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I am new here, just a couple questions

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Prostate Cancer
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Posted 7/13/2018 9:10 AM (GMT 0)
Hi,
a month after my RALP, my PSA is at 0.02. Oncologist is considering Radio Therapy and Hormone treatment whilst surgeon and urologist are happy with the 0.02. I am terrified of the side effects and toxicity of both.

Does the improved chance of longterm cure outweigh the risks?

I am also distressed with having 100% ED. Not the faintest sign even when I am mentally aroused. I am worried about atrophy setting in despite taking 5mg Ciallis daily.

Besides waiting I would like to take a more pproactive approach towards healing. I have read that some members have tried stimulating the area with Tens treatment. I have a unit but am unsure of electrode placement. I have trried around the perinnium and Penis base. Can this aalso hlp with the incontinence?
Posted 7/13/2018 11:10 AM (GMT 0)
Well it seems like you are just 5 weeks out from surgery- correct? it may be a little early to be evaluating a .02 post surgery PSA. If it were me, I would not make any decisions on Radiation Therapy (not radio therapy) before 12 weeks at the earliest. The half life of PSA is generally 3 to 4 days. Your .02 seems to hit that mark dead on. You may be at .01 or even down to .007 at this point. Just re-test and then evaluate again. An equally important factor in your evaluation process is that you are staged at t3b and having a Gleason 4+3. These place you in an intermediate class of risk. Radiation therapy was inconsequential for side effect for me. I was at .06 when I started and have been at <.006 for three years after salvage radiation. No hormone therapy. I am not at as high a risk factor as you however. Good luck.
Posted 7/13/2018 11:23 AM (GMT 0)
Hello Diver and welcome. In my opinion, one month out with your PSA is too early to make the move to radiation. Wait for another PSA test to see if yours keeps dropping.

Re the ED, that's pretty normal with surgery from what I understand. There are things you can do to improve your chances of recovering your sexual function including taking cialis and using a pump. Some of the guys who are more knowledgeable in that area will be along with their comments.

Jim
Posted 7/13/2018 12:51 PM (GMT 0)
Diver... You have to remember that you just had major surgery so right now concentrate on healing up and one of the best ways is to do lots of walking and then do some more walking along with kegal exercises things will continue to get better. Get another psa in a month and see where you are at as it is way to early to start SRT. Mayo Clinic likes to wait at least 6 months to give a guy time to heal up a little and get good control of your continence.

Larry
Posted 7/13/2018 1:52 PM (GMT 0)
Welcome to HW.

One month post RP is very early days. You've got a lot more healing to do. It's way to soon to be considering a secondary treatment and at a PSA of .02, unwarranted. Way is you Onco recommending that?

Both ED and incontinence will continue to improve as the weeks go one. The surgeon cut a lot of stuff inside you, takes months for that to all heal up. You might try a vacuum device for the ED - that can help get some blood flow going. Mental arousal will no long work the way it did, you'll need physical stimulation as well (lots of it).

Hang in there,
Andrew
Posted 7/13/2018 2:11 PM (GMT 0)
Diver-

Probably too soon to tell about the need for further treatment. I'd say wait till the next PSA test; looking for a trend.

It is also early days regarding ED. It can take a long time for nerves to heal. Follow a penile rehab program and be patient. You should recover function, although it may not be the same as before surgery.

Good luck.
Posted 7/13/2018 2:15 PM (GMT 0)
Welcome to the forum, Sea Diver. You’ve gotten very good advice above, so I won’t repeat what they said.
Keep in mind that ED can improve, not for weeks, or m0nths, but years. Do try to be proactive though, as Tall Allen said, with working in it.

I have been having consultations with a Radiation Oncologist (2 actually), and was told (by both), that with today’s advanced technology, long term side effects are rare. Just make sure if you do follow up radiation at some point, that you are at a facility with the most advanced machines.

But you are far away from that point yet, and as others have said, you may not even get there.
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