Radical prostectomy

Good Morning Ljs  A warm welcome to the online prostate Community - it's a great place for help and advice.

I am so sorry to read your post and fully understand why you are up so early - there's plenty going on. You don't give your full diagnostic statistics but I am surprised that with "stage 4 aggressive" you had the option for surgery - I am aware they believed it had not spread. In my personal case there was the slight doubt that it had spread and surgery was off the menu.

In the couple of years I have been on the Community I can't remember anyone with this issue but I may be wrong so I do hope you get some replies and advice. 

The good news is your team have the problem in hand and the CT scan isn't too far off - I wish you well with this. Keep us posted with your progress please.

Best wishes - Brian.

Hi Millibob - I suspect Ljs means it was thought to be Gleason grade 4, which was subsequently upgraded to Gleason grade 5 once they had the post prostatectomy pathology report.

 Ljs - I can sympathise with the very early awakening and cuppa - these are stressful times.  However, I have (in my opinion) good news for you:

There isn’t a Stage 5 cancer, so I’m pretty sure that you are Gleason 5 (I would suspect Gleason 5+4=9, the same as Millibob, who just replied to you). The fact they went for removal means that you are on a CURATIVE pathway, and I would have hoped that they removed all the cancer during surgery (remember, a Gleason 5+4 on the pathology bench is no longer a risk to you!).

 However, you said that the consultant said (in April) that it had spread.  OK - this is not uncommon with a patient with 5+4 cancer who has elected for surgery.  You will no doubt get a rising PSA - from a very low number post surgery - (as an aggressive cancer can leave bits behind, that have escaped the main lesion), then the next stage is likely to be salvage radiotherapy.  Don’t panic.  The radiotherapy is very accurate and painless these days and I should think that you will have some hormone therapy alongside (again, quite tolerable).  I think that they will still treat you on the curative pathway and there are plenty of us on this site as testament to how good these treatments are!

Regarding the bowel pain : please remember that even though the surgery is classed as keyhole surgery, it is a big operation and you said that the surgeon had to move the bowel.  This will take time to settle and they are doing the right thing to scan to make sure that nothing else is amiss.  It is unlikely that cancer is causing the pain, as nothing showed up outside the prostate pre surgery, so if any is left it will be microscopic at this stage.  I’m sure that they can give you medication to help with the pain, soften stools, etc, whilst the body repairs itself.

Hope this settles your mind and you can get a better nights sleep  tonight!   AW

good morning millibob, my consultant did warn me that it may have spread before the  M.R.I. I was offered either treatment when I was told the stage I was believed to be , obviously subject to developments.as I said I was stage 4 aggressive and stage 8 -10 on the Gleason chart. but after surgery I ended up as 5 and 9-10 Gleason aggressive. I have been assured that the safe area is clear of cancer by the lab. what goes round in my mind's gremlin's is what if its entered my blood stream including all the other possibilities. thank you and all the best.

good morning AW, thank you for your  thoughts which are appreciated. you will see in my reply to Millibob what is going through my mind, no doubt until I have my 3 monthly check up . take care and all the best.

Hello Ljs 

All sounds to be well - if there are clear margins, then that's fine - they have also removed the lymph nodes which act as a "motorway system" around your body so again all is well.

Your regular PSA tests will tell if there are any issues but now your prostate and all infected tissue has been removed this should be untraceable.

Ljs said:

what goes round in my mind's gremlin's

That's the problem with this cancer - even like me on a "Curative Pathway" your mind does go into overdrive.

Best wishes - Brian