PSA 150 - Are we looking at PC w Mets or is there a chance it’s something else?

Your husband is relatively young, and I hope the two of you have a healthy sex life. One factor to consider is that with surgery there is a strong likelihood that the surgeon will have to cut fairly wide around the prostate to get all of the cancer. If that happens, there is a strong probability that nerves will be taken and that ED will result, making both of you unhappy. ED is less likely to result from RT, I believe. But the best way to get ED is to have BOTH RP & RT.

Recommended by the surgical and nursing team, that's to be expected. Pushing too hard for surgery, not in your best interest My two surgical consults also pushed for surgery, cut wide and follow up with radiation? One actually told me, In his training for cancer,they were taught three things, cut it out, cut it out and cut it out. No thanks.

Based on those stats, that is not the best option for your husband. Like I mentioned before, clear scans doesn't mean "clear". Just too small to be seen, for now

You guys need to do your own research. IMHO, the aggressive radiation triple play, external beam , temporary ADT and Brachy, is probably your best option. If that fails, the cancer was already out of the barn.

And why is he not a good candidate? I was 56, with urinary issues and an enlarged prostate going in.

It's often said that surgeons recommend only surgery and radiologists recommend only radiation. It's refreshing and encouraging to see a doctor recommend a treatment he does not provide. Usually the catheter is in for only a week, not two.

Glad you talked to an RO. You did your due diligence and now you have a plan which you are comfortable with. That in itself must be a relief. Now you can focus on the task before the two of you.

My best hopes for a good outcome!

Yes the 18th will be here soon.
Thanks for the list Halbert & for keeping tabs on us. Much appreciated.

On our way to the city to see Anesthesia today. I’ve had all my surgeries at this hospital so a familiar place for us. It’s still hard to believe this is happening. He doesn’t look or feel sick. With the Casodex & Flomax the urinary symptoms have decreased considerably & except for being tired he’s feeling pretty good. I choose to believe that’s a good sign .

I’ll keep you posted on how he’s doing & continue to document his/our story.

Best wishes for a successful surgery and smooth recovery for your husband LadyJ. You've done your due diligence and have decided on treatment, take comfort in moving ahead. My husband followed a very similar course. Diagnosed at 57 and recommended surgery by his urologist and RO due to his age. His pathology was worse than was expected, and he is now on ADT and RT due to a low, but persistent PSA following surgery, initially 0.06, dropped to 0.04 shortly after starting ADT, next is in May and hopefully, lower still.

Hello forum family!

It’s a nippy sunny morning & there is a forecast for snow ❄️ on Monday. Yikes! We are so ready for warmer days & for spring to stay.

Well we are on the other side!! My husband had his RP w Lymphodectomy & Nerve Sparing on 18/04/19. I could feel myself starting to breathe easier while talking to the surgeon postop. Although a bit more disease than the scans showed, & diagnosed G9 w 150-185 PSA...they were able to spare his R nerves 👏. We are so grateful. He removed lymph nodes to be sure but said they looked disease free & so did the bladder, urethra & rectum. We won’t know margins untill we have pathology reports but we feel so blessed that the surgery went better than expected.

His post op recovery didn’t go so smoothly though & was complicated by an Acute Kidney Injury d/t a significant leak around the urethra sutures. Apparently this can happen as the urethra heals, but I was not aware it could happen to the extent that it did & it was a bit frightening. The CT showed the fluid had collected around his L kidney pushing it up into the abdomen under his rib cage. Not permanent thankfully but he was on IV antibiotics and in step down for 4 days as this resolved. He looked nine months pregnant and had difficulty expanding his lungs so his oxygen stats fell requiring oxygen for several days. It was the best Easter gift ever when that leak closed & the fluid started pouring into the catheter bag!!

On Wed one week later I was able to take him home, but d/t the extra fluid the drain and catheter have to be in place for another 10 days. Requiring several drsg changes a day and a bit more care.

Another surprise...We were told he would have swelling but the scrotum swelling to the size of a small melon was a shock & no one warned us we might need an open front toilet seat when we got home so he would fit! Thankfully the hardware store 5min to close had one. It’s funny now but not so funny at the time 😂. The swelling is resolving now too w the drain & as he moves around more.

He was d/c on antibiotics and blood thinner injections for a month to prevent blood clots & T3’s but he’s barely needed them. Walked around the yard yesterday and sat outside for a bit. Even made himself a grilled cheese sandwich. He’s weak, but all things considered, doing great & improving daily, counting down the days to remove the catheter and drain!!

~LjK

Hi Nytngale,

Thank you! Yes things could have been much worse. We had some wide eyed Residents by Fri evening!
One day at a time for all of us around here 😊.
How are things at your end?

LJ - when the doctors say there may be a little swelling and bruising, you should understand that you will experience melon type swelling and bruising like your abdomen was punched on one side by George Foreman for 10 minutes. The catheter saved me the trouble of having to push the melon down to do anything at its peak for a couple of days. It was actually good for something... Did think about getting a new seat though for a while though...

Hello All,

My husband is nearly 3wks post op from his RP and although still a bit weak, feeling pretty good.

He’s being very patient, but getting very frustrated w his tubes!! They were supposed to come out today, but complications persist! Both the catheter and drain have remained in place because we are still getting 300-400cc/day from the drain. We now have been instructed to send a drain sample to check for Creatinine levels. Yup they’re checking for a persistent Urethra Anastomosis Leak! He’s been on Cipro but that ends today. The drainage is normal, his temp is normal. Urine output from the catheter is clear & normal. Keep hoping all this fluid is still from the original post op leak (which was a significant amount of fluid), & it’s just taking a bit more time to clear. Urethra Anastomosis Leaks can happen but they usually resolve on there own; this doesn’t seem normal to me. We are staying calm, but this is concerning!

Has anyone else experienced anything like this? ~LjK

LjK what did the final pathology report say?

Jane, this may be a bit late but I had a drain in at home for several days and I found it best to sleep on the couch propped up against the back rest. That let my catheter drain good and the drain not be bothered while a slept. Getting both tubes out was a huge relief. I am 3 months post RALP with a PSA of <.01 and no issues other than ED and a am seeing slow improvements with that. I am still high risk for future treatments, but I will deal with that if and when it happens. NEVER GIVE UP!!!

Thanks for sharing that FranPro. Great to see another low PSA post surgery & that you’re staying positive & doing so well!! My husband finds sleeping on his back is most comfortable for him & does ok w naps in his recliner 😀. Thankfully the Stanley Cup playoffs are on and he loves his hockey🏒!

Thanks Nytngale. We will!!