PROSTATE CANCER AND SURGERY TO REMOVE IT

Hello Andy (ANDY33) 

So I am not medically trained but my understanding is that 2 bundles of nerves surround the prostate and a small number of nerves run through the prostate.

The surgeon will have seen the MRI, however the operation is to remove the prostate and all the cancer. Once he's made the first cut, there's no going back and once he's in there he will do what is necessary. He needs to remove the prostate gland (and the seminal vesicles) whole to keep the cancer contained so if it's attached or entwined with any nerve bundles the chances are these will be damaged in removing the prostate gland.

I hope this helps as there are no guarantees as to what he will find once he's started.

I hope all goes well goes you on Saturday.

Best wishes - Brian.

My husband has apparently had nerve sparing and a year on there is no improvement and he has ED. See if they do NeuroSAFE so they can check without removing the nerves as a precaution.  Once they are in they just take want they want! My husband regrets surgery but it’s a personal choice and he rushed his decision. Wishing you all the best 

Hi,  I had my surgery two days ago.  It was originally discussed with me about nerve sparing surgery as my cancer was only on one side of my prostate so that might have been possible. 

However having had the biopsy which showed gleeson score of 9, the surgeon advised that it was safest to take everything as there is a risk of remedial microscopic cancer being left behind.  I was OK with that as the main priority is getting rid of the cancer. 

Whilst in there, he apparently spotted some other tissue which looked odd too so he removed that too and has sent it for tests to see if it was cancer.   

I hope ths surgery goes OK for you.  

Best wishes

Mike

Thank you mike for responding. I have the same base line approach, its about removing the cancer to ensure i can live longer, cant afford to risk leaving any behind, now i know how intertwined the nerves are.

are you saying there is no improvement regarding cancer removal, or just in regards to ed?

Thank you for replying, it is much appreciated. i recently had a second biopsy as the psa is slowly creeping up (6.7) and this showed progression to stage 2 gleeson 3-4 so after  5 years of monitoring ive had enough, its got to go.

kind regards

andy33

There is a large variation in 3+4. Pattern 4 could be just 5% or 45%. If it’s a low % then it’s  more like Gleason 6 outcomes. Why would surgery be the best option? For low risk 3+4 I feel that AS is a good long term treatment for me. Surgery has several risk factors.

My husband has no erectile function at all even with  a full nerve spare. He’s had 3 PSA tests since surgery, all results are 0.03. It’s the impact it has on relationships. It’s a couples disease and has affected both of us. It’s very hard to adjust to the new norm of a limited sex life tbat is taken away overnight and for us even more difficult after 34 years of marriage. We have found it devastating. My husband is a changed man in himself, he’s very depressed and wish he had opted for radiation. His Gleason was 3-4 PSA 15. Everyone’s circumstances are different. Surgery wasn’t right for us. Wishing you all the best