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Due to have robotic surgery

User
Posted 15 Jun 2021 at 21:25

Hi,

Recently diagnosed with locally advanced prostate cancer. Gleason score 7 (4+3) right side and Gleason score 7 (3+4) on the left side. Bone scan clear. Discussed with oncologists and surgeon but have opted for surgery. Aware that I will need radiotherapy at some point in the future. Would really appreciate any advice re- after effects of surgery, useful  tips etc. Length of time for activities as I am a keen tenpin bowling player and keen Gardner with an allotment. I am 64 years old.

 

User
Posted 15 Jun 2021 at 23:13
Just out of interest, why are you having surgery if you already know that it isn't going to get rid of the cancer and you are going to need adjuvant RT? Why risk two sets of side effects when you could just go straight for the RT now? Or, if high risk, RT with brachytherapy boost?

Have the side effects of surgery been fully explained to you?

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

User
Posted 16 Jun 2021 at 16:15
Hi,

Thank you for your response. I have opted for surgery as I think this is the best option for me right now. The oncologist offered 4 weeks of radiotherapy plus hormone treatment. I am aware that further down the line I may need radiotherapy but that could be several years always,so it’s down to my personal choice and the oncologist did not disagree with my decision. The reason for my post was for practical advice re- the surgery.

User
Posted 16 Jun 2021 at 16:42

Did the Consultants actually say that you would need RT in the future or was it a general comment about RT sometimes/often being needed in the future following surgery?

User
Posted 16 Jun 2021 at 17:30

Hi Keepbowling,

I went down the HT, RT route so can't offer direct experience of surgery, but it has came up enough times on this forum that I can summarise what others have said in the past. First thing is everyone is different and you have no idea how side effects will affect you. Some people go in perfectly fit and come out with no problems others come out with all sorts of complaints. This forum is very biased towards the problem patients as the people who come out with no problems get on with their life and don't come on a forum like this to seek advice and help.

I think most people would say: do hardly anything for the first two weeks, up to about six weeks build up to a normal level of activity (not your normal, just normal for a 64 year old), after six months probably start getting back to your normal level of activity (which sounds a bit higher than for most 64 year olds).

Throwing bowling balls around after major surgery is not something you will be wanting to do straight away, but hopefully will be something you will be quite capable of after a short while. It sounds like something which would be a bit of a problem if you end up with stress incontinence but will probably be manageable with pads.

If your surgeon has told you you will probably remain continent that is good news, but if you don't know already a surgeons definition of continent is not needing to use more than one nappy pad per day. Most normal people would not consider that to be continent, but hey ho! that's surgeons for you. If you didn't know that was the definition of continence then you probably haven't had enough information to make an informed choice.

Do you know if the surgery will be nerve sparing?

If the answer to ProSixty's question is "Yes, I will definitely need RT later" then you are being told they will remove the prostate and the cancer in it, but they will be leaving some cancer outside, which will probably continue to grow (and possibly spread to other parts of your body in which case you will have advanced and incurable cancer). The advantage of RT is these cancer cells outside the prostate can be zapped at the same time as the prostate, and hopefully get rid of all your cancer.

Nothing is certain with cancer. Four weeks of RT is neither here nor there and the side effects generally mild, though two years of HT would not be much fun.

If you go in to this thinking I'm young(ish) and fit and this will be a breeze, then you are going to come out the other side of this emotionally scarred.

If you go in to this thinking s**t, I've drawn the short straw and got cancer, but it's reasonably treatable, and if I am lucky I may be cured, and if not I still have at least five or ten years left and I can have a lot of fun in that time whether I am cured or not, then you will come out the other side with far better mental health. 

Good luck.

 

Dave

User
Posted 16 Jun 2021 at 17:36

Originally Posted by: Online Community Member

Would really appreciate any advice re- after effects of surgery, useful  tips etc. Length of time for activities as I am a keen tenpin bowling player and keen Gardner with an allotment. I am 64 years old.

I had a RARP a year ago and was told...

* No heavy lifting for 4 weeks (includes lawn-mowing and hoovering)

* No cycling or horseriding for 6 weeks

* no driving for 2 weeks

* no sexual intercourse for 4 weeks

* walk as much as you feel able to (helps prevent DVT), but if you have pink urine, you're overdoing it

You will probably have a catheter and bag for 7-10 days. During that time it's quite hard to do anything physical apart from short walks. Walking with a catheter bag is a bit awkward, but OK if you take it easy.

I built up slowly with the walking, but if you add more every day you'll soon be walking a few miles. I was rather bored of walking after 6 weeks (I'm an avid cyclist). My surgeon told me I could cycle after 6 weeks and "your perineum will tell you if you've done too much" (it never did). I built up pretty slowly in terms of distance/time. Up to about 30 miles (2 hours) after a month. But now. One year later I did a 101 mile ride last weekend (on the anniversary of my surgery). So I'm pretty much "back".

After RARP there is a risk of hernia as they have to cut through some areas to allow the instruments through (2 small holes each side and one in the middle for the CO2 inflation, plus a larger hole at the navel through which the prostate is removed.)  I've been VERY careful to avoid heavy lifting for much longer than they suggested. Since hernia would require another surgery and non-urgent surgery is rather backed up after COVID-19, it seems to me that avoidance is best.

I hope this is helpful. If you have any other questions, there are lots of people on here who are happy to share their story. If you want to see more of my story, it's mostly in my profile. 😀

 

 

Edited by member 16 Jun 2021 at 17:38  | Reason: Not specified

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

 
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