Recovery after radical prostatectomy

Hi Troc

In answer to your question about RT straight of Surgery (adjuvant Radiotherapy) apparently some specialists like to carry this out as a belt and braces approach but before you agree beware of possible extra side effects.

Another approach is to have salvage Radiotherapy (if necessary) after monitoring PSA for a few months depending on the PSA results. That way u don't have to go thru with the RT if it is not required.

good news that the cancer has not obviously spread, it all hinges on the first PSA result  which I would imagine would be soon as 2 months have gone by since surgery.

Steve

Thanks

I asked one urologist about salvage and he of course said the word basically meant saving.

I have read however that many urologists now say there is no difference because if its within say 5 months the effects are largely the same.

The main difference is you get stuck with the level of continence you had at start of RT.(and thats important as other side effects can also be bad)

May I ask you if you had radical prostatectomy yourself?

I still have some aches and weird feelings around the genitals etc.

I know the healing can take 3 months especially  as I had both nerve bundles removed and the lymph nodes .

My right wound drain was in for over three weeks for the first two weeks losing 500 millitres a day.

So it was a heavy op.

Hi Troc

I had RT, not surgery , just my preference, so can't help u with side effects on that subject. I know that there are plenty of people on here who have been thru it so hopefully they will post.

All the best

Steve

Hi Troc, I had surgery July 2015. It’s normal to have aches and pains for a while as nerves settle down after the trauma of major surgery. They will disappear after a few months usually.

Continence wise I’d say you’re doing really well. I found I leaked if I walked too far or too quickly for the first few weeks after catheter removal but it improved quite quickly thereafter.

Being Gleason 9 doesn’t automatically mean you need radiotherapy as a mop up. That depends on whether the cancer was well contained within the prostate and if your post op histology is favourable i.e. no nasty surprises when they sliced up your prostate, cancer contained and negative margins. 
Have you had a post op histology report?

I was Gleason 3+4 initially but prostate was bulging with cancer at the edge of the capsule. I ended up being restated Gleason 4+4 and T3a. 
All the best,

Hi

thanks for that its good to know it hurts a while...

I had the histology report and it was R0 in the end.(so no remaining cancer to be found)

They were quite advanced at my hospital and did frozen section biopsy during the operation.

They had a doubt about the connection to bladder and surgeon originally did not cut too close to avoid permanent incontinence.(the frozen section biopsies have to be looked at and evaluated  fast during the op)

The final histology however  shows margins of at least 2 mm in that section so was classified R0.

Lymph nodes were clear.

That was the good news .

I was not happy they removed both nerve bundles as they said they would try nerve sparing .

They say this is standard with Gleason 9......

I have now been told that some nerves were spared but I intend  to consult another urologist on this (fascie nerves and and some vascular nerves on the side of the prostate)

According to the Professor may mean a chance of an erection using PDE5 inhibitors.

I know that continence is the most important and of course living,although living with total incontinence must be hell.

I will have some new results soon and we will see.

I did achieve an orgasm without erection which was surprising to me as it seems to be mainly mental.

So that's the story till now

Hope you have no new problems and postoperative all is ok?

very best regards

Thanks

hope you will  do well

all the best

Roy

Hi Troc,

My dad was Gleason 9 and had RP via robotic surgery; single side nerve sparing. He was staged Pt2, N0, M0 with negative margins. Only perineural invasion was present in his pathology report. It seems like you & him are similar cases.

I will try to answer your questions:

1- My dad had incontinence which has gradually disappeared over a period of 3 months after the surgery.

2- He also reported some discomfort which disappeared over time.

3- He was not offered adjuvant radiotherapy right away, rather they monitored his PSA. His first PSA turned out 0,010 which now reached 0,2 in over 10 months after the surgery. He will now undergo salvage radiotherapy.