On to the next chapter

Well, got the cath out yesterday. Oh what a relief it is!  Then realized it is not enough to be tagged with this dreaded disease we have the indignity of incontinence.  I peed all over the examining table without realizing it.  Fortunately I came prepared with pads.  It was a two hour drive home added to stopping for lunch and a little shopping so it was about three hours since I started using the pad.  Got home and my wife noticed by pants were soaked.  So far that has been the worst of it, although I wasn't that active the rest of the day.  Actually the amount of wetness through the night was surprisingly small, although I got up several times to pee. 

Also got the printed pathology report. The only disconcerting part, from what I reported in an earlier post, was a notation about perineural invasion which said it was present and extensive.  Urologist did not appear too concerned and from posts I have found, maybe that is the least of my worries.  Lymphovascular Space Invasion was absent so that made me feel good.  So like the rest of you who have  reached this point of surviving cancer I await my first post op PSA in six weeks.

I have one question I hope some of you can provide incite.  I asked about my cancer stage.  He said the pathology report shows a pathological cancer stage of T3a, which sounds rather forboding.  But he said for our purposes my clinical stage is T1c, which sounds so much better.  So do any of you have knowledge of what the difference in staging is and why?

tdnjam, glad you got the cath out...I remember my husband sighing with relief at the uro's office when it came out. I'm sorry about the leaking but that should improve over time. I will tell you what the uro told my husband 6 months ago...though my husband was leaking, per se, he did have the occasional "squirt". In spite of Kegal exercises, the squirts would still surprise him from time to time. The uro said try this exercise: tighten up the rectum as if you were trying to hold in a fart. Do this as often as you can. Guess what: my husband hasn't squirted nor has he needed a pad in 2 months. You might want to try this one and see how it works for you.

Now, the pathology report. It is not uncommon for the Gleason score or stage to be upgraded after surgery. You are in the same position my husband was in: clinical stage T1c, surgical stage T3a. His upgrade was due to extraprostectic extension (one small focus) on the right side. Perineural invasion is very common on both biopsies and surgical specimens. In fact, I think most men who have surgery find they have perineural invasion so I wouldn't worry too much about that finding. Did your path report indicate clean margins? Usually a T3a means that the cancer has moved outside the prostate gland proper but not necessarily that it has spread to other areas (such as the bladder or seminal vesicles...I believe in these cases, the stage is T3b).

The clinical stage of T1c means that the prostate cancer was found due to elevated PSA and that no abnormal findings were found on DRE. Only men who have surgery to remove the prostate receive two stages: clinical and pathological. The surgical pathology is the definitive one, and gives a very detailed summary of the pathologist's findings. A biopsy is a sampling of what was found in the prostate, and gives the uro an idea of what's going on but definitely doesn't tell the whole story.

Anyway, take heart...my husband is going on 5 years after surgery and his PSA continues to be undetectable and he has had no other issues.

As to your first PSA in 6 weeks, keep in mind that it will take a few months for all the PSA to flush out of your system. My husband's first PSA test said 0.1...uro said it will be undetectable at the next test (4 weeks later) and it was.

Sounds like you're doing just fine. It will take some time to recover - that can feel like a slow process at times. Upgrading stage and gleason score is common. The next PSA test will give a good indication about how successful the surgery has been. I am betting you'll be just fine.

Andrew

You've already passed one hurdle better than I did. My catheter got hung up on an internal stitch and I ended up being led around the room, them pulling and me following along. I later took it out myself a few days later after the stitch degraded a bit more. There was a bit of an internal pop as that stitch let go.

Just continue doing better and you're home free. You'll probably find your nights dry long before your days.