.8 PSA and just diagnosed Gleason 8

Hello Pete,

I feel for you. I've been there. Pretty much exactly there where you seem to be. Kinda sucks but you'll get past it.

I think, technically, your radiation will be what they call "adjuvant" instead of "salvage". The difference is that "adjuvant" radiation is done for men with high-risk disease and worrisome results on their post-op pathology without waiting for a rising PSA to indicate that surgery has actually failed. Adjuvant radiation is usually scheduled so the treatments end approximately six months after surgery. That gives the patient as much time as possible to heal and recover continence before the radiation complicates the healing process.

You haven't mentioned any sort of hormone shots but those are (almost?) always part of the deal with adjuvant radiation. They don't want the disease to advance while they let things heal from surgery and Hormone Therapy (HT, aka Androgen Deprivation Therapy or ADT) will keep the disease bottled up while they wait. The hormones also make any remaining cancer cells more sensitive to the radiation and improve the odds for avoiding recurrence. If your doctor hasn't talked to you yet about the hormone shots he probably will. Sorry if I have spoiled the surprise.

I call the combination of surgery, hormone therapy, and radiation "The Three-Scoop Sh:t Sandwich." The good news is that the radiation (which you are probably worrying about just now) is not the most flavorful ingredient. The bad news is that the hormone shots are the worst part for lots of guys. But since your doctors are treating you with the intent to cure you, and since "cured" means no more hormone shots for the rest of your life, the shots will be temporary (probably somewhere between 6 months and three years with 18 months to 2 years being fairly common.) That gives HT the same advantages as banging your head against the wall -- it's really nice when you get to stop.

Have you talked to your doctor about some sort of physical therapy for your incontinence? They put sticky electrodes on your belly and your butt crack and hook you up to a machine that monitors your pelvic floor muscles while you do your Kegal exercises. They can help make sure you are doing them right and can give you numbers to show how you are progressing. It does help a lot of leaky guys and, since you have the radiation coming up it might be something to ask about sooner rather than later.

Good luck. Keep us posted.

Actually, once you can get past the idea of the injections the rest isn't so difficult. On the other hand, getting past the idea is a struggle. It's probably a little bit early for you to think about injections but you don't want to wait too long. The idea is to get something going on in that department in the first couple of months. You want to find a way to get three erections a week. Normally, the erections that all men get during REM sleep are enough to keep the tissues exercised and oxygenated, but until your nerves recover your nocturnal tent-pole may be a no-show. If you can get pills to work you are good, but if pills don't work in a few months you might want to look into injections. Those almost always work.

If it comes to that be sure to ask your doctor about a mix of drugs called "Trimix". Trimix is a "compounded" medication -- you need to get it from a special pharmacy called a "compounding pharmacy" where they make custom drug mixtures. Despite having to be mixed by hand --I think they just add sterile water to a pre-filled vial and give it a shake -- trimix is much cheaper than the commercially available boner shots and works better to boot.

redsea said...
The only shots they have talked about so far are the ones in my John Thomas for erection and I am not ready for those yet (if ever). Course in talking with the nurse on that subject she said they do the first shots in the clinic to see how they work and I am thinking what a waste of a perfectly good boner!!!

My doctor encouraged me to get home and use it. Wise man. I have to say that was a very awkward office visit. From getting the shot to getting scanned by a nurse to checking out and leaving while ROCK hard. This whole experience certainly has relieved me of my modesty.

Trimix requires refrigeration to preserve full effectiveness. The mini-fridges in cruise line staterooms work fine but you do need to throw an icepack in your luggage for the travel time before you board.

If your oncologist does want you to do some HT along with the radiation it might be a good idea to get started with the injections sooner rather than later... before you forget why they seemed like a good idea.

Hey all, had my rrp 9/29/15 had mumorous problems from my robotic prostectomy. In surgery for twelve hours, doc had to take the stitching out from the euretha and bladder, took another 2 1/2 hours. Had cancer outside my prostate in my nerve endings. Stay in hospital was 7 days, in 31 days I had catheter removed, suffered from bladder spasms 4 or 5 a day. Have had no control over leaking and sometimes complete urine flow? No feeling when I have yo pee.
Am going to therapy for pelvic floor, results so so. It will be 5 months since surgery, this is truely getting old. As far as sex forget it. I am 66 soon to b 67 in March. I need a second opinion, my surgeon has not been much of a help?

Small victories. Am now able to sleep at night without having to use a shield or anything. Daytime does seem to be getting better but am still having to wear pads. Since I had no nerves spared I am not real hopeful on correcting ED. My wife and I are both 67 and she says I am suffering not her!! LOL.