I'm 65 years old, generally in excellent health. For example, I can spend a full day loading and unloading 25' vans of furniture for the semi-annual sale that my church does to raise money. At the end, I'm tired, but I and my 70-year-old church buddy can out-work most of the younger men in the church.

We travel extensively in Europe and elsewhere, and spend most of those days on foot, tramping through cities, in and out of historic sites, etc. No problems.

When we're not traveling, and when the church gives me some time off, I am renovating the third floor of our home to make an apartment up there: 1600 square feet, gut rehab down to the studs and joists.

So, you can see that I am physically active with no physical issues that restrict me in any way. My wife says I have a few mental ones, but we're not going there in this discussion.

And now I find that I have cancer.

Actually, my urologist has been tracking me for about 3 years, I guess. Maybe 18 months ago, he started to say "Hmmm, I can feel a 'rough spot' on your prostate, but your PSA looks good (below 2.50 ng/ml)." So we didn't do anything about it.

At the same time, I was having increasing trouble urinating, so he put me on Proscar to treat benign prostate hypertrophy (BPH). That worked real well, and soon I was again sleeping through the night, whereas I had been getting up once a night to pee. I guess I was on Proscar from about Fall 2003 to Fall 2004. At that point, he suggested that I get off of it, for no particular reason other than just concern about being on any drug for long periods of time.

Then in late 2004, I read an article in Business Week, reporting that the inventor of the PSA test had re-canted his support of the test, saying that it really only measured the size of the prostate, not its level of disease. [Bob is not quite correct here; the doctor (Catalona) who established PSA as a standard test still supports its use strongly - another erstwhile supporter of the test (Stamey) demonstrated in a study that there are more men with a PSA below 4.00 ng/ml who would be diagnosed with PCa than there are above 4.00 ng/ml. Because there are many tumours that do not 'leak' high levels of PSA, the DRE is an important part of the diagnostic process and that is the point Bob is making here.] At my next urology appointment (2/25/2005, the day of my 65th birthday), I asked the doctor to decide whether to have a biopsy only from the results of his educated finger, and to disregard the PSA value (which was low, at 1.93 ng/ml). He decided that it was time to biopsy.

I'm thinking to myself, "Yes, this is a good thing to do, but like most tests I've ever had, it will be negative. Another waste of time."

The biopsy itself (March 9, 2005) is, in summary, no big deal. It's a little embarrassing, as you're lying on a table with your bare ass hanging out there, and the sonogram device stuck up your butt. And there's a bit of pulling and pushing as the doc tries to get the right image on the screen. No pain, just pressure from his manipulations.

At this point the doc says: "Aha, I see a cyst here; perhaps that's what I'm feeling in the DRE." I'm thinking "Great". Next he says "Now isn't that interesting!" I respond "I'm not sure I like hearing a doctor say that." I still have no idea what that last exchange was all about.

The actual sampling is a bit "sharp". Like sticking yourself with a needle in your finger. But it is quick for each sample, so you just feel 8 minor jabs, one for each sample.

I had no adverse reaction at all to the biopsy, though of course you can get an infection since the needle goes through the colon into the prostate, and the colon is hardly the cleanest place in the world! But the antibiotic seemed to protect me just fine.

Two days later, the doctor called, saying that there was some question about the reading of the biopsy, that the local pathologist at our town hospital (who I know from being on the hospital Board of Trustees) was concerned that he wasn't getting a clear reading, and had sent it off to Dr. Epstein at Johns Hopkins, apparently well-known for his expertise in this area.

Another three days: doctor calls, "You have cancer in one of the 8 samples, and abnormal cells in another one". Gleason 3+2, probably T1c or T2a.

Now, I'm feeling a little sad. And fearful. There's still a lot that I want and hope to be able to do in life. For the first time, I'm facing something that could end my goals. I find that it brings home the fact that I'm not immortal - obviously, we know this intellectually, but I'm talking about emotionally. Unpleasant sensation.

A week later (March 22, 2005), after reading Walsh/Worthington "Guide to Surviving Prostate Cancer" (excellent book) and Korda's book on his personal experiences (another good book) my wife and I met face-to-face with the doctor. He reviewed the options (radiation, surgery, etc.) with the same information, basically, as Walsh's book. We concluded that surgery was the best approach, because there's a high chance of "getting it all" and secondly because there still is the possible radiation approach later if there's a recurrence of disease. As I understand it, once having radiation, there's no surgical second chance.

This fellow offered to do the surgery at my local hospital. When questioned he said that he does some ten operations of this type annually, and that one of his partners does 30. Since one of the better indicators of likely success in surgery is the quantity of operations done in a year, I chose to look elsewhere.

During the week between telephone call and in-person discussion I/we had talked to everyone that we could think of who might have a reference to a good surgeon: gynecologist, the doctor who did the biopsy, fellow Board members at the hospital (nearly all of whom had had PCa), etc. I also found the book America's Top Doctors, and the regional one for my area.

I started calling: Walsh is out of the business, another highly-recommended guy is unavailable until longer than I want to wait. My urologist's recommendation also came highly recommended in the Top Doctors book, and I had an introductory meeting with him on March 28. He is impressive in his knowledge of the field, at least to a layman, and does 150 RPs a year (a bit different from 10). Surgery is scheduled for April 25, with the usual self-donation of blood in the intervening weeks. Surgeon says that with 3 units of blood, there is a 1% chance that he will run out and have to supplement with someone else's blood. That seems a reasonable risk to me, and besides there's no other choice, as they can't hold blood longer than that 4-week period, and I can't donate more than once/week.

The hospital (NY Presbyterian) fortunately has guest rooms where my wife will be able to stay during the period that I will be in-hospital. We made her reservations today, also. That's great as she is not one for doing a lot of driving, as it's an hour's drive in messy New York/New Jersey traffic from home to the hospital. It's not cheap, but it's still a "good deal" for us.

3/30/05: we are going through the process of getting sign-off from my cardiologist, which is complicated by the fact that I have some arrhythmia, so he has to see me in-person first. And he has to give permission for blood donation, but he's willing to do so without seeing me personally. It's hard to get the details pulled together quickly: doctors do NOT want to be rushed!

My attitude (emotions) is much better now that we are in the problem-solving and planning mode. It's what I do well, and it takes my mind off the possible outcomes. Planning all the stuff that needs to be done before going into hospital (who's going to mow the yard, what medical supplies do we have to lay in for the recovery period, blah blah blah).

Meanwhile, I am trying to make some progress on the third floor renovation. And we have a furniture pickup to make from a donor to the church annual sale …

3/31/05: Today I made the appointments for my three autologous blood donations. It would have been done a couple of days earlier, but for the fact that the surgeon and my cardiologist (or their staffs, who knows?) couldn't manage to fax and sign the blood donation forms in the right manner. It gets more than a bit tedious to try to push people along to do what it seems they MUST have been through before, but are managing to either screw up, or just not do, anyway!

Now we just trundle along 'til THE DAY.

Actually, I have two other appointments in the meantime: my cardiologist will not approve me for surgery without a face-to-face meeting, even though I've seen him within the last 6 weeks or so. And my surgeon wants my to have the pleasure of another cystoscopic exam of the urethra. Though he doesn't say so, I suppose this is in part for him to make sure that he is not going to run into some unexpected cancer in the urethra or bladder. He says that he will use this tool to also show me the use of the sphincter that I'm going to need after surgery: some advance practice time! Oh, boy, what things there are to look forward to!

I asked him if I should be worried about dying on the operating table, and he said that No, this is a safe enough operation. That was good to hear.

4/04/05: Today was my first of three autologous blood donations. Fortunately, there's a place here in NJ so that I don't have to travel into NYC for this. Don't you wonder if the people who run hospitals EVER look at the housekeeping: the blood donations operation is in a former conference room, and the registration room probably had a former life as a closet or a person's office. There are marks on the wall, and an unpainted area where a cabinet was once fastened; there are shelves with various junk shoved onto them; old slides from measuring the iron content of donors' blood sitting around in shoeboxes. I really wondered if it was a clean enough place to donate safely.

Anyway, the actual process is very simple and easy, and the phlebotomist hit the vein on the first try. Thirty minutes and I'm back on the road; didn't even have to pay to park!

4/6/05: Meeting with cardiologist. He approved the surgery without examining me. Not sure why he needed me to make an appearance, except that he questioned whether this was really the right treatment for me: seemed VERY concerned about possible or likely "leakage" issues following the surgery. (This is actually something that I have NOT been very concerned about: figure I can always carry a bucket with me if it comes to that.) And asked if I had pursued any sort of "lumpectomy" process rather than radical removal: that lead me to wonder if he really is knowledgeable about treatment options, since I don't think that there is such a thing a as partial removal. I did take a referral name from him to another Urologist; I would like a second opinion anyway from someone who's not tied to my present urologist in any way. Scheduled that meeting for 4/13.

4/11/05: second blood donation

Between running around to various meetings with medical people, I am keeping my mind busy with church-related activities and home renovations. I don't find that I am worried particularly about the operation or the results, but trusting that it is going to go as it should. There is, after all, nothing that I can do about it, having chosen the treatment plan and the person to do it --- it's up to him to "get it right".

4/12/05: Cystoscopy and hospital pre-admission testing

I learned today that Columbia Presbyterian's pathologist has given a higher grade to my prostate cancer than had Johns Hopkins: 6 = 3 + 3 (up one grade). I'm glad that I didn't postpone my surgery for a planned trip to Europe. Get this thing done!

He then showed my the sphincter that I will be using post-surgery, and had me do the Kegel exercise so that I could see the sphincter operate. That was helpful.

Cystoscopy is the insertion in one's urethra a camera so that the surgeon can see what he's going to be dealing with. Your position is identical to that for a woman's gynecological exam. You're lying there with everything hanging out in the open, while half the hospital staff (it seems) parades by the operating table. The first victim of modern medicine is modesty!

The nurse inserted a topical anesthetic in the end of the urethra, then the doc inserting ths scope. There was a little stinging as the tool advanced into the tool (grin), but no serious discomfort.

He pronounced me clear for the operation (RP).

We (wife and I) had a session at my request with the surgeon's nurse to discuss after-care:

Would I need a visiting nurse aide: No, I should be fully ambulatory. Should only need assistance if the surgical site "opens up", which is unlikely. That's generally a problem only for fat people, which I'm not.

Would I need a shower chair: No, you should be fine.

Will I need any sorts of bandages or ointments: Possibly bacitracin or zylocaine jelly for the tip of the penis while catheter is in, but otherwise nothing.

Will I need to get additional catheter bags: No, just re-use the ones that you will have on leaving the hospital.

How serious an operation is this: The recovery time is not at all bad, compared to other surgeries.

Kegels: after surgery you will be instructed to do 10 Kegel contractions each hour, holding each one for a count of ten. To the extent that you want to speed your recovery, you can start with these now.

Rubber sheets: you might want one for your bed, but most people turn out not to need one.

Catheter removal will be 2 weeks after surgery; could be a little earlier if the catheter is really bothersome.

Adult diapers: They do NOT recommend them, as it impedes the psychological recovery. Just get Depends Guards for Men and wear them in brief-style underpants.

Dr. Biehl's (cardiologist) surgical release has not been received in surgeon's office. Office manager says not to worry about that. I get the feeling that the surgeon is a "go" whether or not the release arrives!

4/13/05: met with Urologist recommended by cardiologist for a second opinion. Result: "You are a fine surgical risk, and your selected treatment is the one that I have the most confidence in." So, it's a "go" for surgery.

4/18/05: last blood donation.

4/19/05:The surgeon's head office person called: "I have received a 'weak' release for your surgery. Would you please call your cardiologist's office and see if they will give a more definitive release." Of course, they have had this existing release for ten days, and have not bothered to read it until now!

I call the cardiologist's head office person and make sure that she understands that this situation is NOT acceptable. She says "Yes, they will resolve this issue tomorrow."

4/20/05: Lo and behold, today the release as originally written is, in fact, fine! I feel as though I get to do all the work to make this thing happen, and am in the middle of a surgical pissing match!

Meanwhile, last weekend, we held a very successful furniture sale in our driveway. This is part of the furniture that generous people have donated to my church, and which I store in my garage until our next sale (four times a year).

We had glorious weather, without a hint of rain: important when the stuff is all pulled out onto the asphalt! Although my chief helper in all this was on vacation, the rest of the church members pulled together to cover for his absence. We sold $4200 worth of used "stuff": furniture, children's toys, books, etc. And we deliver the larger pieces in my trailer.

These sales also generate a lot of donations, so I am now working to do the 6 or 7 donations before I go into the hospital, plus finish delivering the stuff that was purchased. Looks as though I'm just barely going to get it all done in time for 4/25 surgery!

4/23/05: Last night we held the Tricky Tray money-raiser at church. I was one of the major contributors to that event, and it went real smoothly. That's the last "big deal" for a while, and especially for me!

I called to day and cancelled a furniture pickup for tomorrow night: we need to go have dinner with Mom, since it will be the last time that I can get over there for a while, also.

We both seem to NOT be getting too upset over this pending operation. I've not been having trouble sleeping, for example, and Carole likewise. I do, however, find myself thinking as we do stuff together: "Hmmh, this could be the last time I ever do this." So, it's not far from my thoughts, even though this is not thought to be an operation with a high death-risk.

Monday (4/25) is THE DAY.

4/25/05:

Up at 4 am, depart at 5 am, at hospital at 6 am, registered at 7 am, into Operating room at 7:30, just as scheduled. Don't remember squat from then until mid-afternoon when I got into hospital room.

Operation was "open" (rather the laparoscopic), as my surgeon wants the ability to feel the material that he is removing. Discomfort is similar, perhaps a bit less than, open hernia repair that I had a few years back. I'm comfortable in any fixed position; it's just the transitions between sitting/standing/lying that are the challenge. And getting the catheter adjusted in each of these positions so that poor Mr. Dick is at least semi-comfortable.

The first night, I had some bladder spasms from the catheter, but one or two doses of triptophan (spelling?) seems to have quelled that.

The hospital staff made sure that I survived the night, at the expense of getting much sleep!

No food at all, and only permitted a tiny bit of water. Doctor wants to make sure that my bowels are "up and running" again so that I don't develop an impaction.

4/26/05: Surgeon makes "house call": "The cancer was contained within the prostate, we'll have the final pathology report in 2 weeks to confirm that, we were able to spare both sets of nerves, how do you feel?" He really talks in no more words than that, but with a real twinkle in his eye. Further: "If you don't have gas today, you can have a suppository tomorrow. Goodbye."

"As soon as you pass gas, you can have food and water" is the mantra of the day, but no success. The hospital staff is very busy. Fortunately, I have Carole with me, staying in the hotel suite of the hospital. Without her, it would be a real trial: getting up in the morning, taking walks around the floor to encourage the bowels to get going, getting back into bed, etc. Anyone who attempts this operation without someone as a personal helper is brave!

4/27/05: Still no action; suppository inserted, 30 minutes later got results. One of the young people from the surgeon's team reappeared saying "Now have lunch, and if you don't vomit, you can go home." I guarantee you that this is a person who has never eaten this hospital's food --- no matter the state of your health, you would be fortunate to eat the unappetizing slop that they serve without vomiting!

However, with the incentive of going home, I ate enough of it to pass the test, and an hour or so later we were on the road. In retrospect, I'm happy that that was the only food that I was qualified to eat there.

Just as we were getting ready to leave, my roommate (semi-private room), who had had cancer surgery probably of a bit more severity than mine, nearly choked to death. Fortunately, Carole was able to run to the "help desk" and get a nurse. It took the nurse 15 minutes or so to get the guy stabilized. It's frightening how easily one can go from "normal recovery" to "emergency".

4/28/05: We are adapting to life-with-a-bag which I will have for the next ten days. It's no real problem, you just have to think through your moves when dressing/ undressing so that you know which bag you want and whether the bag or the clothes should go on first!

I fashioned a circular cushion out of the type of airbags that one uses to cushion items in shipping (bags, plastic strapping tape, old towel), as I find my perineum to be a bit tender. That's the part between penis and anus. Since I'm sitting so much, it got to be sore enough to require some relief. I made the bags into a "square", except that they are far enough apart that there's an open part in the middle.

I'm still working on finding how best to position the catheter so that irritation to my penis is minimized. Takes a bit of fumbling around after I lie down in bed, for example.

4/30/05: Today marks the return of regularity! Ta da!!!

It is also a very unhappy day: my brother-in-law in France called last night to say that my sister had finally succumbed to her leukemia. It has been a long fight, with bone marrow treatments, etc., and a slowly-declining resistance. So sad to see a vibrant, lovely person die so early (age 59). I have the job this morning of holding Mom's hand (age 92) while we tell her this news.

5/3/05: I am now comfortable enough that I can sleep on my stomach (my preferred situation). Major improvement. Walked 2 miles today - to town hall to pay property tax bill! I am looking forward to 5/9/05 when I get the catheter removed. It's not a major problem, just a continual irritant whenever I get up and sit down rubbing on the end of my penis.

I am getting just a small amount of bleeding out of my penis around the catheter, and have been using an over-the-counter anti-bacterial cream in an attempt to avoid infection. So far, effectively. Each day I am substantially more limber in my movements, which is a nice mental boost. Still can't put my socks on, but I can take them off now.

The family is hard pressed to cope with Laura's death. Particularly her husband. They were a very inter-dependent couple, and I think it is going to be very hard for him to re-balance his life without her. Tomorrow is the funeral, but it's in France, so I won't be able to attend. I suppose that I might be able to make the trip, but I don't know how I would handle some sort of medical problem deriving from RP while I would be on the road. And I'm not supposed to be lifting things such as luggage… So, I will be staying home.

5/5/05: I'm getting tired of the catheter! Whenever I move, the catheter moves in/out of my body a little bit, maybe ¼ inch, and the end of my penis is pretty irritated. This problem is exacerbated by doing the Kegel exercises to tighten up the sphincter muscles because that also causes the same catheter movement relative to my penis. I have tried lubrication with antibiotic ointment, but that seems to dry out too fast. And of course, the surgeon's main nurse is on vacation for this week! The local support group meets tonight: perhaps someone there has an idea. This bothered me enough that we did not go walking yesterday, and maybe won't today either.

May 6, 05: I invented a semi-solution to the catheter irritation problem. I cut a small hole in the end of a condom, and passed the catheter tube through it. I then bound the cut end of the condom to the catheter tube by winding 6 or so turns of sewing thread around the condom and tube, and tying it. Then I filled the condom partly with sterile lubricant, and pulled the condom on as one would normally wear it. Problem solved. Except that the condom tends to come off if I walk a long time with it. But it surely is a lot more comfortable: the lubricant totally solves the irritation problem.

May 9, 05: Today I got the catheter removed. It's a clever device, the catheter. There are really two channels in the catheter tube. One conducts the urine, and the other the saline solution that inflates the catheter ball inside the bladder. The nurse first filled my bladder by pouring saline solution up the catheter. This fills the bladder so that she can determine if it is working properly after the catheter is removed. Then she drained the inflatable ball, told me to lean back and relax, and zip, out the catheter came. It felt like she pulled about two yards of catheter out (a strange feeling, but not painful at all). She then got me to test whether or not I had urinary control (now there's a joke for you!!). I had been practicing my Kegel exercises, but they didn't seem to do a whole lot of good. I could dribble fast or dribble slow, but dribble for sure! I managed to dribble until my bladder was empty, apparently, as the dribble stopped. Good thing that I had the pads with me.

She gave me the pathology report orally: cancer was Gleason 7, bi-lateral, nothing in the seminal vesicles or lymph nodes, there was one small spot along the surgical margin. I am to return in one month for follow-up visit with the surgeon. At that time they will take a PSA reading with a more sensitive test done by a lab (Dyanon) that they find to be most accurate in these tests. That will be repeated one month later. Implication: if those readings start to rise, then radiation.

The progression of the Gleason readings has been interesting: 5 from Johns Hopkins reading of the biopsy, 6 from Columbia Presbyterian's reading of same biopsy, 7 from the Col-Pres reading of the actual excised material. Corresponds to what Walsh/Worthington report in their book: readings are not very precise, and the analysis of the removed organ is frequently worse than that from the biopsy. In retrospect, I'm glad that I didn't wait around, but went aggressively after this thing!

The nurse further said that: some men are continent immediately, and some not for 6 months; most men do NOT have trouble with leakage at night; some men find that they cannot urinate at all and have to have a catheter re-inserted. Now, several hours later, I'm still in the same situation (dribbling). I suspect that it's going to take some time before my body gets back to normal. It's had a hell of a trip, after all.

Evening: I went to the meeting of my church's governing body. I had changed pads (Depends Guards for Men) at about 6 pm, meeting started at 7:30, concluded at 9 pm. Part way through the meeting, I felt the need for the toilet. I was amazed to find on arriving there that the pad was almost entirely filled. By the time that we got home after the meeting, my pants were also wet through. Moral of story: don't leave home without your (spare) pads [thanks to Karl Malden!]

I seem to have little or no feeling that I'm leaking. We did put a plastic mat and towel over the bed linens before going to bed, on my side of the bed. However, during the night there was zero problem. My body let me know when I needed to get up and go. The only problem was not peeing on the floor between bed and toilet, and particularly when backing up to the toilet. (I don't have a strong enough stream that I can stand and pee: it all dribbles down the front of me instead of arcing into the toilet. So I sit. Not a big problem.) I did set the alarm for 3 hour intervals, in case my body forgot its warning function, but no problem with that. Strange that the need to pee is so clearly signaled at night, but not during daytime. I am doing my Kegels: set my watch to beep every hour to remind me. I'm a little confused about exactly how much I'm supposed to contract: around anus only? whole perineum? Base of penis? Gluteus maximus (buttocks)? Guess I need to call nurse for clarification.

May 10, 2005: Talked to the nurse. Basically contract all the muscles from anus through to base of penis, but not really the gluteus maximus. Good, that's what I had been doing.

May 12, 2005: I dribble whenever I'm standing, but am pretty continent when sitting or lying down. When I get up from bed, for example, it takes every muscular effort not to dribble before I'm over the toilet. I'm wearing the Depends Guards for Men all the time. They can hold a surprising amount of urine! At night I don't seem to leak much: only one night (5/11) did I leak significantly: filled the entire Depends, but didn't leak into the bed, happily. I am Kegeling like mad. Can't tell if I'm making progress or not in terms of leakage, but it does feel as though I'm more in control of those muscles, and that I can tighten for a longer period of time before the muscles "fade out". I am now better able to tell when I'm dribbling. Initially, I couldn't tell at all. Maybe next comes the ability to control the dribble?

Since I dribble so continually when I'm upright, I don't fill my bladder to any significant degree. Thus, when I urinate, it's a very weak stream. Unless I'm sitting on the toilet, the urine just dribbles down the front of me. So, I sit! There are worse things in life than that! When I get up in the night, I do have more of a stream because the bladder is fuller. The nurse said to measure progress from week-to-week, not day-by-day, as there are relapses etc. Two steps forward, one back. One of the reasons that I'm keeping this log going is so that I can look back and remember how it was last week, last month, so that I have some gauge of my progress.

May 14, 2005: For the first time today, I feel as though I may be gaining some control over "dribbling". This evening, we went to the local Mexican restaurant for one beer and appetizers, and then to a movie. I did NOT go to the toilet between restaurant and movie, and it was a full two-hour movie. When we got ready to leave the movie, I said to Carole that I would likely have to sprint directly to the toilet once I stood up. But, I did not feel the very strong urge to pee, as I have been feeling, when I stood up, and was able to walk at a reasonable pace to the toilet, without dribbling en route. And even better, especially considering the state of cleanliness of the toilets, I was able to pee standing, for the first time since surgery, without dribbling all down my front. So, I was able to store enough urine to make a steady stream for the first time since surgery. Felt almost like a human being (or as close as I get to that).

May 25, 2005: I am making no progress with the dribbling, as far as I can tell. I think that I would have to go sit on the toilet every 2-3 minutes to avoid wetting my Depends. I am getting up at least twice a night to urinate, but do not leak much if at all during the night. Also do not leak much if at all when sitting. When I am standing or walking, it just runs most of the time, and I have little awareness of it, and no control as far as I can see. I am doing the Kegeling ten times every hour (using my watch chime to remember to do these).

June 1, 05: On 4 of the past 5 nights, I have only had to get up once during the night! Great. Although it's really been no problem to get up - I go right back to sleep.

This morning, I had a good experience. I went to the dentist's for semi-annual cleaning. I sat in the chair for 45 minutes, got up, and was able to wait comfortably for the toilet to be vacant. I then passed perhaps a cup of urine! That's at least twice what I have been able to retain since surgery without leaking. Seems like progress. Then I went to church where I was on my feet doing some serious physical work, and unable to take any pee breaks. I soaked through my Depends for the first time in a while. So it's one step forward and a half step back. But as I keep saying to myself, it's only pee, and it's mine anyway, so what's the difference.

June 9, 2005: Follow-up meeting with surgeon today. Pathology report and his analysis: I was a T2b, with a Gleason of 3+4, and both lobes involved. There was one cancer spot on the margin of the removed material. His guess is that this is not significant, as usually there is more material removed at the margins that never makes it to pathology lab (cauterization, etc.). He took a blood sample for high-sensitivity PSA test, results to be available next Tuesday.

No restrictions on my activities, now. The little bump on my arm, which was larger following surgery, is a thrombosis (blood clot). Not to worry about this, as they never move to the heart. Over time it will be re-absorbed and go away.

Since I am still dribbling quite a bit, I asked him to check my Kegel-ing practice. He concluded that I am not doing it nearly hard enough - have to put your whole being into the effort to have success. Best way to tell how hard is to have a gloved finger inserted in your anus. Fortunately, I have some gloves!

He gave me a sample pack of Viagra in case I am anxious to get back in the saddle. He thought it a little early to be effective. He says that the common side-effects are sinus-type headache, blue-tinged vision, and in rare cases (p = .000001), blindness (permanent)! I think that I will wait for "natural" recovery of this function. Surgeon predicts that I will be dry and potent.

June 15, 2005: Yesterday I had a sudden real improvement in my dribbling - I worked the whole day on my third floor renovation, mostly standing and walking around, which are the most likely dribble-times. At least through noon, I had dribbled almost not at all! Hooray.

Today, again, I seem to be retaining more urine before it overflows: When I urinate, I'm releasing a lot more urine. Still, I have almost no sensation of needing to urinate --- I mostly pee by the clock. Since I have my wristwatch set to chime at each hour in order to remember to Kegel, that's the time that I go pee as well.

July 7, 2005: Had my second follow-up visit with the surgeon. The PSA test from June was undetectable (less than .01), which is a good sign. He took another sample today.

I am gradually getting better at managing urine flow, but it's a slow process. If I am working quietly, at my desk for example, I'm better able to recognize when it's time to pee, and therefore get less leakage. When I'm working on a project by myself or with others at church, for example, then the time tends to fly by, and before I know it, I'm dripping. It's similar with remembering to do the Kegel exercises. Again, if this is as bad as I ever have to cope with, then life is a breeze!

January 20, 2006: It's now been 8 months since my surgery. I'm doing very well.

My "dribbling" had been gradually getting better, to the point that in December 2005 I felt that on most days I was losing less than a quarter of a teaspoon of urine. Then one day I forgot to put on the Depend, and I was fine. On the first of January 2006, I decided that "that was it, I was done with the pads". Declare victory and move on. Since then I have had only one time that I leaked a little. As long as I pay attention to the urge to pee, and don't try to "do one more thing" before I go to the toilet, I'm OK.

I still have no erections at all. I have the occasional "tingle" that in the old days would have been advance notice that an erection was on its way, but it doesn't inflate more than about 10% of what would be required to call it an erection. Fortunately, our marriage is built on more than sex, so it has not been much of an issue for us. And masturbation still works fine, though it's a little strange to have a climax with a limp dick!

My PSA is still below 0.01 - the doctor checks every 4 months for the first year, then goes to 6 month intervals.

March 23, 2007: No change really since the last report. I remain healthy, with no recurrence of prostate cancer. My PSA remains unmeasurable (less than 0.01).

I have no real erections --- If I look at sexy material, I get maybe a 20 or 25% erection, but it wouldn't be enough to accomplish a "normal" vaginal penetration. I also don't have an much interest in sex, though that maybe at least partly due to normal aging?

I never think about having had cancer, or worry about a recurrence. I'm satisfied with my treatment and my surgeon. For me, I made the right choice.

Bob

I continue to be at zero PSA. I am not under any treatment program -- just normal living! I get about a 20% erection, not enough for doing anything useful with it, but I'm OK with that as a tradeoff versus having cancer.

Good luck to everyone who is going through this process.

Bob

There has been no change since my last report in July 2008. Doing fine, never think about it (having had cancer). Life is good.

Bob

There's nothing new to report: PSA stays at zero, no long-term effects from surgery aside from continued impotence and very occasional "dribbling". This dribbling occurs sometimes when I stand up from a sitting position if I forget to tighten my muscles first, or if I workout too hard at the gym, or if I wait too long after feeling the urge to urinate ("I'm busy doing something here, just wait a minute!") That turns out not to be a good idea. But, after all, it's only a few drops of piss!

Bob

Nothing new to report: I continue with a zero PSA score, a small amount of "dribbling" when I lift too much at once, but otherwise no complaints.

Nothing new to report; life is good.

I'm still here and kicking. No recurrence, no symptoms. One of the benefits of having had the prostate removed is that I sleep through the night without having to get up to pee. If I go to the movies and drink a huge soft drink, then I will have to get up, but not usually.

It has been a LONG time since I checked in here! I'm doing fine at age almost-82, though a little less energy than I used to have.

I've had no further incidences with prostate problems of any sort, ad remain disease free. I do have some dribbling when I stand up or sit down, but the lightest of the dribble-pads contains it for a whole day. It's a little annoying, but better than some of the alternatives!

I did have my PSA re-checked several years back, just as an excess of caution (no symptoms), Undetectable.

I hope that many of you are faring as well as I have been fortunate enough to do.

I'm happy to answer any questions.

Bob Chapman

I continue to be healthy, without recurrence of cancer. My only compaints are that I dribble whenever I sit down or stand up: just a "spurt" usually, then finished. I've sometimes thought that drinking alcohol increases dribbling/leakage, but hard to be sure about that --- life is too complex to isolate individual effects such as that.

Cialis and Viagra continue to give me "enough" erection to have successful bedroom exercise. Happily, my wife is encouraging and helpful.

I had a PSA re-test at 10(?) years just because I thought it was a good safety check, but nothing detected.

I continue to be fine at age 84. My only issue is that I dribble as I stand up or sit down, and sometimes I have uncontrollable urgency to urinate. I always were a "light" dribble pad, which occasionally doesn't have enough capacity, so I get wet. All in all, an OK situation compared to the alternatives!

Bob's e-mail address is: bob_chapm AT msn.com (replace "AT" with "@")