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Joe Tillson and Fred live in Virginia, USA. He was 58 when he was diagnosed in April, 2009. His initial PSA was 2.30 ng/ml, his Gleason Score was 7, and he was staged T2a. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

In December 2008, I had an annual physical where my PSA was 2.3. My digital exam was normal. One week later, I came down with a case of prostatitis. My internist placed me on a course of antibiotics for 17 days. When the systems cleared up, he referred me to an urologist.

At that visit in February, the urologist detected a nodule on the right side of my prostate; he scheduled a biopsy. The results of the biopsy showed PCa in right middle apex and the lower part of the prostate. Based on my age and physical condition, he and I decided that the Da Vinci Laparoscopic surgery. Dr. Michael Fabrizio was going to be the surgeon.

After meeting with the surgeon, I was scheduled for a CT scan of the pelvis area and a bone scan. Both scans were clear.

My surgery was scheduled for 23 June 09. It was successful and based on the pathology report I had excellent margins. I came home on the 24th and will go back to the surgeon's office to have the catheter removed.

I went through surgery fine; had relatively little pain. I am only on Tylenol for my discomfort. Other than, I have had a low fever. Being in great health and physically fit, I was surprised how weak and tired I am right now. But it seems to improve every day. I will follow up when I go through the process after surgery. I don't see surgeon until after July.

UPDATED

August 2009

My first PSA test after my surgery in June was not detectable. What a relief. I don't see my surgeon for another 6 weeks. He is an excellent doctor, but very hands off.

My incontinence has reached a plateau; I am dry at night and only leak slightly when sitting down (especially at night). However when I walk, I leak continuously. Last week I started PT. The therapist indicated that my pelvic floor muscles are strained. By late afternoon, the perineum feels swollen and sometimes sore. She cut back my Kegel exercise to 10 5sec/10sec contractions twice a day, added stretching exercises and a cold pack for 20 minutes twice a day. While this is going to take some time, I think there is marginal improvement so far.

I think my ED is slowly improving. While I can't get an erection, at times my penis gets semi-hard. I am taking 5mg of Cialis and using a vacuum pump daily. Since both sets of nerves were spared, I am optimistic that the ED will improve over time.

So far I feel very fortunate in this journey.

UPDATED

November 2009

I have had my second PSA test after surgery; PSA still continues to be not detectable.

Urinary incontinence has improved significantly. I now only have stress incontinence.

ED has not improved significantly; continuing 5mg Cialis and use of vacuum pump daily. However, have just asked the doctor if Cialis can cause tinnitus (ring of the ears) as I have had it daily on an intermittent basis since surgery. Hearing loss is a rare side effect of Cialis. Have not heard back yet.

I choose RP in order to have the best chance of eliminating the cancer and minimizing the chance it will return. At this point, I am progressing well with the side effects. 4.5 months is too soon to make a judgment on ED.

UPDATED

March 2010

It has now been 9 months since my surgery. PSA tests continue to indicate less than 0.1.

I no longer wear any pads and only have occasional stress leakage.

My ED has improved somewhat, but is not near normal. I continue to take 5mg Cialis and use a pump daily. My doctor tells me to be patient as I am improving and it can take up to 18 months for the nerves to heal.

Physically, I am back to normal doing all the things I did before surgery. Overall, I am doing well and continue to believe I made the right decision to have the surgery. With a Gleason score of 7 (3+4), if I had delayed, I would be having some sort of treatment sooner. It was better to get it over-with and get on with life.

UPDATED

March 2011

During the last year, all of my PSA tests have been non detectable with the last one done in September 2010.

I had some slight bleeding intermittently last summer. My surgeon in September scheduled me for a cystoscope in December. In October, I passed a small kidney stone. I underwent the cystoscope in December anyway; fortunately all was OK!

My continence is good; only some minor stress incontinence. My ED is improving slowly, but I still have a way to go to be back to normal.

UPDATED

April 2012

I continue to have no signs of the cancer and my continence is very good. My ED is better than it has been, but even with 100mg of Viagra, I cannot get a full erection. However, I decided not to pursue Trimix or any other form of help.

UPDATED

May 2013

My PSA tests continue to be undetectable and my urologist has moved the testing frequency to an annual basis. At times I have stress incontinence, but it is minor. I do not use any pads for it. My ED has not changed for the last 2 years or so. I must use 100mg Viagra and get about a 70% result.

Even though I have some side effects, I stand by my decision to have the surgery.

UPDATED

June 2014

My PSA levels continue to be non-detectable. Earlier this year, I had significant discomfort in my perineum area to include frequent urges to urinate. Urologist diagnosed it muscle stress in my core muscles and bladder neck. He prescribed physical therapy and Floxmax. Stretching exercises strengthened my core and the issue resolved within two months. ED continues to be a problem. I can get some help from Viagra, but I think I will see no improvement from here on out. I have decided against using injections, Muse, etc. My continence remains very good.

UPDATED

July 2015

At 6 years from surgery, little has changed. I can get stress incontinence when exercising. Using 100mg of Viagra gives me some relief from ED.

UPDATED

October 2016

I continue as I have reported previously. Rarely do I have any stress leakage and only when I am very tired. I must use 60mg of Viagra to gain an erection. I continue to have PSA tests that are undetectable.

Joe's e-mail address is: jlt1112@gmail.com


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