I had no symptoms. My doctor performed a DRE and noticed no abnormalities. We found out through my "you're turning 50" PSA test , which came back at 6.1 in 2012. He suggested that we check my PSA again in 6 months. Well, 6 months stretched into 9 months before I had my PSA tested again. It came back at 6.4. My doctor suggested I go see a urologist. I made an appointment at TUCC (The Urology Center of Colorado).
I was able to get in to see the urologist fairly quickly. The urologist performed a DRE and was concerned that he felt a firm area on one lobe of my prostate and ordered a biopsy. They performed a 12 core biopsy and ultra sound exam. My prostate looked normal on the ultra sound and the technician felt that, if there was prostate cancer, we were catching it an early stage. The biopsy results came back and your heart just sinks when you hear the word "cancer". Of the 12 cores taken, only 2 showed cancer. One was graded a gleason 4+3 and the other a 4+4, so they round up to the highest score and grade the cancer a gleason 8 and staged me a T2a as the cancer appeared to be confined to one lobe and in a small confined area of that lobe. So now I had choices. I read everything I could about the disease. My urologist scheduled an appointment for my wife and I to sit down and discuss what my options were.
We go over some paper work and my urologist shows me some nano grams from leading hospitals that show treatment options and success rates. I had already decided to go with the robotic prostatectomy. At my age, it just made the most sense. There will be risks with any treatment, but I liked the idea of knowing more about the numbers after the pathology of the removed prostate. You don't get that information if you decide on radiation treatments as they do not have a removed prostate to test.
I did my homework on the robotic surgeons at the TUCC and chose Dr. Juan Montoya. He had performed over 800 robotic prostatectomies. My meeting with him went well. I liked him from the very beginning. He felt I had an excellent chance of cure due to the small area of cancer and my low PSA number.
My surgery went well. The Dr was able to spare all the nerves. Any pain I had post-op was tolerable. I got the catheter out after 10 days and have been mostly continent since. Sneezes or heavy coughing may produce a leak now and then, but I can live with that. I do have some ED, but it's much less than I anticipated. My pathology came back 3 days after my surgery and it was good news. The cancer was confined to the prostate, the margins were clean, the seminal vesicles were not involved, no extra prostatic extension and the lymph nodes they removed were clean. As Dr Montoya put it: "It's the best chance of cure that is possible". I feel very blessed. The PSA tests done since the surgery have been undetectable.
If you are reading this, please remember you have options. Don't let anyone tell you PSA tests are unknown, inaccurate, or this and that. That test most likely saved my life. Read everything, but be selective. Like anything out there on the internet, there is a lot of misinformation. See a urologist and have them answer your questions. Talk to guys that have gone through this. They can be a lot of help and comfort.
I had my 8 month post-op follow up in March and am happy to report my PSA was undetectable and all systems are working quite well. ED, which was somewhat of a problem continues to improve. I'd say to around 90% of where it was before surgery. Incontenance is not a problem. I still may leak now and then, especially if I bend over to pick something up or if my bladder is full, but overall I stay dry all the time. The moral of the story is: Give your body time to heal. Things can and will get better. My next PSA and follow up is in September. Until then, God Bless and stay positive!
15 month post surgery update. PSA remains undetectable. ED is no longer an issue. Overall, I couldn't be happier with my decision to have the robotic surgery.
As I'm now having my PSA tested every six months, it was time for the 6 month PSA test. I received the test results yesterday and my PSA is undetectable. I cannot for the life of me understand the controversy over PSA testing. Lately, I've seen multiple articles, from journals and medical institutions, down playing the PSA test, some saying the test is completely unnecessary. Others saying the test should not be used anymore. I know most of us on this site would completely disagree with such statements. I know my urologist would. In my opinion, such statements are reckless, foolish, and completely misleading. At the very least, the PSA test is an indicator that something is amiss with your prostate and further examination is necessary. Sure, you might have an infection or BPH, or some other prostate related issue. But wouldn't you like to know for sure? I have no doubt the PSA test saved my life. The results of my elevated PSA test sent me to see the urologist. My DRE was normal. Had I not had my PSA tested and only went by the results of the DRE, who knows how long I would have gone without treatment.
I went in for my 6 month PSA and follow up and thankfully my PSA remains undetectable. ED is no longer an issue. I need no medication for ED. I think it's important to remember that if you had nerve sparing surgery, it takes time for things to start working again. Up to two years, and in some cases, longer. It's easy to get discouraged, but be patient. Things do get better. The same is true for bladder control and leaking. It gets better. Keep up the fight. Stay positive!
6 month PSA test came back undetectable. No real issues to report. ED is not an issue. All systems working almost as well as before surgery. No incontinence. Occasional leak when heavy lifting or a hard cough or sneeze. Time. Time is the key. Healing takes time. Until next time, keep up the fight!
Annual checkup time and 6 month PSA test. I am happy to report a continued undetectable PSA and all other systems functioning well. ED continues to be a non-issue. I do not need any pills. Incontinence is also a non-issue. I still have the occasional leak, but it's not a problem worth worrying about. I think the most important thing to remember is that healing does take time. I am three years out from my surgery, and I believe that the nerves are still healing. Things are still getting better month by month. I was fortunate that both nerve bundles could be spared. I am still very happy that I chose the surgery over other treatment options. Until next time, stay positive and keep up the fight!
I just received my results from my six month follow up PSA test and I am quite happy to report that my PSA remains undetectable. I have absolutely no regrets regarding the type of treatment I chose and all systems to continue to operate well. ED and incontinence are not an issue. Until next time, God Bless and keep up the fight.
Tom's e-mail address is: firstname.lastname@example.org