What happens after treatment

Hi Bobblejes and welcome.

Often talked about on here , obviously, yes it can be a problem and from what I have seen over the years since being diagnosed in 2013 is that surgery can Def be an issue for ED.

I have to also say that not everyone having surgery has an ED problem.

So I had Radiotherapy and some months after treatment was over everything was back to normal, only thing, a dry orgasm' as no more semen or very little, but you do get used to that .

See what others say

Best wishes 

Steve 

Hi Bobblejes , sorry to hear that your OH is joining our club.  Firstly, Gleason 6 is low so that is really good news and he may not need treatment yet..   PCa is very slow growing, so depending what else is found a treatment plan will be put together.  It’s too early to start worrying about these until you have more info.

As for sex, yes it is usually a major factor for us chaps and the thought of losing the ability was for me a very big issue.  However, I started on Hormone Therapy (HT) and amazingly not only physically did I lose the ability, but mentally I lost all desire, much to my amazement. Each treatment comes with its own side effects and you need to balance each one once you know the options.  I am sure other will be along soon to add their thoughts, but please ask any questions and keep us updated.  David

Hi Steve, thank you so much for your reply, that is comforting for him to know. Really appreciate it. It's so scary, Sarah 

Just one other thing, David did mention it, active surveillance could be an option if stats are low, U don't mention PSA or any staging.

Of course some would rather start treatment and forget about AS.

Good luck with whatever u decide

Steve 

Aww David, thank you for sharing,  not something you want to happen,  I do feel for you. Thank you again, much appreciated,  Sarah 

This is a question which many men have difficulty with, and, if they are not careful, can dominate everything else.

Your husband is young for this diagnosis, which may help with sexual difficulties.

I don't think that they can really be escaped, but you can plot to minimise the effect. There are a wide variety of devices and medications which may help, and of course, your hubby may simply not suffer from a problem.

If you are offered surgery, then there are nerve endings within the area of the surgery which can cause more or less of a problem.

With a Gleason 6 rating, it is possible that your doctors will suggest a wait and see approach.

If you opt for radiotherapy, then side effects last for a while after the treatment and probably don't include problems with sexual activity at all.

If you are offered both radiotherapy and hormone therapy - possibly the commonest practice - then your hubby will almost suffer loss of libido (desire for sex) together with erectile dysfunction. It is very likely that this will happen because it is a side effect for most of us BUT it tends to go away when the treatment plan reaches its end.

Almost certainly the main thing is patience. Trying and failing can cement a pattern of behaviour which is hard to break. 

Get the options. Make sure you and hubby talk about the options, including the sexual side.

This web page summarises it much better than I can - 

https://prostatecanceruk.org/prostate-information-and-support/living-with-prostate-cancer/sex-and-relationships

There are other people on this forum who can give better and different answers and stories than mine.

For myself, I am over 20 years older than your husband. My wife had a problem which meant we were already living a life without penetrative sex, so we were well-prepared for this. I am on a curative pathway, which I suspect your husband may find a familiar phrase when discussed with the medics because Gleason 6 cancer do not generally move fast, which includes both radiotherapy and hormone therapy.

Once I got into the hormone therapy, erectile dysfunction was very quick and my libido fell off a cliff. Given that we expected this, there were no problems in our relationship. The loss of libido meant that I no longer actually cared much (as David2017  said above) and my wife said she no longer felt as if she was letting me down.

I want to tell you, perhaps for passing on to your hubby, that facing this together has made our overall relationship much stronger. We show affecting in other ways than sex, and, for us, it really works.

For your hubby, at his age, there is a very strong chance that he will come through his treatment and recover quite quickly after that.

I wish you both well.

Not sure about stage,  but his PSA was 3.5, he's 49 years old. They said anything above 2 was a concern. They took 13 biopsies and each one had cancer present

Hello Sarah Bobblejes and welcome from a wife. The others have given you very good replies so I don't have much to add apart from giving you a link to a book which you can download for free explaining the diagnosis process and treatment options.

https://issuu.com/magazineproduction/docs/js_prostate_cancer_guide_for_patients_ezine

With all cores being positive then treatment will probably be advised but take your time to choose the one which you can both live with long term. Some health authorities do not offer things like Brachytherapy but there is no reason why it should be precluded if you are willing to travel.

I have also given you a link to a NICE website who helps to inform about the risk on ED and incontinence with different treatments.

https://www.nice.org.uk/guidance/ng131/chapter/Recommendations#localised-and-locally-advanced-prostate-cancer

There is a lot to take in at the moment and initially all thought tends to revolve around the word cancer but things do get better once you have a plan. Caught early prostate cancer will be treated with curative intent and from what you have posted it looks as if your husband is on this pathway. For now keep a note of all test, conversations and meetings along with dates and who you spoke to so that you can politely remind the experts of the 62 day rule if things look as if they are slipping. Also you may be able to see results earlier if your husband has full access to his medical records which you can request through your GP.

Ask whatever questions you like, no matter how trivial they might seem and we will try and help.

Ok, so PSA nearly normal, is that the only one or are there previous?

probably another important point, what does the MRI show in terms of  tumour size and if near the capsule edge.  That is what the staging would partly disclose, could be worth contacting them and asking for a copy of the MRI report and/or staging.

Steve

Thank you so much, it's an emotional time, a time when you need to try and think straight,  so your help and advice is unmeasurable. Sarah