 Mar 2019 at 19:11
DR, I must offer a small correction to your earlier posts about the effects of RT. It does result in dry orgasms (radiation destroys the prostate just as surgical removal does!), and I personally am currently experiencing the side-effect of having to urinate every hour during the night, which is pretty exhausting. I’m told that this is an extremely common side-effect during the later stages of RT, and that it should wear off within a few weeks of treatment ending. RT is perhaps “gentler” than surgery but it certainly isn’t free of side-effects!

Best wishes,

Chris

User
Posted 24 Mar 2019 at 19:23

Good Evening Chris 

Thanks for your kind explanation very nice of you.

Yes got you.what your saying is RT comes with price as well.not a free ride.

Yes could be less risky and painful than RP.

But still good to me really if I knew that RT was less messy than RP I would have chosen  RT treatment instead instead of RP.

I confess.I m a solid 100% idiot. I did not do my home work before the operation really.

All The medics were suggested to me RP even they arranged a private clinic for me to have a  RP operation than they cancelled it.

Never seen my Key worker/nurse more than once.

Anyway all my fault.

Saying that I do remember your advises everyday taking care of my body respect for it.I do have gentle walks every trying not to lift anything that is heavy. But still pains there  saying that I dont take pain killers anymore since early March.

Sex life is zero .

Once again Thank you.for your advisers before my operation and afterwards. 

Have a nice evening 

D.R

User
Posted 25 Mar 2019 at 00:18

Hi Chris 

I forgot to ask you that, as  your getting up almost every hour for bathroom duties are you not doing any PFE ? Or because of your having RT treatments PFE is not effective?

Thank you and Good night 

D.R

ps .I'm genuinely sorry for that.I can understand that how much it can be tiring.:( 

User
Posted 25 Mar 2019 at 06:45

It happens because the radiation irritates the bladder and makes you need to "go" a lot.

Regards,

Chris

Edited by member 25 Mar 2019 at 06:45  | Reason: Not specified

 
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