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AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 9/30/2008 9:04 AM (GMT -6)   
Hi. I was diagnosed with prostate cancer on 9/23/2008, so I'm just starting out in this process. Met with doctor again yesterday for a Q&A session, but there are a few I forgot to ask:

1) Those nerve bundles they talk about saving - do those nerves also provide sensation to the penis, or is that a different set of nerves?

2) Just how does a pill work? Does it "force" an erection, or is there some mental control over this event?

3) Can you have an orgasm without an erection?

thanks in advance

AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 9/30/2008 9:31 AM (GMT -6)   
Oh, and one more:

Now that I have prostate cancer, does that mean my risk factors for other types of cancer are also higher?

thx
Diagnosed on 9/23/2008
Gleason 6, T1c
clueless otherwise


Art662
Regular Member


Date Joined Sep 2008
Total Posts : 54
   Posted 9/30/2008 9:46 AM (GMT -6)   
Hey astro -
Welcome and you will find many, many helpful people here.
I do not have PC - but can answer #3 which is yes, you can.
1979: Organic impotence at age 25 from drug reaction to coumadin.
1979 Half shunt & vena cava clip emergency surgery - 4 weeks in Ohio State Medical Center
1981 IPP implanted - 3 1/2 weeks Baylor U. Houston by F. Brantley Scott
1981 IPP replaced - 10 days Baylor U. Houston by F. Brantley Scott
1985 IPP replaced IPP due to implant shift - 1 week Mayo Clinic by William Furlow
1985 IPP replaced, penile degloving to correct scarring, shortening and cylinder contracture. Suspensatory Ligament procedure - 2 1/2 weeks Mayo Clinic by William Furlow
1989 IPP replaced, repair of Tunica albuginea around corpora cavernosa . Degloving to relive penile shortening - 10 days Baylor U. Houston by F. Brantley Scott.
2000 IPP removed due to fluid loss and possible infection - 6 days Cleveland Clinic by Dr. Karl Montague
2000 IPP replaced - 4 days Cleveland Clinic by Dr. Karl Montague.
2002 IPP replaced, penile degloving to correct penile shortening due to IPP removal for 2 months. Repair of Tunica albuginea around corpora cavernosa - 3 days U of Washington, Seattle Dr. Richard Berger.


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/30/2008 10:01 AM (GMT -6)   
Welcome to HW. Sorry to hear about your dx, but glad you found us. I'm not sure about the first question, but I believe the nerves are responsible for erections, not necessarily feeling. Therefore, the reason to try and spare the nerves is to prevent ED. Question 2: The pill does not "force" an erection. There is a mental component and it obviously doesn't work for everyone. It is a PDE 5 inhibitor, which means, it helps increase the blood flow to the penis. The pills have been very successful for a large percentage of men with ED, but not for everyone. Question 3: Yes. Good luck and keep us posted on your journey.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 9/30/2008 12:10 PM (GMT -6)   
Welcome to the club, sorry you havd to come.

The nerve bundles are for erections. Sensation nerve bundles are located elsewhere in the abdomen. There are 2 branchs or bundles that run along the outside of the prostate and its supporting structures. During surgery, it is carefully cut away from the prostate, trying to do as little damage as possible to them during the prostate removal. Just the act of moving them and seperating them from the gland creates some damage, sometimes more severe than other times, depending on the surgeons skill and your good or bad luck. Regrowth and repair is a slow process, taking upwards to 2 years in more severe cases, short months in most.

I haven't seen any studies that say you are at an increased risk for other types cancer. The prostate cancer cells themselves are specific to the disease, not like they are generic to any others.

Pills work to dilate the blood vessels in the abdomen and penile area, to allow a natural flow of blood to allow an erection. It does not create, stimulate or in any form trigger the act of erection. You must still be stimulated or aroused, just like you used to be to get an erection. So it isn't a magic 'stimulating" pill.

Yes, orgasm without erection is possible and usually the first way that we are able to after surgery. The feelings may be less or even more intense, and the ejaculation will be dry, but each one will improve in intensity for most people. Loss of urine during orgasm is common for a while, but most learn how to control it with practice. This is one of the reasons why we all have a free pass for m*asterbation, it's rehab therepy for the penile blood vessels, the erection nerves and the nerves that pass sensations to and from the brain. The more the better, the quicker the recovery time for most guys.
James C.
Co-Moderator- Prostate Cancer Forum

Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08 Caverject started/stopped, aching. 2/24/08 .5ml Bimix started-success
Present- 1 year: ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's: 3 mts-0, 6 mts.-0, 9 mts.-0.


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 9/30/2008 5:26 PM (GMT -6)   
I can't better the excellent responses here except to add an answer to your last question: are you at higher risk of other types of cancer?

I think the answer is a guarded "yes" -- slightly. There have been suggestions that the genes for prostate and colon (bowel) cancers are linked. I have had both.

So I would suggest if there is any family history of colon cancer, that you have a colonoscopy. Colon cancer caught early is very treatable, and without side-effects.


Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week PSA: 0 

Post Edited (Piano) : 9/30/2008 4:29:03 PM (GMT-6)


leaky
New Member


Date Joined Mar 2008
Total Posts : 15
   Posted 9/30/2008 9:37 PM (GMT -6)   
Hi Astro,

This is not in response to your post but may be useful in the future.

To help in remembering questions you want to ask, make a list before you go to the MD. Secondly if possible take someone with you to listen to the answers provided by the MD.

While dealing with stressful situations we need all the help possible.

Best,
leaky
70 when diagnosed in 10/2004, open surgery 12/2004, margins clear, pre surgery PSA 6.4, 3+4=7, cancer from apex to base left side, 30 gm prostate, right nerves spared, seminal vesicles & lymph nodes (6) removed.

ED & incontinence problems since surgery, life changing & indescribable unless you have experienced it.

Advance male sling 03/2008, AUS and IPP scheduled 10/2008. All work done at UT Southwestern in Dallas.


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 10/1/2008 6:14 AM (GMT -6)   
Thanks everyone.

leaky,

Yes, I wrote down these and many other questions. Had them on my laptop all organized with bullet points and everything. Managed to miss a few anyway... which made me feel like a real idiot.
Diagnosed on 9/23/2008, age 47
Gleason 6, T1c
clueless otherwise


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/2/2009 3:53 PM (GMT -6)   
Update:

Robotic (da Vinci) LRP was performed 1/22/09 by Dr. Pow-Sang at Moffitt Cancer Center here in Tampa, FL. Surgery went well, doc said he was able to save 100% of the "veil" and sphincter. Catheter comes out in a few days and I can't efffing wait...

cheers & beers,
Chris
Diagnosed on 9/23/2008, age 47
Gleason 6, T1c
da Vinci LRP performed 1/22/2009 at Moffitt Cancer Center
catheter due out on 2/4/2009


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/2/2009 4:01 PM (GMT -6)   
Good luck and a speedy recovery Chris.

Please let us know. Scott
Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 PCA3 negative
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/2/2009 5:04 PM (GMT -6)   
Astro, hello and welcome to our little corner of the world. Looks like you got some really good answers to your questions. Your concern about being a cancer magnet of sorts is one I too am concerned about. Some men have PCa, and never have had or ever will have any other kind of cancer. In my case, my PCa was the 4th cancer that I have dealt with since I turned 45, and I am only 56 now. That would be a good question to ask your doctor next time you see him. I always have a list, and still mange to forget something, so I think that's par for the course.

And yes, astro, catheter time is no fun. Hope you continue to heal well, sounds good so far

david in sc
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/2/2009 5:15 PM (GMT -6)   
Good topic about the cancer causing another cancer question. During my original diagnosis this question was asked because of family history with various cancers. Gland cancers normally are associated only with the gland it originates from...however other forms of cancer can cause new locations to develop...the main one that I was interested in was the Squamous Cell skin cancer that I had. I was told squamous cells can actually be formed anywhere in the body...so it is one that can resurface later somewhere else in the body. Prostate on the other end, normally won't invade other organs, but and that is a big but (no pun) can spread to nearby organs involved with the urinary trac. So prostate to spread to colon will not normally happen or vise versa. Now I am sure someone will come along and prove me wrong, given that cancer doesn't have any rules nor follow any rules we want them to follow.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06

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