Post radical prostatectomy 60 yr old. In a dark alone place.

At age 59, eleven months ago I had radical prostatectomy. DaVinchi procedure Henry Ford Hospital, Detroit MI. I'm now 60. I had gone through the incontinence for 4 months and no erections since surgery 11 months ago. Around 4 months ago Ive been taking daily 20mg Viagra. It is now 11 months! The nerve sparring did occur. Ive used vacuum to encourage blood flow. I have been put on one dose 30mg of Lupron 4 months ago. Why? All psa results from April to January have been <0.1 undetectable. Then one test said in January psa (0.1). I freaked out when they said your cancer is back. I insisted to do something. They offered Lupron 30 mg every 4 months. I took the shot... 3 days later they retest the same blood draw and called me and said your cancer is NOT back your psa is <0.1 undetectable. I said the Lupron is started. They said its OK wont hurt. Lupron does not cure it delays or defers. Well with all said I been to few Dr. with many opinions. I got psa tested at another hospital with more sensitive equipment. Results 2 days ago <0.02 undetectable. Am I fooled with this result from the Lupron or is it real? Other Dr. said if your 60, had radial prostatectomy, forget an erection ever! Im reading all these threads. Im lost, alone, no hope. I need an erection to have sex again.

Hi Polar Bear,

Paul65 is right...the Lupron isn't going to help ED.

But can I ask for your history at diagnosis (biopsy results, DRE results and PSA...what "risk category" were you?), and for clarification on this one point from your post before commenting further...?

Do I understand correctly that all post-RP PSA tests were undetectable, until one in January was reported to be at 0.1ng/mL...but when that same blood sample was retested a short time later it, too, came back as undetectable? And in between those two readings from the same blood, you started Lupron. Since then, just days ago, you had another test at another locations with an ultrasensitive reading of <0.02ng/mL.

If I got all this correct, the Lupron shot might have "jumped the gun," but your doctor told you, it "won't hurt."

Am I following along correctly? What were you stats at diagnosis?

Welcome PB, you have found the best support group on the net! Take some time to look further on this forum for the information you seek and you will find some great answers. Usually when we get that first sign of recurrence due to a PSA test coming back detectable, we re-test to make sure it was not a mistake. Like others have said, the Lupron won't hurt you, but you may have to deal with some of the side effects of it until it wears off. Those SE's are usually ED, lost of interest in sex, hot flashes and sometimes emotions and weight gain. Because you had a small met in one lymph node, your post op path report probably stages you a 3 now. Usually, the surgeon will talk to you about your choices of adjuvant therapies such as Lupron and/or Salvage Radiation. You might want to seek an experienced Radiation Oncologist to consult with about that. After the Lupron shot, your PSA tests will not be accurate until it wears off.

I would also fire the Dr. who told you no more erections. You will find men on here decades older than us still enjoying life! It can take up to 3 years to get through the ED, and yes, sometimes it never comes back. But you will not know for that for at least another 2 years. In the mean time (and your Dr. should have already done this), you need to look in to Penile Therapy in which you have already started. Besides the pump and the Viagra, have you tried the other 2? Cialis and Levitra? One or the other may surprise you. 20mg daily Viagra is for recovery. Every now and again it's ok to try 50, 75 or 100mg for that erection with the approval of your new Dr. If you get no results, then there is injection route. I know it makes the hair on the back of your neck stand to think about it, but really, it isn't really that bad. Search Trimix, Bimix and Caverject.

I am almost 5 years out and Trimix has made my single self a hero in my forest.

I am/was 52 when I had my surgery and now am 100% ED. So much for that nerve sparing crap I talked to the doc and after getting over the fear of the shot I gave Trimax injections a try. The shot has been a life saver for me. It took a bit of trial and error but it does work great. After about an hour and half things return to normal. Talk to the doc and see if this is an option for me. PS, after about an hour my wife will say, I can't take it anymore. Not like the old sex, but this is better than no sex

So in the reading of all these posts, I gather...Wait and see. I'm a lets do it, kind of guy. Take control, the clock is ticking, deploy, deploy! I'm am TYPE A. Being TYPE A, racing thoughts is very self destructive. Now what I learned here is wait. ( the guy who presses the elevator button a thousand times) Let the Lupron dissipate. Watch the PSA levels see if they stay <0.02 naturally, not smoke and mirrors under Lupron. In addition, being 11 months has passed and Lupron running out of gas 4 months ago. See if a tingle of life is present in my ED. The 1 year to life clock has ticked for an erection. Then live a new life. FEAR every month waiting for the PSA result. I rather be in another fire fight! Being in control is being in control. This is a crap shoot. I'm a bad ass afraid of the darkness engulfing me.(loss control) Wait for it? Wait for it? Want to be a man again. Just have to say you guys are brave...

Hello Polar Bear, My husband had his surgery at Henry Ford also, He had a steady .4 psa following surgery from the start. at the 8 week mark with incontinence being the issue he was given a 4 month Lupron shot and that brought him to undetectable. I know they don't want to do salvage radiation with the incontinence being an issue. Radiation will stop any healing in that department is what we were told.His incontinence is minimal now but, we chose to have one more lupron shot to decide and interview radiation drs. We have one on the books now. I am researching more radiation drs too. I would like to talk to at least 3. When this 8 months of Lupron is wore off we HOPE radiation will not be necessary, but...we will be ready to pull the trigger for sure.
As for the ED part...yep..he was cut wide with no nerve sparing. We tried the trimix with little response at 15 units. A new urologist gave us a super quad mix and told to start at 3 units. Have not tried it yet...use up the other first... I will post about the radiologist meeting on here.
Jen posting for Dave

If you are a reader, get Dr. John Mulhall's, Saving Your Sex Life book. Then follow it. Hubby is also 11 months out, no Lupron or salvage at present. Erections were not really happening with daily Cialis and sex day boost of 100 mg Viagra, so we went for the tri mix. Bam! There was our little friend, back in action! A little unnerving to give the shot, but I figured if he was willing to take it, I should be willing to give it (pun not intended). Now at eleven months we are starting to see the 100 mg Viagra produce and we are not needing to do the injections unless we want to It just takes more time for some men than others, don't give up yet.

It's human nature to trust the experts, but in this scenario you need lots of experts. Find the PROSTATE ONCOLOGY expert in Detroit, not just an oncologist.Find the urology EXPERT in Detroit. This forum will help you, keep trying!

I hate to be the one to break the news to you, but with a positive node, you are a stage 4 cancer. I'm in a similar situation, had RP a year ago, pathology indicated a positive node, so the best practice for MD Anderson (a world-class cancer center) for my situation was adjuvant radiation when the prostate bed healed and a six month injection of Lupron. If my PSA rises, I go back on Lupron.

Confused. If after RP 11 months pass with PSA <0.1 ng. With Lupron 30 mg started for 4 month treatment. Started because of false PSA reading. Surgery was successful but 1 of 10 lymph nodes removed at RP surgery showed a 1 cm cancer. Am I in the clear or have a long road to fighting upcoming cancer. Overwhelmed with thoughts. Should i just wait for Dr. to give direction or point him in a direction?


4-27-2015
PSA 14.7
2 of 10 cores positive
3+4=7 Gleason
T2
bone scan negative
CT scan negative
age 59 when diagnosed
Erections before surgery now none.
99% in control of bladder

My PSA was zero and I was started on Lupron followed with adjunct radiation. You are apparently high intermediate risk like me. I'm worried about keeping the beast at bay and not about an erection.

alephnull, did your radiation treatment finish and cure you of cancer? How many treatments? Daily? How long did the treatments last?

I am severely claustrophobic I would have to be drugged to go into a tube of radiation. How was the radiation journey?

Polar Bear.
You are most certainly not dead! But your erections may need to be, at least for awhile, with your pathology. Seek out a good radiation oncologist, which the guys here can recommend, so that you are ready for RT. The others will give you better advice than me, but you might be able to achieve a very long respite from further mets, if not an outright cure.
Beth