radical prostatectomy or laparoscopic radical prostatectomy

Sounds like a reasonable decision Mark. I also investigated going private for Proton Beam Therapy which is available in Prague, Germany etc. Having researched it, it seems very positive with claims of much reduced side-effects but as my surgery was already scheduled I decided against it. Luckily worked out ok for me but, as I understand Proton Beam has just been launched in the UK, it may be that when your active monitoring indicates the time to act, it may be another NHS option for you to consider (just to add another level of complexity to decision making ).

Good luck.

Tony

 Hi Mark sorry to hear your diagnosis it’s a devistating thing to deal with maybe I’m not the guy to ask but I had very similar results as you ..so I thought I’d  reply.... 3 years ago (aug 2014)  I went through “nerve saving” surgery by the Da Vinci robot apparently they could only save the nerves to one side of the Prostate...I became impotent and  incontinent overnight..I was 52...and I was very sexually active pre op ....the incontinance was only “cured” by the insertion of a “male sling” (jan16)  I still dribble if I have a coughing or sneezing fit ...but it’s somewhere near normal ..,this is despite considerable pelvic floor exercises from pre and post surgery to today...on the erection front it has been my worst nightmare...I was prescribed caluis from about 2 months post op and given a pump I have persevered with both to this day and I still can not achieve an erection ...I can obtain an erection if I inject my penis with “Caverject” and I can eventually reach orgasm all be it a”dry orgasm “ which in itself is depressing....my sex life is all but over as my wife is now less than enthusiastic by the time I’ve gone through the rigramole of preparation....I’ve also lost 2”” in length and 1” in girth even though I “exercise” my “manhood” with the pump almost daily (as instructed) pre op I was “the man” a” jack the lad “ I’m a shadow of my former self ...I’ve had some 20 sessions of counselling to no avail..I constantly read positive posts on here and it makes me feel worse !!! I am happy for them though I’m just envious of stories of “ continent in 3 weeks “ and “erections in a month” !!! People say your alive be happy!! I say I wish I had taken my chances...!!! At 55 I smell of piss and have no chance of having meaningful sex ..nobody talks of this and nobody understands !! ...they can’t there not me !!!! I know all the above won’t help but if you get out of this  better than me well good luck to you and I mean that...I only wish I had read something like this post prior to my op ...my advice is this research research research !!! Find the best surgeon and insist.. no demand that he leaves you post op in the best condition possible as I think in this country they are only concerned with the cancer (which is understandable) and not the person they leave post op ...I’m sorry for the warts and all post...and truly good luck in your journey 

Regards John 

Hi Mark45,

As many have said already, everyone is different. I was diagnosed in October 2016 with a PSA of 56 and Gleason 3+5. I was immediately offered tri-modal therapy; surgery, radiotherapy and hormone treatment. I had Da Vinci surgery at St Georges in Tooting on Dec 8 and went home with a catheter the following day. My staging was upped to T3b and Gleason went to 4+5. I recovered well but don't underestimate the effects of the surgery. After the catheter was removed (about ten days later) I had a little incontinence but soon got on top of it and was done with pads within a fortnight. My cancer was as close to breaking out as it's possible to get and there was no nerve sparing. Viagra and Cialis have done nothing for me so I'm moving on to Caviject in a few weeks. I've been using a vacuum pump to keep the blood flow going but the rigmarole combined with zero libido resulting from the hormone treatment has put sex at the back of the queue. I'm lucky to have a very supportive, caring and understanding wife who's mainly glad I'm still here.

I had 33 sessions of radiotherapy in through May and June and managed to continue working until the last week, when I was just exhausted. I did get a bit of increased frequency/urgency by the end but I'm pretty much fine now. Pelvic floor exercises are key. I've been a bit lazy about it but I'm back on it now with the help of the excellent NHS Squeezy for Men app. The Marsden have also been giving me a course of acupuncture to help with the hormone symptoms. My PSA is undetectable.

Mentally, it's tough too. The hormone treatment makes me moody, sweaty and tired but I'm pushing back and trying to drop a few kilos, build up my fitness and treat myself right. The docs are looking at whether moving me back to monthly hormone jabs will help with the spikes I get after a big dose of Zolodex and I'm getting great follow ups from the team at the Marsden in Chelsea.

I would definitely recommend the Da Vinci route if you go for surgery. More accurate and less time in hospital - all good as far as I'm concerned.

Good luck and keep in touch on here.

Mark59 ;-)

I think active surveillance is best at the moment, especially since your doctor has told you that you can wait. 

I've had robotic prostatectomy for the accuracy of the procedure. My continence and erection are not as before, but I think I was lucky and my doctor was really good so I managed to maintain them at mediocre level (for a PC survivor). Recovery will be long, but lets hope your PC stays low and you won't have to go through with any course of treatment. 

My advice is to talk to both surgeons and radiotherapy doctors and hear both sides of the story before you make a decision that best suits you,

I have just got a date for my robotic surgery I am fully aware of the possible long term effects but I really just want the cancer out of me so I feel I have to go ahead so will you all keep your fingers crossed for me on the 24th Feb

Hi Bb9270, hope all goes well on 24th February.

Unless I am missing something you have added this to an old thread.

It would be better if you started your own thread and also post details in your bio. For example diagnosis, Gleason score, scan results, treatment options with dates. 
Best wishes,

Thanks ido4 I am a bit of a Luddite but thanks for your thoughts