Hi Arthur,
I posted this about an hour ago but there appears to have been a site malfunction, and it wasn't added to your conversation???
Following my prostectomy, two years ago, the pathology report of my prostate was almost identical to yours apart from the R1 bit. I had 9 lymph nodes removed they were all clear. I had extra prostatic extension. The cancer had just breached the prostate capsule, hence the T3a staging. I was also Gleason 9 (4+5)
Your first PSA test is .04. Was there a less than arrow in front of it <? One of my local labs only measures PSA down to .04. So in that particular lab < .04 means the PSA is below what they measure to and is therefore deemed undetectable.
The other lab I use, measures down to .02. Fortunately all my follow up PSA results from this lab have also been undetectable, that is <.02. The less than arrow is therefore quite important.
If your .04 is without a less than arrow in front of it, it means there is a bit of PSA that's still detectable. If your lymph nodes are clear it could mean that there is a microscopic amount of residual tumour left behind.
Like Francji1, I'd never heard of the additional R1 part of your final cancer staging. I'm not medically trained but believe that R1 is similar to a positive margin, that there may have been a microscopic bit of residual cancer left behind, usually at the prostate bed. Please don't take this as gospel, it's only my interpretation of what I've read, and you should ask for clarification from your consultant.
Whatever your .04 PSA reading is very low and hopefully will remain so in the future.
I believe, that only if your next PSA tests show a rise or reach .2, that further salvage treatment is considered.
As for your incontinence problems. It's very early days, mate. I believe the average recovery rate is about 6 months.
Your erectile dysfunction is to be expected and will depend on what nerve bundles your surgeon managed to save. I had non nerve sparing surgery and was told I'd never have a natural erection again. Unfortunately, to date, this has been the case. However you may find that you recover better than me and ED tablets or injections and vacuum pumps may help. In my case I've found Invicorp very effective.
I hope you get clarification of the exact meaning of your cancer staging with your consultant and that your side effects improve. I wish you a speedy and full recovery.
Best of luck mate๐
Edited by member 30 Dec 2024 at 08:35
| Reason: Additional text