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User
Posted 13 Jan 2022 at 11:37

Friends, I was diagnosed with PC last week. My 70th birthday is next week! It all started with a high PSA blood test back in early November 2021. The NHS and the hospital here in Cambridge have been amazing. I had an MRI within a week, and biopsies 10 days after that. My diagnosis was confirmed only 2 months after the original blood test. I also had a CT scan last week and next week I have a bone scan. This afternoon I have a telephone appointment with the surgical team. My biopsy results were Gleason 3+4, grade group 2 OR Gleason 4+3, grade group 3, and T1-T2. It could have been much worse. I have read and reread all the material given to me by the hospital and more online. My question is this. What advantages, if any, does radiotherapy have compared with robot-assisted radical prostatectomy, except that it does not involve surgery. It also seems that RT results in the same kind of temporary or long-term incontinence and erectile dysfunction issues as RARP. But in addition can cause bowel problems and extreme fatigue, not to mention the need for long-term hormone treatment. I'd be interested to hear from anyone who chose the RT option and why they chose it. Thank you.

User
Posted 13 Jan 2022 at 12:11

Hi Simon my  prostate cancer was gleeson 9 I decided to go the radiotherapy  hormone therapy route as I have a fear off operations  had 37 sessions of radiotherapy on hormone therapy for 2 years  PSA has gone from 24.9 to 0.01 and something back to normal now found the whole treatment very tolerable with minimal problems good luck whatever way you choose treatment wise 

User
Posted 13 Jan 2022 at 13:20
Incontinence is not a common side-effect of RT! In my case I had RT in 2019 because it was the recommended treatment for me, and found it all very tolerable. A few weeks of increased peeing frequency towards the end of and soon after treatment, but that settled down quickly. Bowel disturbances lasted longer - about a year to fully settle down - but were never more than a minor inconvenience; I just took Imodium if I went out for the day.

Three years later and everything's fine.

Best wishes,

Chris
User
Posted 13 Jan 2022 at 15:52

I had my RALP in early November 2021. Unlike OhDear!, I am still 70% INcontinent during the day but dry overnight. Just proves outcomes will differ. I chose RALP because I was strongly advised that should subsequent salvage treatment be required, surgery is very difficult after RT, but RT is not compromised by previous surgery.


Good luck.


Peter

User
Posted 25 Jan 2022 at 18:10

Hi Simon,


My OH had his surgery on the same day as Ivan. He is slightly older than you at 73 but I too am alot younger than him. It’s so difficult to make a decision. Surgery really wasn’t an option that anyone pushed for Rob, but he really wanted the tumour removed along with lymph node, knowing that he would almost certainly need ART at a later date.


He had his catheter in for 4 weeks but since it’s been removed his continence has been much better than I thought it would be. He’s dry at night but if he’s awake he gets up for a wee (maybe a couple of times), throughout the day he’s fine when sat, when he stands he often feels like he needs to wee but can make it to the toilet. Walking around he’s getting the odd dribble but generally really pleased. No idea if it will stay this good and of course everyone is different. 


In terms of ED we are still waiting on a prescription for sildenafil and pump. He has been on HT for 5 months so at present has no desire for sex anyway. Initially we thought he would be on HT for life so we already had the conversations about sex life etc. The surgeon did manage to save 50% nerves so we’re hopeful he will get some function back in the future. We were so worried they wouldn’t get all the cancer though so nerve sparing became a much lower priority for us.


Best of luck with whatever you decide. 

User
Posted 13 Jan 2022 at 11:37

Friends, I was diagnosed with PC last week. My 70th birthday is next week! It all started with a high PSA blood test back in early November 2021. The NHS and the hospital here in Cambridge have been amazing. I had an MRI within a week, and biopsies 10 days after that. My diagnosis was confirmed only 2 months after the original blood test. I also had a CT scan last week and next week I have a bone scan. This afternoon I have a telephone appointment with the surgical team. My biopsy results were Gleason 3+4, grade group 2 OR Gleason 4+3, grade group 3, and T1-T2. It could have been much worse. I have read and reread all the material given to me by the hospital and more online. My question is this. What advantages, if any, does radiotherapy have compared with robot-assisted radical prostatectomy, except that it does not involve surgery. It also seems that RT results in the same kind of temporary or long-term incontinence and erectile dysfunction issues as RARP. But in addition can cause bowel problems and extreme fatigue, not to mention the need for long-term hormone treatment. I'd be interested to hear from anyone who chose the RT option and why they chose it. Thank you.

User
Posted 13 Jan 2022 at 13:49

I am not really answering your question as I underwent surgery at Addenbrookes for the removal of my prostate on 21/12/21. And like you I found the process of being assessed, diagnosed and treated very quick and effective.


I decided to undergo surgery rather than RT because I liked the idea of the cancer (hopefully) being completely removed, of knowing exactly what grade my cancer was ( with a core sample biopsy you can never be entirely sure) and because I have never liked the idea of a dangerous substance ( RT) being used on and in me.


 


As mentioned by others, there are more immediate side effects with surgery, namely ED and incontinence.  Just over 3 weeks after surgery I do have some "feelings" in my nether regions and with my nerves all being spared on the left hand side and most on the right I am confident that I will be able, over time, to harden up. Though, obviously, I will not be ejaculating semen. Re incontinence, when I had the catheter removed after just over a  week after surgery, I was, for around 6 hours, totally incontinent  though this did improve before I went to bed. I am presently around 70% continent and this is improving, if not daily certainly week on week.


If interested, my cancer journey, which started March 2021,  can be found on my profile

User
Posted 13 Jan 2022 at 14:10
RT can go beyond where surgery can. In quite a number of cases RT is needed to supplement Prostatectomy so if applicable going straight to RT may avoid the double whammy of RP and RT.
Barry
User
Posted 13 Jan 2022 at 20:48

Settle down, chaps. No offence taken, Ivan. To answer your question, I started PF exercises 5 years ago after my TURP. I can't say I have been doing them religiously every day for all that time but certainly, I did for many weeks before my Op. The fact that I am dry overnight and can hold my pee for some time after getting up means all the plumbing is in order, it just degrades as the day wears on and I am told that this is not unusual and should resolve in time. Just wish it would progress faster, of course 

User
Posted 14 Jan 2022 at 01:24

I went down the RT route, not by choice my diagnosis, suggested RT with HT was the only sensible option. Very glad I didn't have a choice I would have probably chosen RP.


RP seems the more certain choice, but it is no more successful than RT and does a lot more collateral damage. I think RP is popular because anyone can understand how a knife works, whereas you need a degree in biology to understand how cancer DNA is damaged by RT but healthy DNA isn't (actually it is, but it repairs itself, now you see why RT is not trusted by the common man).


If your tumour is T1/T2 you may want to investigate focal treatments, they have very few side effects and can be repeated when the cancer comes back. You may need to be referred out of area for these treatments, so unless you ask they will not be offered.


If you have RT it will probably be accompanied by two years of Hormone Therapy (HT).


Two years of HT isn't great, but I got through it. ED is a bit of a problem. I can't rely on it springing to attention like it used to, but I'm trying a few pills.


 

Dave

User
Posted 15 Jan 2022 at 10:44

Originally Posted by: Online Community Member


I went down the RT route, not by choice my diagnosis, suggested RT with HT was the only sensible option. Very glad I didn't have a choice I would have probably chosen RP.


RP seems the more certain choice, but it is no more successful than RT and does a lot more collateral damage. I think RP is popular because anyone can understand how a knife works, whereas you need a degree in biology to understand how cancer DNA is damaged by RT but healthy DNA isn't (actually it is, but it repairs itself, now you see why RT is not trusted by the common man).


If your tumour is T1/T2 you may want to investigate focal treatments, they have very few side effects and can be repeated when the cancer comes back. You may need to be referred out of area for these treatments, so unless you ask they will not be offered.


If you have RT it will probably be accompanied by two years of Hormone Therapy (HT).


Two years of HT isn't great, but I got through it. ED is a bit of a problem. I can't rely on it springing to attention like it used to, but I'm trying a few pills.


 



Tadalafil can help, though it can give you heartburn - regulate the dose, if it does.


Works for me, most of the time 😎

User
Posted 25 Jan 2022 at 09:27

Hi Oh Dear! Thank you for your help. My journey began only in early November 2021 when I forced my GP to allow me to go into the surgery for a long-overdue PSA test, having missed out in 2020. My PSA was 10.5, and since then Addenbrooke's and the NHS have been amazing. It will be blood test to surgery in 3 calendar months. I'm booked in for RARP on February 6th. I thought I was sure, but then, following a video conversation yesterday with the oncology team to discuss RT, I'm not so certain. I have been taking 5 or 6 yoga classes every week for two years, including two every week that focus on the core, and, as the instructor says, "squeezing the little one," so I'm hoping my pelvic floor is already in good shape. I just had my 70th birthday, and I feel horror at the thought of any kind of major UI for more than a couple months. Also, my wife is much younger than me, and we still have an active, if infrequent, sex life. I'm told they can probably save one of my nerves if I have surgery. But the oncologist, and other things I have read suggest that I have less chance of becoming incontinent and impotent (I call it incompetence) with RT than with RARP. I need to decide this week, and I feel more anxious now about making the right decision that at any time since this all began. I'm sure everyone has the same anxieties. It's a bummer having to make the decision yourself rather than just being told what's going to happen.

User
Posted 25 Jan 2022 at 10:04

Morning Simon


It would certainly make life easier if you knew what the eventual outcome of surgery or RT would be , say in 10 years time, so that making a life-changing decision would not be so difficult. Although I was only on Active Surveillance for 6 months before my operation, I now believe that I had the symptoms of prostate cancer ( weak urine flow , going regularly to the loo during the day, but not during the night) at least 10 years earlier. And , I have no doubt, I would have probably have had a raised PSA level if I had been tested at age 54 instead of 60 . So, having at least 13 years treatment free is, I think, a bit of a bonus.


My understanding is that both RT and surgery have the same results in terms of life expectancy, though surgery does initially have more side effects. As I have previously mentioned, I chose surgery because I liked the idea  that the cancer would-hopefully- be totally removed, that I could undergo RT if, by chance, the operation was not successful and because I never liked the idea of being treated with a dangerous substance. Additionally, by having your prostate removed you are able to determine the actual final grade of cancer (it could be higher than that found during the biopsies). Two close friends of mine both opted for surgery at Addenbrookes in 2010 and both 11 years on are still alive (one is 81 , the other is 79) and  both regained ED and full continence. Though, that said, both have in the last couple of years started to wear a pad again for small leaks. My incontinence, 5 weeks on, is still improving and I am now probably 80/90% back to where I was before the operation. ED wise, I am beginning to get a little hard and do have an orgasm, though, obviously, no semen is ejaculated.


The robotic surgeons at Addenbrookes have a very good reputation and both  undertake a high number of operations each year. I cannot fault the treatment I received from Addenbrookes and was so satisfied that I  donated £1000 to their "buy a robot" appeal.


It is not easy making the decision as you do not know the eventual outcome , but take account of what you have read, go with what you think is right for you and don't keep thinking "if only".


 


Keep us appraised of how you get on


 


Ivan

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User
Posted 13 Jan 2022 at 12:11

Hi Simon my  prostate cancer was gleeson 9 I decided to go the radiotherapy  hormone therapy route as I have a fear off operations  had 37 sessions of radiotherapy on hormone therapy for 2 years  PSA has gone from 24.9 to 0.01 and something back to normal now found the whole treatment very tolerable with minimal problems good luck whatever way you choose treatment wise 

User
Posted 13 Jan 2022 at 13:17
All else being equal, the outcome between RP & RT is very similar in terms of remission & recurrence. With surgery, unless you are exceptionally lucky, ED & incontinence is immediate and you hope it will get better over time. With RT, ED & incontinence can happen later - over the next 5 years, for example rather than immediate - but some men don't have either problem, even many years later.

There is an added risk with RP and that is the risk associated with having a general anaesthetic.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jan 2022 at 13:20
Incontinence is not a common side-effect of RT! In my case I had RT in 2019 because it was the recommended treatment for me, and found it all very tolerable. A few weeks of increased peeing frequency towards the end of and soon after treatment, but that settled down quickly. Bowel disturbances lasted longer - about a year to fully settle down - but were never more than a minor inconvenience; I just took Imodium if I went out for the day.

Three years later and everything's fine.

Best wishes,

Chris
User
Posted 13 Jan 2022 at 13:49

I am not really answering your question as I underwent surgery at Addenbrookes for the removal of my prostate on 21/12/21. And like you I found the process of being assessed, diagnosed and treated very quick and effective.


I decided to undergo surgery rather than RT because I liked the idea of the cancer (hopefully) being completely removed, of knowing exactly what grade my cancer was ( with a core sample biopsy you can never be entirely sure) and because I have never liked the idea of a dangerous substance ( RT) being used on and in me.


 


As mentioned by others, there are more immediate side effects with surgery, namely ED and incontinence.  Just over 3 weeks after surgery I do have some "feelings" in my nether regions and with my nerves all being spared on the left hand side and most on the right I am confident that I will be able, over time, to harden up. Though, obviously, I will not be ejaculating semen. Re incontinence, when I had the catheter removed after just over a  week after surgery, I was, for around 6 hours, totally incontinent  though this did improve before I went to bed. I am presently around 70% continent and this is improving, if not daily certainly week on week.


If interested, my cancer journey, which started March 2021,  can be found on my profile

User
Posted 13 Jan 2022 at 14:10
RT can go beyond where surgery can. In quite a number of cases RT is needed to supplement Prostatectomy so if applicable going straight to RT may avoid the double whammy of RP and RT.
Barry
User
Posted 13 Jan 2022 at 15:52

I had my RALP in early November 2021. Unlike OhDear!, I am still 70% INcontinent during the day but dry overnight. Just proves outcomes will differ. I chose RALP because I was strongly advised that should subsequent salvage treatment be required, surgery is very difficult after RT, but RT is not compromised by previous surgery.


Good luck.


Peter

User
Posted 13 Jan 2022 at 16:35

Did you, Peter, recommence Pelvic Floor Muscle exercises after your catheter was removed? I did them for about 6 weeks prior to surgery and recommenced them ( 6 times a day) as soon as my pipework was removed. I was told by the nurse that continence would not dramatically improve unless I strengthened my pelvic floor muscles. I expect one could expect some improvement in continence as the internal damage (which, apparently, is about 10 times worse than what could be seen on the outside) caused by the surgery repaired itself, but it would not, I should think, be as good as one undertaking the aforementioned exercise. Interestingly, one of my village neighbours who underwent prostate surgery when he was 68 (he is now 80), who said he just let nature do its thing after surgery, was fully continent about 8 months after his operation but has in the last year has again started to wear a pad during the day.


 


Ivan

User
Posted 13 Jan 2022 at 18:40
That is quite an insensitive comment, Ohdear. It is not helpful to promote this idea that men who are left incontinent after RP have somehow just not tried hard enough.

Despite your understanding, pelvic floor exercises only have an effect on men left with stress incontinence post-op. The vast majority of men still incontinent 6 months post op do not have stress incontinence.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jan 2022 at 19:39

I am not sure, Lyn, why you have repeated a comment that you made a number of messages ago which did not make sense then. How you can read my comment and claim that it says that men left incontinent after RP have not tried hard enough is beyond me. But, you are,of course, entitled to your opinion.


I am guided by what the professionals told me and they recommend that pelvic floor exercises are commenced well before surgery and continue afterwards once the catheter has been removed. As you probably know, only 8% of men who have had their prostate removed suffer from long-lasting incontinence, with most who had normal bladder control before the procedure regaining it within 6 months. For most men regaining full continence is a gradual process that can go on for several weeks or months and is helped by undertaking pelvic floor exercises.

User
Posted 13 Jan 2022 at 20:45

Ha! Not sure where your stats come from but in England, the official data is that 90% of men are using one pad per day or less at 12 months post-op. There is no data to support the idea that most men are dry at 6 months - the trick is in understanding the definition of 'continent' being used. The 10% know they are incontinent and have to find ways to live with that but there is also a proportion of men (estimated to be around 30% by BAUS) using a pad per day or when they go to the gym or who have to wear a condom when engaging in sexual activity or only ever wear black trousers just in case. These men are no less distressed by their incontinence and can be hyperaware of any suggestion by health professionals, family, friends or their peer group that they have brought it on themselves. PFEs are important but will not overcome incontinence that is not down to poor pelvic floor muscles.

Edited by member 13 Jan 2022 at 20:51  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jan 2022 at 20:48

Settle down, chaps. No offence taken, Ivan. To answer your question, I started PF exercises 5 years ago after my TURP. I can't say I have been doing them religiously every day for all that time but certainly, I did for many weeks before my Op. The fact that I am dry overnight and can hold my pee for some time after getting up means all the plumbing is in order, it just degrades as the day wears on and I am told that this is not unusual and should resolve in time. Just wish it would progress faster, of course 

User
Posted 14 Jan 2022 at 01:24

I went down the RT route, not by choice my diagnosis, suggested RT with HT was the only sensible option. Very glad I didn't have a choice I would have probably chosen RP.


RP seems the more certain choice, but it is no more successful than RT and does a lot more collateral damage. I think RP is popular because anyone can understand how a knife works, whereas you need a degree in biology to understand how cancer DNA is damaged by RT but healthy DNA isn't (actually it is, but it repairs itself, now you see why RT is not trusted by the common man).


If your tumour is T1/T2 you may want to investigate focal treatments, they have very few side effects and can be repeated when the cancer comes back. You may need to be referred out of area for these treatments, so unless you ask they will not be offered.


If you have RT it will probably be accompanied by two years of Hormone Therapy (HT).


Two years of HT isn't great, but I got through it. ED is a bit of a problem. I can't rely on it springing to attention like it used to, but I'm trying a few pills.


 

Dave

User
Posted 15 Jan 2022 at 10:44

Originally Posted by: Online Community Member


I went down the RT route, not by choice my diagnosis, suggested RT with HT was the only sensible option. Very glad I didn't have a choice I would have probably chosen RP.


RP seems the more certain choice, but it is no more successful than RT and does a lot more collateral damage. I think RP is popular because anyone can understand how a knife works, whereas you need a degree in biology to understand how cancer DNA is damaged by RT but healthy DNA isn't (actually it is, but it repairs itself, now you see why RT is not trusted by the common man).


If your tumour is T1/T2 you may want to investigate focal treatments, they have very few side effects and can be repeated when the cancer comes back. You may need to be referred out of area for these treatments, so unless you ask they will not be offered.


If you have RT it will probably be accompanied by two years of Hormone Therapy (HT).


Two years of HT isn't great, but I got through it. ED is a bit of a problem. I can't rely on it springing to attention like it used to, but I'm trying a few pills.


 



Tadalafil can help, though it can give you heartburn - regulate the dose, if it does.


Works for me, most of the time 😎

User
Posted 15 Jan 2022 at 11:53

Originally Posted by: Online Community Member


Tadalafil can help, though it can give you heartburn - regulate the dose, if it does.


Works for me, most of the time 😎



Thanks Bob, that is exactly my problem, with all the PDE5 inhibitors. I have a minor problem with acid reflux, which becomes much worse with blue pills (other colours are available). I'm now taking lanzaprazole, so I can take the PDE5 inhibitors. So yes if I can get the dose right I will be happier.

Dave

User
Posted 15 Jan 2022 at 12:02

Some of the collateral damage from RT may not be seen straight away, but affect you in later life, whereas with RP things can only get better.


But both treatments are likely to be superceded in a few years, if the recent stories are true. Which is a good thing.

User
Posted 15 Jan 2022 at 12:05

 


Dave


Re taking Lanzaprazole, if taken for a long time it can affect your kidneys. I have been taking 15 mg almost every day for over 10 years and believe, after undertaking a deal of research, that the drug may have reduced my kidney function (presently around 68%). Now it is true to say, apparently, that most people's kidney function reduces once you reach 40 so it may just be a coincidence. But, nonetheless, I am trying to wean myself off the acid reflux drug by only taking one tablet every 2/3 days.


 


Ivan

Edited by member 15 Jan 2022 at 12:06  | Reason: Not specified

User
Posted 25 Jan 2022 at 09:27

Hi Oh Dear! Thank you for your help. My journey began only in early November 2021 when I forced my GP to allow me to go into the surgery for a long-overdue PSA test, having missed out in 2020. My PSA was 10.5, and since then Addenbrooke's and the NHS have been amazing. It will be blood test to surgery in 3 calendar months. I'm booked in for RARP on February 6th. I thought I was sure, but then, following a video conversation yesterday with the oncology team to discuss RT, I'm not so certain. I have been taking 5 or 6 yoga classes every week for two years, including two every week that focus on the core, and, as the instructor says, "squeezing the little one," so I'm hoping my pelvic floor is already in good shape. I just had my 70th birthday, and I feel horror at the thought of any kind of major UI for more than a couple months. Also, my wife is much younger than me, and we still have an active, if infrequent, sex life. I'm told they can probably save one of my nerves if I have surgery. But the oncologist, and other things I have read suggest that I have less chance of becoming incontinent and impotent (I call it incompetence) with RT than with RARP. I need to decide this week, and I feel more anxious now about making the right decision that at any time since this all began. I'm sure everyone has the same anxieties. It's a bummer having to make the decision yourself rather than just being told what's going to happen.

User
Posted 25 Jan 2022 at 10:04

Morning Simon


It would certainly make life easier if you knew what the eventual outcome of surgery or RT would be , say in 10 years time, so that making a life-changing decision would not be so difficult. Although I was only on Active Surveillance for 6 months before my operation, I now believe that I had the symptoms of prostate cancer ( weak urine flow , going regularly to the loo during the day, but not during the night) at least 10 years earlier. And , I have no doubt, I would have probably have had a raised PSA level if I had been tested at age 54 instead of 60 . So, having at least 13 years treatment free is, I think, a bit of a bonus.


My understanding is that both RT and surgery have the same results in terms of life expectancy, though surgery does initially have more side effects. As I have previously mentioned, I chose surgery because I liked the idea  that the cancer would-hopefully- be totally removed, that I could undergo RT if, by chance, the operation was not successful and because I never liked the idea of being treated with a dangerous substance. Additionally, by having your prostate removed you are able to determine the actual final grade of cancer (it could be higher than that found during the biopsies). Two close friends of mine both opted for surgery at Addenbrookes in 2010 and both 11 years on are still alive (one is 81 , the other is 79) and  both regained ED and full continence. Though, that said, both have in the last couple of years started to wear a pad again for small leaks. My incontinence, 5 weeks on, is still improving and I am now probably 80/90% back to where I was before the operation. ED wise, I am beginning to get a little hard and do have an orgasm, though, obviously, no semen is ejaculated.


The robotic surgeons at Addenbrookes have a very good reputation and both  undertake a high number of operations each year. I cannot fault the treatment I received from Addenbrookes and was so satisfied that I  donated £1000 to their "buy a robot" appeal.


It is not easy making the decision as you do not know the eventual outcome , but take account of what you have read, go with what you think is right for you and don't keep thinking "if only".


 


Keep us appraised of how you get on


 


Ivan

User
Posted 25 Jan 2022 at 10:10

By the way, Simon, I meant to mention that initially the surgeon thought he could only spare the nerves on the left-hand side of my prostate but when he chatted to me the day after surgery he told me that not only had he sparred all the nerves on the left-hand side he had saved most of the nerves on the right-hand side too.


 


I am due my histology feedback consultation on 03/02/22 so will know then whether the surgery resulted in negative margins (i.e. all the cancer was removed) and whether the grade of cancer remains the same as that found during my 2 biopsies ( Mostly grade 1, Gleason 3+3=6, with 5% grade 2, Gleason 3+4= 7).


 


Ivan

User
Posted 25 Jan 2022 at 14:30

Hi Ivan, I was also told they will be able to preserve only one nerve, but was planning to ask them to try to save both. Given your experience I definitely will. Sounds like you're doing great. 80-90% bladder control after only 5 weeks would be very acceptable to me. Best of luck in the future. Keep well.


Simon

User
Posted 25 Jan 2022 at 14:38

A point, Simon, re nerve sparing . I told the surgeon that I would rather be free of cancer than have him spare nerves that could contain cancer cells. Whether he followed my request only time will tell.


 


Ivan

User
Posted 25 Jan 2022 at 18:10

Hi Simon,


My OH had his surgery on the same day as Ivan. He is slightly older than you at 73 but I too am alot younger than him. It’s so difficult to make a decision. Surgery really wasn’t an option that anyone pushed for Rob, but he really wanted the tumour removed along with lymph node, knowing that he would almost certainly need ART at a later date.


He had his catheter in for 4 weeks but since it’s been removed his continence has been much better than I thought it would be. He’s dry at night but if he’s awake he gets up for a wee (maybe a couple of times), throughout the day he’s fine when sat, when he stands he often feels like he needs to wee but can make it to the toilet. Walking around he’s getting the odd dribble but generally really pleased. No idea if it will stay this good and of course everyone is different. 


In terms of ED we are still waiting on a prescription for sildenafil and pump. He has been on HT for 5 months so at present has no desire for sex anyway. Initially we thought he would be on HT for life so we already had the conversations about sex life etc. The surgeon did manage to save 50% nerves so we’re hopeful he will get some function back in the future. We were so worried they wouldn’t get all the cancer though so nerve sparing became a much lower priority for us.


Best of luck with whatever you decide. 

 
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