Prostate Cancer: My Experience
July 29th, 2008 | by admin |close windowUse the following HTML to link back to this content:
IGNORANCE IS BLISS …… BUT DECEIVING
Although I would never have had the courage to make a joke in the earshot of the ladies, I noticed in their late 40s my wife and our lady friends began, one by one, to gather in parties, whispering about the trials of their imminent or ongoing ‘changes of life’. As time passed, though, their frustrations grew and they weren’t so secretive in sharing their problems and husbands were drawn, hesitantly, into the conversations. In my naiveté (or stupidity), it didn’t cross my mind then that an even more dangerous gender-specific problem was lurking in the future for me and too many guys like me.
My wife is a retired nurse so she is a ’stickler’ for our getting the recommended medical examinations in the frequency suggested. There is no telling her, ‘No. I don’t want to.’! Of course, those exams include, at least annually, the particular exam guys hate most, the digital prostate exam (DPE) and prostate specific antigen (PSA) blood test. There is nothing more embarrassing (I thought, then) than trying to make small talk while a doctor inserts a rubber gloved finger and probes into the ’south end’ of a north facing guy, bent over an exam table! Embarrassing, but I know necessary, so I gritted my teeth and made that awkward small talk each time. For years, my doctor, fortunately, found nothing in his exams.
Digital exams are supplemented by the PSA test - a blood test in which the antigens produced by a cancerous prostate can be detected in a man’s blood. Doctors will generally want to perform an annual PSA test beginning at a patient’s age 50 unless a family history of high incidence of prostate cancer suggests an earlier or more frequent test for an individual. A high PSA or a rising PSA is certainly a worrisome signal. I do not have a family history of prostate cancer and my PSA was about .5 for three years and the ‘normal’ range is between .03 to 3.89 so I was feeling pretty good about myself!
DIAGNOSIS - FINGER AND BIOPSY
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Suddenly, when I was 55, though, my doctor, after finishing the DPE and telling me I could pull my pants back up, didn’t tell me the usual ‘feels normal’. This time, he said something which got my attention: ‘I felt a little something - very little, but something - and I think we ought to have a specialist take a look, too’. Definitely something I did not want to hear! Having been blissfully ignorant about my prostate to that point, in the time it took to set up an appointment with a urologist, I did some research into what that ‘little something’ might be. What I learned from the Prostate Cancer Foundation (www.prostatecancerfoundation.org) and from my doctors, subsequently, should be of interest to every man.
What is the prostate, though, and why is this walnut size gland so important? The prostate is located between the bladder and the penis and in front of the rectum. The urethra, the tube which carries urine from the bladder and out of the body, passes through the prostate and, very importantly, the extremely small nerves which control erections are attached to both sides of the prostate. The prostate’s primary function is to produce the seminal fluid and it and sperm pass through the prostate during ejaculation. It is surrounded by sensitive and vulnerable nerves and blood vessels which greatly affect urination, erection, and ejaculation. Processes of no mean significance to every guy!
I learned more in my research, too. One of every six men will suffer prostate cancer in a lifetime and, in fact, a man is 33% more likely to face prostate cancer than a woman is to suffer breast cancer. Fortunately, 86% of prostate cancers in the developed world are diagnosed early and the five year survival rate is nearly 100% and the survival rate at 10 years is 86%. Fortified with this information, I was more assured when my new urologist felt the same ‘little something’ in the DPE he administered and called for a prostate biopsy.
The biopsy was certainly another ’step up’ in embarrassment! On the appointed day I reported to the urologist’s office and a registered nurse escorted me to an examination room. She told me in her most reassuring voice what to expect and how to prepare. The doctor would insert a device into my rectum, holding her fingers apart to demonstrate the size of the device. About the size of a small corncob! He would use the device to take a few ‘photographs’ of my prostate and, then, take several tissue samples from it. I knew this was not going to be a ‘walk in the park’ but I knew, too, it was a necessary experience. When she was certain I knew what to expect, she told me to strip from the waist down, lie on my side on the examination table, cover myself with a sheet already folded on the table, pull my knees toward my chin, and await the doctor’s and her return .
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In a moment after I had prepared as ordered, my doctor, accompanied by the nurse, entered the room and offered a cheery greeting. I am certain my greeting was much less cheery and witty as he rolled a chair near my hips and readied the equipment. He asked if I knew what was going to happen and I tried to make some silly joke to confirm I knew everything and that I was cool and collected. Moments after he asked me if I was ready, I felt the lubricated device push into me as the doctor began a running commentary to explain what he was doing. First, he took the photographs but I only heard a small buzzing sound without any other sensation at each exposure. Then he announced he would begin to take the 10-12 tissue specimens. I noted the nurse moved to my side, placing her hands on my leg and arm and leaned her body into my hips so I would be absolutely still as each sample was taken.
There was a pinching feeling as each sample was taken from the prostate and extracted. Not painful, just a pinching feeling each time. As the specimen was extracted, it was taken by the nurse to the opposite side of the room and cataloged according to the point from which it had been removed from the prostate. Before each specimen was taken, the nurse would return to lean into me. After what seemed to be a long time - but only about 10 minutes - the procedure was over, the doctor left, and the nurse instructed me to dress. She returned in a few minutes to tell me what to expect ‘post procedure’: a little tenderness and, for several days, blood in my stool, urine, and semen. She told me since it was Thursday I should expect the doctor’s call with results early in the next week.
I drove home, thinking seriously about the effects of blood pooling in various places in my body, so I decided to do a little ‘research’ and ‘procedure’ on my own. In the privacy of my bedroom, I performed an act which little boys are always told will make them ‘go blind’ but, in this case, I convinced myself was a necessary ‘medical’ procedure. I am glad I did because I was a bit disconcerted and a lot amazed when my ejaculate consisted of nothing but bright red blood! That’s a sight for which it is difficult to prepare. Getting ahead of myself in this tale, I performed the same research a week later and the ejaculate was black and like ’sludge’. A very, very disturbing sight which I don’t want to see again! Anyone having a biopsy is wise to know these effects so he or a ’significant other’ isn’t shocked if this occurs without warning! Could be the end of a fragile relationship!
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Early in the morning after the biopsy, I answered the phone and was surprised to hear my urologist’s voice. Immediately, I knew this could not be good news since it was too soon and I suspected doctors only call with bad news. Unfortunately, I was right! My doctor told me he was surprised but my biopsy indicated a very small, localized cancerous tumor and asked me to set up an appointment with him in the next few days to discuss what we should do about it. He cautioned me not to be too worried but we would have to make some decisions in the near future. My wife was running errands when the call came in but I told her immediately upon her return. She was worried, of course, but comforted when I told her the doctor’s description of the small size of the tumor and how good it was it had been detected early.
WHAT NEXT?
We made the appointment for a few days later and I spent those days getting even more deeply into online research of the various treatment options I would be offered. I learned there are several options and choosing one is a decision reached between an individual and his doctor(s) based on the advantages and disadvantages of a particular treatment and the patient’s age and general health. The treatments include some combination of surgery, radiation, hormone deprivation, chemotherapy, dietary changes, and the use of herbal supplements. My research indicated doctors often disagree about which treatments are best and, in any case, a choice for one individual will not be the best choice for another.
Certain factors seem to be in general agreement, though. First, prostate cancer is, generally, a slow growing cancer but it grows fastest in the ‘young’ men who have it. In this case, a rough rule is ‘young’ is below 60 years of age. Men older than 70 with a diagnosis can expect the cancer to grow much less rapidly. Second, the most aggressive approach is a surgical removal of the prostate - get it out! - and the other treatments attempt to reduce the size of the cancer over time to minimize its long term effects. Sounds pretty frightening, doesn’t it, so the reader can imagine the anxiety I felt as the appointment neared. My wife and I had already discussed our research and we agreed - unless my doctor strongly suggested otherwise - to go for the most aggressive approach, surgical removal of the prostate. At age 55, we decided that would be the best way for me to go.
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We were not surprised in my appointment as my doctor began to lay out the several options and their advantages and disadvantages. They were pretty much in line with what we had learned and nothing which suggested we should change my ‘preference’ for surgery. The biggest concern for me was the bladder catheterization for a week or two following the surgery and the very probably short- hopefully, short - term urinary incontinence. I knew, too, that erectile dysfunction was probable in the short term. In both cases, my doctor told me the effect usually lasted for 6-8 months for someone of my age and generally good health. Neither was something to which I looked forward, of course, but they were problems I concluded were worth having for that period of time to get the cancer out!
My doctor ensured I understood he was a urologist and surgeon and might be biased in believing surgery was the best option while a radiologist and oncologist might prefer radiation or chemotherapy and hormonal therapies with which they would be more comfortable. I decided I didn’t need other opinions but decided that morning on the surgical removal of my prostate. Another patient with a comparable diagnosis, though, might want to consider second and third opinions to discuss the other options.
We did have to decide when the surgery would be done. It was January but my wife and I and several friends were already scheduled for a three weeks cruise and roadtrip in Europe in May, not something I wanted to do too soon after surgery. My doctor surprised and pleased me, though, when he stated the small size of the tumor and my very low PSA numbers meant we could wait a few months so we decided on surgery in June, after our return from Europe. He said, though, he would want to do a computed topography (’CAT’) scan of my abdomen and pelvis before the surgery to determine if the cancer had spread beyond the prostate, sketching out how much cancerous tissue he would have to cut out. He also said he would want me to submit a ‘2 unit red cell autologous donation’ so I would have my own blood platelets, red cells, and plasma available in surgery to put back into me, if necessary.
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My CAT scan was done in early February in a Tucson medical services clinic. Since this was my first CAT scan, I was not absolutely certain of what to expect. I did know CAT scans frequently include the injection of an iodine dye to provide a ‘contrast’ for the equipment. I understood, though, my doctor did not want a contrast dye injection and I had a medical appointment sheet which seemed to confirm that - the block specifying ‘dye contrast’ was not marked. That made me feel less anxious about the procedure - no needle! When the appointed time came, though, I was escorted into the CAT scan room and, when the technician told me what was going to happen, he stated he would inject a dye into my veins! I responded, of course, that my understanding and my sheet of paper indicated ‘no dye’. He said he always injected dye and, in any case, the order from my doctor from which he was working indicated ‘dye’. He showed me his sheet of paper and there it was - ‘dye’ clearly marked with a big ‘X’. A ‘bummer’ and a battle I knew I couldn’t win so I meekly submitted to the needle .
The tech told me before he began that I would feel a ‘wooshing’ feeling and a bit warmer but it wouldn’t be too bad. Thankfully, he was right and the dye injection didn’t bother me. After the injection, he pushed me into the scan for a few minutes and I felt nothing while I was being scanned. Not too bad an experience to be able to talk authoritatively at parties about ‘my CAT scan’! A telephone call a few days later from the doctor’s office informed me the CAT scan indicated no spread of the cancer: fantastic news, of course, and permitting the plans for surgery in June to go forward. Another good exam result and one confirming we had identified this beast early.
The next several weeks passed without additional procedures and we were able to depart for our trip to Europe. As I enjoyed the trip, though, the knowledge I would face surgery shortly after our return certainly dampened my enthusiasm in those moments when I remembered it. I was still comfortable with the choice of the surgery option, though, so I did not question my decision.
We returned to Tucson in early June, giving me four days to rest before my autologous blood draw. I didn’t know what to expect in this procedure, either, but it turned out to be similar to donating blood. I was asked to lie in a large, soft chair for about 30 minutes while a nurse drew blood from my arm and routed it through a machine from which the needed elements were withdrawn. Then, what was left of my own blood was returned to me through the same tube. I just sat quietly and watched a televised movie as William Holden played a priest in China resisting Communist soldiers as they occupied his village! The procedure was so short I could not enjoy much of the movie! The blood would be shipped to Tucson Medical Center where my surgery would be done, waiting if I needed it. It would be destroyed if I didn’t need it. I confirmed that point because - as I reminded my doctor and the technicians who drew the blood - my six+ years in Europe from 1988 to 1995 included potential exposure to ‘Mad Cow Disease’ and the American Red Cross will not accept my blood donations in the fear its recipient might be contaminated.
SURGERY
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The chosen date for surgery was June 23. Of course, the fun began the day before when I had to consume what seemed a huge quantity of the Fleets laxative to clean my bowels the night before and deny myself any food and drink after midnight. Not a pleasant process but one I had completed before so I knew the taste of the Fleets would be bad but I would survive. I just screwed up my nose, drank down all that stuff, and stayed close to the bathroom because if one medical product works efficiently, it’s the Fleets!
I was scheduled for a very early surgery so my wife and I were up very early the next morning and standing in front of TMC’s sign in nurse several minutes early. After the necessary sign in paperwork and having provided the correct answers about my empty bowels and stomach, I only had to wait for a few minutes before being called back for the final preparation. That included stripping completely, giving my clothes and valuables to my wife, putting on the always horrible hospital gown which never, never closes completely in the back, and lying on a gurney. Of course, more hospital staff entered the room to ask the same questions, over and over again, as they checked the information on my new plastic wristband: what is your name?, who is your doctor?, what is the procedure you’re going to have?, did you cleanse your bowels?, have you eaten or had any food or had liquid? I realize this redundant checking was necessary to ensure I did not undergo a hysterectomy by mistake but it does become rather silly after the fifth or sixth time.
After 10 or 15 minutes, an orderly arrived, I kissed my wife goodbye and he pushed me down the hall into a larger room - a ‘preop’ room - in which my gurney was rolled into a line of other gurneys with other patients also waiting for the final move into the operating room. Here the surgeons had a last chance to talk to their patients and the doctors and nurses who were going to administer anesthesia visited their patients and gave them the first little bit of anesthesia. As I lay awaiting my doctor’s final visit, I listened to the soothing, reassuring conversations between the doctors and anesthetists and the patients. To take my mind off what was to come, I listened in and tried to determine what sort of surgeries those with me in the ‘lineup’ were going to have. Seemed to be a pretty wide range of maladies needing correction!
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Soon, though, my doctor arrived in his ’scrubs’, looking much too young to be very good at this. He assured me everything was going to be okay and I told him I was counting on him to make that the case. He smiled, told me he would see me after I left the recovery room, and left. Only a couple of minutes later the ‘gas passer’ arrived and introduced himself. I have had one surgery in a military hospital and three in civilian hospitals and I met the military anesthetist a couple of days before the surgery and we discussed the various options. In my civilian surgeries, I met the anesthetist only minutes before I was moved to the OR, after I had already been given some ‘relaxants, and only then discussed the options. I wonder if the difference of when one speaks to the ‘gas passer’ is ‘policy’ or just the way it happened in those occasions?
The newly introduced anesthetist told me he was going to start an IV and it would burn a little. I wasn’t surprised because I knew the line would have to be a relatively large one. And burn it did but he must have turned the ‘ magic valve’ because I recall his being beside my gurney and, then, the next thing I remember I was in the recovery room, or perhaps it was my hospital room. I wish I could state I remember something of that long period of time from the preop room to my waking up but I don’t. I know nothing of what happened in the operating room.
On fighting my way from the fog in my head, I noted my wife and someone who had to be a nurse were standing beside me, both peering down into my face and asking me if I knew my name and where I was. Silly women! Of course, I did but I couldn’t understand why it was taking so long to make my mouth say the words proving to them how smart I was! Thankfully, as we each looked into the others’ eyes, the fog slowly began to clear and I was able to answer those questions and even tougher ones, too. The nurse asked if I was in any pain and I told her that I really wasn’t. She told me that I could expect some pain, though, but the staff would give me pills to take care of that and antibiotics as a standard procedure to prevent infection.
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After the fog had fully cleared, I began to take stock of my body. I noted a lot of bandaging on my lower abdomen and a plastic tube running into the bandaging on one side and running out the other side. I didn’t like the look of that but the nurse told me not to worry; this was a standard drain to take away fluids from the incision area. I didn’t fully realize then this tube ran beneath my skin in the abdomen! Although I couldn’t see one end of it beneath the bandaging, there was also another tube running into a plastic bag hanging from my bed. The nurse explained this was my catheter to drain away urine. This was my first time to be catheterized so I wasn’t sure how that was supposed to feel. I tried to feel something but I didn’t. Thankfully! For the moment, that was all I could see but I later saw the several incisions and that I had been shaved completely from about the navel downward. I had a ‘blinding flash of the obvious’ and realized that a person or persons unknown, male or female, had shaved me and catheterized me. One day I’ll be walking down the street and someone will have a flicker of recognition …….. and won’t laugh, I hope.
After a while, my doctor dropped in for a few minutes to check on me and to let us know everything had gone very well and he hadn’t found evidence the cancer had spread into my lymph nodes or tissue surrounding the prostate. I thought about asking if I could see this little thing which caused so much trouble but thought better of it. I was in no shape to take the look I would have gotten from my wife! He told me he wanted me to stay in the hospital for a couple of days for them to monitor me and to ensure there was no infection and then he left for his other patients.
HOSPITAL STAY
The next couple of days were uneventful. Well, as uneventful as being in a hospital can be. No one expects the food to be very good - just bland - but that’s not what I remember most, that is, the great number of nurses and other staff who came to check on my IV, bandages, drain, and catheter. Someone’s checking every few hours that the IV bag had the right antibiotics, for cleanliness around my incisions, and to empty the drain and urine bags. Picture this. A woman walks briskly into your room and you’re lying there with your legs covered by sheets and a blanket but spread wide and those tubes are running in every direction and there is an IV in your arm. Not at your best! Nevertheless, the woman - always a woman and without announcing her intent until well underway - pulls the covers down and your gown up, completely exposing your privates and she inspects here, looks there. She then usually emptied the drain of that ‘liquidy’ stuff on one side of the bed and the urine bag on the other side. And then, she is gone to the next patient! I know they were doing their job and doing it well, but my privates don’t enjoy being at such a disadvantage! Should the nurses have been required in fairness to disrobe, too? An interesting ‘medical protocols’ question! Under the rules in place, though, two full days of this and I was ready to go home as soon as possible!
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For sure, I couldn’t figure out the medical staff’s schedule! There is something about the night schedule, though. Nurses come in every two hours or so to take vital signs and each morning at 4:00 am a technician came into my room, threw on the lights to their brightest, and drew blood. Very difficult to get sleep that way! Then, at about 6:00am, a nurse would enter the room and ask ‘cheerily’, ‘Did you sleep well?’ Was that a rhetorical question or just something learned in nursing school?
The last morning in the hospital a nurse entered my room and announced to me and my wife I had to have my first true shower. I was all for that but I wasn’t exactly certain how I was going to shower with all these tubes attached. Not to worry, of course, she and my wife helped me from my bed and I walked slowly to the bathroom and shower as they guided all the tubes and bags, preventing my getting too entangled. Of course, my embarrassment wasn’t over because they had to assist me remove my gown over the tubes but I was allowed somehow to shower alone behind the shower curtain although they stood near the open door if I needed assistance. Dignity is so fleeting!
GOING HOME
Feeling clean, at least, and ready to get some real clothes on, I awaited my doctor’s visit to okay my discharge and perform one other key procedure - the removal of the plastic drain tube which passed through small incisions on the left and right side of my abdomen. I knew my catheter would remain in for a while but the drain wouldn’t go home with me. When the doctor arrived, he told me I was doing very well and he confirmed I showed no signs of infection so I could go home. Without much preparation or warning, he pulled up my gown - notice a trend here? - grabbed one side of the drain, tugged firmly, and, ‘ziiiiiiip’, it was out! Another one of those ‘feelings’, not painful but ‘funny’ and difficult to explain. But I was on my way home to my own bed with no nurses in the room at night, shower, and food with a little spice to it! I would have to figure out how to manage all the bandages, staples, tubes, pumps, and bags but I wanted to get home.
I had a ‘pain pump’ for the first three days at home attached to a small tube in my abdomen so pain medicine could be administered automatically at a slow rate. I don’t recall much about it so it must have been doing its job. At no time - from waking up in the Recovery Room through my entire recovery period - do I remember any particular pain.
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The catheter was to be my constant ‘friend’ for the next two weeks, though. I had two types of bags to attach to the catheter - a large one which I used at home and a small one which could be strapped around my leg and, wearing long pants, it allowed me to travel. I kept the large one in a plastic bag so I could move about home pretty easily and even entertained visitors with ‘bag in hand’. I could take it into the shower, too. I had to empty it every five or six hours and it would be very full when I awakened each morning. The traveling bag was much smaller so I had to empty it much more frequently, e.g., going to a restaurant restroom and hiding in the toilet stall to drop my pants, close the valve from the catheter, and open the bag’s empty valve. I hope I didn’t frighten anyone who might have gotten a glimpse of this process!
My doctor saw my wife and me two weeks after the surgery to remove the catheter. In what was becoming a too frequent position, I lay flat on my back with my privates covered only by a small sheet when he came into the room. My wife sat a few feet away. He examined the area and told me he was satisfied the incisions were healing well and, then, he asked me if I was ready. I sort of was but was still caught by surprise when he turned his head to answer a question from my wife and, with his head still turned, grabbed that catheter and gave it a quick but strong pull! I had been warned by a friend who had been catheterized for a while to expect pain but, again, the removal wasn’t really painful, just a ‘rushing’ feeling as I could feel the tube being pulled from my abdomen out through my penis. Too bad I couldn’t actually watch the process. I had to ask my nurse wife who has ‘played’ with many catheters in her nursing career what it looked like! Realizing it had been extracted, I joked with the doctor as he threw it into the trash can: “Okay, doc, I’m ready. Do it now!’ He didn’t laugh as much as I thought he would!
‘DEPENDS’
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Of course, the surgery and catheterization had ruined my bladder control, hopefully, temporarily. My best friends became a variety of bladder incontinence products - liner pads at first and, then, for trips away from home, full absorbent underwear (one brand name: Depends). I hoped to get by just with the pads but a few days after the catheter was removed I had a terribly humiliating experience at a automobile tire shop as I sat while my tires were changed and some other unexpected, time consuming work was done. I had not expected to be away from home so long so I had not brought ‘replacement’ pads. As I waited for the work to be finished, the pad was saturated with urine and when I was called to the counter to pay my bill, I noted with horror there was urine running down my led and pooling at my feet! Luckily, there was no one behind me in line and I was able discreetly to spread the pool around with my shoe. That experience convinced me for a long while to wear only Depends types of underpants when I left home. They hold so much more than those pads. Of course, they’re glorified diapers as was emphasized to me one day as I pushed a Safeway grocery cart and noticed an advertisement attached to the cart. The ad was pushing ‘Buzz Lightyear’ diapers for little boys! Of course, thereafter, I called my pants ‘Buzz Lightyears’!.
EXERCISING FOR CONTROL
I had not regained full bladder control several weeks after the surgery and catheterization so I began my Kegel exercises to end this ’stress incontinence’. Kegel exercises strengthen the muscles that control the bladder and, although designed for women, can be used by men, too. They can be done anywhere, anytime so the person sitting next to you right now may be doing his or her Kegel exercises! In essence, the exercises require identification of those muscles which stop or slow one’s urine flow and, then, squeezing and relaxing those muscles several times, 3-4 times per day, for months if necessary. No cheating, though - can’t use the muscles in the stomach, leg, or buttocks. It’s not ‘heavy lifting’ but try identifying just those muscles! Okay. You’ve had a couple of minutes. Not so easy, is it? And boring, too, so keeping focus is difficult.
The exercises improved my bladder control from practically ‘no control’ to an occasional leak when doing one of those things women seem to fear - laughing, sneezing, coughing, bending over, lifting, etc. - but my doctor and I decided we needed a bit more. This bit more was a formal physical therapy program which insurance companies are increasingly accepting as a valid program. It took a couple of weeks for my insurance company to authorize a once a week, six session regime but with that authorization, the program began in earnest. And I met Amy!
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Amy was the nurse who worked me through the PT program and the description of my program demonstrates how much she got to know about me, more than any woman beyond my mother - and not to that degree for almost 50 years! - and my wife. I tell my friends the program consisted of ‘an attractive nurse, electrodes, lubricant, and an electric probe’. Each session began with Amy’s directing me to a room and ordering me to remove my pants and underwear and to lie on a reclining chair with a paper drape across my hips and leaving the room to give me time to follow orders. Upon her cheery return, she would insert a lubricated probe - ‘my little Sparky’ - into my anus and, while I went through a series of Kegel exercises, she cranked up the electricity into the probe until I could feel a little ‘prickly’ sensation deep inside my abdomen. Not painful just ‘prickly’. I squeezed and rested for about 20 minutes in each session while Amy’s computer recorded the efficiency of my muscles. Of course, I used this ‘quiet’ time to ask Amy the most embarrassing questions about urination, and erectile dysfunction and she gave me candid, impassionate answers, e.g. ‘Viagra might help and your doctor could give you a sample’. Embarrassing as these sessions were initially, I managed to grow more at ease with a woman working around my most naked, private parts. There was embarrassment, though, particularly when the probe would ‘pop out’ after a particularly forceful squeeze, and Amy would have to peer around my bent leg to reinsert the probe! An angel of mercy!
Between the six sessions, I had to maintain a log of my daily urination, the timing and ‘pressure’, and Amy would review this log just prior to each session. Thankfully, the log demonstrated my continuing Kegel exercises and my PT program were having a noticeable effect. I was slowly regaining normal, pre-surgery bladder control.
FOLLOW UP
My doctor requested I undergo a PSA blood test in the following December and my PSA was less than .1, exactly where he wanted it to be and a very good sign. I will see him every six months or so for an indefinite time so he can continue to monitor my situation. As a real plus, I think I may have undergone my last DPE since the prostate is gone and there is nothing to examine. I am now more than four years from my surgery and I am glad I decided to have my prostate removed rather than another therapy. The cancer is gone and I’m not merely trying to reduce its size. It may return in adjacent tissue and, of course, I am as subject to another type of cancer as anyone but that is something I shall face with everyone else. My bladder control is about 99% of where I was presurgery and where I want to be and I still try to do my Kegel exercises daily and wear a pad daily.
FOLLOW UP TO FOLLOW UP
My second follow up examination with my urologist occurred in July 2007 and, again, my PSA was less than .1, more great news. He and I discussed my erectile ability and bladder control and I told him I was about ‘85% in the first case and 99.5% in the second’. He offered to prescribe something like Viagra if I wanted it but I told him, ‘Not yet.’ I told him I continued to wear incontinence pads most of the time ‘just to be. I learned something entirely new to me, though, something I must have missed in all the previous discussions and research: my doctor told me I will never ejaculate again. I had not really thought my way through the implications of losing one’s prostate, despite my research, and I don’t remember hearing that. My wife told me later she was aware of that side effect of the surgery so she wasn’t surprised.
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She and I are well beyond having children but other men diagnosed with prostate cancer and who want to procreate must consider the implications of having their prostate removed. Granted: most men who are diagnosed are older but, in any case, no fathering children unless they can impregnate their partner before the surgery or provide sperm for later artificial insemination.
An inability to ejaculate affects the sex act, too, of course. A friend who is the wife of a 61 year old friend newly diagnosed with prostate cancer asked me if this is important. I said, ‘It is ……. and it isn’t. It’s like reading a thrilling short story or novel as the drama builds in the last few pages. As you turn to the last page to learn who the murderer is, the page is blank. And the next page is blank, and the next page, and the next page, to infinity. More than a little frustrating? You bet! Certainly something to think about.
Although the specifics of another individual’s experience in responding to a diagnosis of prostate cancer may be different, I hope enough of mine will be the same to make this helpful ….. and encouraging. After all, one in six men will have to face the same choices as I.
Stumble it!
