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Posted 9/26/2018 4:07 PM (GMT 0)
As a pharmacist I am horrified to learn that a pharmacy may have been unprofessional regarding these drugs.
I would suggest that you determine if it was a pharmacist responsible or one of the pharmacy technicians. Once you let the pharmacist and store manager know that you are a cancer patient dealing with a very distressing issue, I would not be surprised if someone did not lose their job.



Paul
Posted 9/26/2018 4:11 PM (GMT 0)

mattamx said...
Back to the OP.

...If you are depressed, talk to your PCP about antidepressant medication. I think one poster suggested that using depression medication should be a last resort. I don’t think that’s good advice.

That was probably me, but to be more accurate, I was suggesting over reliance on the depression pill mill is, in my opinion, bad medicine.nono There are many types of therapy that can be tried before subjecting one's self to more strong meds, with their inherent side effects. Admittedly, and thankfully, I have no first hand experience in this area, so YMMV.
Posted 9/26/2018 4:28 PM (GMT 0)
I know it is rough to recover after a prostatectomy. I have had surgery and SRT with triple hormone blockade. It took me well over a year in each case to regain potency (with viagra and trazodone -used as a sleep aid - off label). Trazodone is a ant-depressant and was used by some doctors prior to viagra for ED. One of the rare side effects can be priapism.

I also used a pump and injections initially. For me, the pump resulted in a "cold penis". I developed a mild case of Peyrones Disease from the injections. I don't need them now.

One drug that I found that helps me with libido is cabergoline (off-label use for PCa). Cabergoline suppresses prolactin and is a dopamine agonist. From what I have read, dopamine is a neurotransmitter that enables "feel good" activities in the brain. On the other hand, the male body increases prolactin levels immediately after orgasm, which is largely responsible for men losing desire (libido) for more sex. Here is a "cabergoline as a salvage for sildenafil failure study whose results show that "positive clinical results were seen in 31.2% of patients in the cabergoline group compared to 7.1% of patients in the placebo group."

https://www.ncbi.nlm.nih.gov/pubmed/16625231

Ask your urologist about cabergoline and I bet they have no idea what it does for libido. Mine didn't. Fortunately I had a great RO (Dr. Dattoli) who constantly studies all aspects of PCa. My family doctor continued all of Dr. Dattoli's prescriptions when I provided studies that showed the drugs' efficacy for PCa treatment.

I am 65 and living with PCa for the past 6.5 years.

Best of luck, and never - ever give up.
Posted 9/26/2018 4:57 PM (GMT 0)
Regarding insurance not covering penile rehab or ED following cancer surgery, I find it a bit unfair. My wife had a double mastectomy due to breast cancer and insurance would cover complete restoration (which she declined).
Posted 9/26/2018 5:04 PM (GMT 0)
I forgot to ad that trazodone is dirt cheap and there are cheaper sources for cabergoline. You will need to search the web for cabergoline since it is a cash cow. You can find it for $1 per pill, roughly $8 per month.
Posted 9/26/2018 5:25 PM (GMT 0)
Lots of good information posted by others, but let me offer my own experience.

I'm 2 years post surgery, and I had the same shrinkage, etc. I did some penile rehab using sildenafil, but was not consistent with it. I also started seeing a specialist in sexual function, which was really helpful.

The specialist encouraged a regular rehab program, but did not "beat me up" when I didn't always follow through. He said even my intermittent therapy was helping out. He also showed me statistics that most patients recover some function in one or two years.

about 6 months ago I started to feel more sensation down there, and the use of drugs produced an adequate erection. Recently I notice my penis is looking like it did prior to surgery. I guess there is increased blood flow and the tissues retain more of that blood in the normal state.

Is everything the same as it was before my surgery? No, but is it manageable? Yes. I was told not to expect 100% recovery at my age, and that is true.

Nerves are damaged and shocked during the surgery. Nerves take a long, long time to recover. So, be patient. Things are getting better for me. May they get better for you too.
Posted 9/26/2018 5:43 PM (GMT 0)
Yes, stay out in front of the depression, it can really sap your energy. I am 1 year out from surgery and still no response from down below and do feel depressed at times. Get help and don't let it get the best of you. Good luck
Posted 9/26/2018 5:50 PM (GMT 0)

VinceInMT said...
Regarding insurance not covering penile rehab or ED following cancer surgery, I find it a bit unfair. My wife had a double mastectomy due to breast cancer and insurance would cover complete restoration (which she declined).


My company's insurance excludes any care for ED issues. As my ADT wore off, fortunately that is no longer a concern for me. It's a diminished "new normal", but reasonably acceptable now. But along the way I did ask to see a specialist about it, and did so. Only afterward did I learn that it was 100% out of pocket for me.

I protested, arguing that I suppose I can see "normal" ED not being covered, but this is different. This is directly a result of cancer treatment, truly a side effect of that treatment. They didn't care, no coverage at all.

Just another insult from this disease and the way it's perceived and treated.

Old guy with prostate cancer, resulting in sexual dysfunction? Ick, eww, and so what? Geez, so let 'em die. Their wives aren't interested in sex anymore anyway, they'll quit costing social security and their pension funds, life insurance may pay out, and the kids may inherit money sooner. Throw them on the cart. Win!

Younger women with breast cancer? Oh my! We all love boobies. We love our wives, daughters, mothers. Pull out the stops! Do everything! Cover everything! Wear pink! March! Reconstruction! Everything! Everything!
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