Wednesday, November 2, 2016

Grim news

There have been many scary moments during my cancer journey but the highlight is probably the day I got my pathology report back from the surgeon: 
  • Gleason 9
  • Extraprostatic extensions (the cancer had grown outside the prostate walls)
  • 3 positive margins (the surgeon did not get all of the cancer)
  • T3a (stage 3 cancer)
Gratefully there was no cancer found in the seminal vesicles or the pelvic lymph nodes.

I will always remember these words in the surgeon's records: aggressive cancer.

I had read dozens and dozens of articles and research studies on prostate cancer outcomes with various scores.  This was a very black day.

My one hope was a calculator the surgical resident shared with me during our meeting shortly after getting the news.  The calculator suggested I still had a good chance of surviving another 15 years!

A few weeks later more bad news arrived: my first PSA test after surgery.  The hope is that the PSA measured after the surgery is "undetectable" (less than .1).  Mine was .11.  Uh oh....more treatment needed.

Tuesday, November 1, 2016

Recovery


WARNING!  This post is graphic (urine and penises and pain...oh my!)

My post-surgery experience was not very positive. I had an unusual amount of pain in my abdomen.  I was unable to sit down for almost 6 weeks. Gratefully this is unusual.  Most men do not have this much pain.  A physician friend believes it was due to fluids left in my abdomen which was confirmed in a later MRI.

Like all men I had a catheter for two weeks. Not fun. Not so much painful as irritating and a constant reminder that I had tube up my penis. Very unpleasant. Every movement was uncomfortable.  I did my best to ignore it but I was SO grateful when the day came to have it removed. 

Removing the catheter was an adventure in itself. The thought of somebody pulling the catheter out (remember...I was anesthetized when it was put in) freaked me out. In fact it was not so bad. No pain, just a creepy feeling.

Now that the catheter was out I had a new problem: incontinence. As mentioned earlier most men have acute (temporary) incontinence for a few weeks or months after the surgery. In my case it took a couple of months to get my control back.  It is hard to find good statistics on the recovery time but I think my time was close to the median for my age.  Apparently age can affect time to recovery: I was young. The recovery was not linear for me.  I went many weeks with minimal improvement and then saw sudden changes. Of course during the recovery period you are returned to your 1-year old self: diaper-laden.  This wasn't wonderful but it was not that bad.  There are great products available.  They are almost stylish!  OK...I admit that is a stretch.

The next "problem" was potency.  As mentioned earlier men generally have reduced erectile function after a prostatectomy (again...age of the patient matters). Though I had "nerve sparing" surgery I was no exception.  Due to pain from surgery I wasn't interested for the first couple weeks.  My surgeon provided Viagra for the first few months.  Having watched the marketing for years I was always a bit skeptical but it is quite amazing.  Remember though: not every guys has nerve-sparing surgery and even then there are no guarantees of any recovery.  In fact, two years later and I still don't have the pre-surgery erections.  I can manage a wimp hard-on sometimes but I need the drugs for the real thing.

One important point to make about this whole sex issue: erections are not equivalent to orgasms.  It is different for every man but my orgasms were not as affected as my erectile function.  I was able to achieve orgasm within 2 weeks of surgery...well before I was even close to obtaining an erection. 

More details...
  • Work.  I was 59 years old while going through this. Still very active in my career and not ready to let go of it. My employer was very cool. They gave me a medical leave (this is actually required by law in most situations) to give me time for recovery. In the end I only missed about 3 weeks of work.  This was mostly because I wanted to work.  Nothing is a better salve to anxiety and pain then work. I was grateful to lose myself in my job as quickly as possible.  

Pacing

It has now been over three years since I was diagnosed.  The first couple of years were filled with a lot of fear but also a lot of action a...