ED Importance -- is it just me?

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 12/5/2009 10:45 AM (GMT -6)   
Keep in mind I am not trying to be a troll here or start a war , but:


I am amazed at the ED concern here. Does that concern arise much later on when some of the treatments are done and you can think of other things?



At my stage, it seems that the ED concern should not even be on the radar. Incontinence would seem like a much bigger concern (especially for those of us who have jobs...and chairs, beds, etc.).



I don't think at this stage for me, my wife and I are the least bit concerned about ED.



(We have been married for 34 years -- it just isn't important).



Anyway, I'm curious about ED concerns. When does that issue become a major one?



Mel

Slight editing of post to adhere to Forum rules. Also, would you mind typing single spaced, this saves on server space use.

Post Edited By Moderator (James C.) : 12/5/2009 9:56:51 AM (GMT-7)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 12/5/2009 10:55 AM (GMT -6)   
The conventional thinking about the stages of fighting PCa is first fight the cancer, second get continent, third- regain potency. As it is, it is this timeline for the majority of our guys here. Depending on what stage we are in will naturally set your mind about what to be worrying about. Once on the other side, with any type treatment, then it naturally becomes concerns for dry pants and then erections.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN


grouchytx
Regular Member


Date Joined Oct 2009
Total Posts : 32
   Posted 12/5/2009 10:57 AM (GMT -6)   
ED concerns caused me to opt out of surgery and hormone therapy.  We have been married for 42 years.  I explained my concerns to my wife and she said, " I love you and will support any decision you make."
 
Not saying it was the right decision for everyone....just my decision.
 
Bill
Age: 63
 
Gleason: 8 (5+3) Biopsys ranged from 90% to 100%
Refused surgery and hormone therapy. Doctor really made an argument for benefits of hormone therapy, I could not accept the consequences.
 
28 IMRT treatments.  Originally scheduled to get seed implants but doc decided that due to my prognosis High Dose Rate Brachythrapy was a better path to attempt.
 
PSA: 13
 
Let the chips fall where they may.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/5/2009 11:09 AM (GMT -6)   
I agree with James, that is the normal approach, especially from a surgical point of view. Get the cancer out, minimize incontinence, and if possible, minimize any ED issues. With surgery, of course, if you have ED, it will be right away. If you study the posts here enough, some men have nerve sparing ops and have major ED, others have one nerve bundle removed, yet have little problem. With ED however, there are many methods and paths. Recovery times vary case by case, man by man. With RT as a primary treatment, ED will happen after the fact, in some cases, long after the treatment ends.

For most of us, and its a personal choice, we want to be rid of the cancer. And you never know for sure what you are going to get out your treatment choice, regardless of what some famous doctor prints or says, its too individual to know, too many factors.

When I knew I was going for open surgery, my wife and I discussed a lot about the possiblity of me having ED and worse case, perm. ED, at nearly 36 years of marriage and a great sex life prior to PC, we both knew in our hearts, if being free of cancer meant the end of that, again, worse case thinking, then so be it.

That is a quality of life issue each person must make for themselves.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/5/2009 11:21 AM (GMT -6)   
Mel,

James covered it quite well. I remember this quote from Henry Thoreau, "The price of anything is the amount of life you exchange for it."

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 12/5/2009 11:21 AM (GMT -6)   
compiler

You are not alone with your thinking. ED becomes important when you and your wife make it important.

Rich
Biopsy 1998 = Neg Bio 2000 = Neg with PIN Bio 1/10/08 Gleason 10, Stage T1C 8 of 12 samples positive all < Than 5%
Bone Scan, CTs and MRI Negative early 2008
March 2008 MD Anderson - No Surgery or Proton = No Action
Feb & Mar PET (Possilbe Lymph Node Involvement  & Prostacint Scan Negative
March 2008 U of Florida Proton Therapty Lupron & Casodek May 08 for 2 years
Completed 25 IMRT and 17 PBRT U of Florida Proton Therapy Institute 7/24/08
Latest CT June 08) showed no trace of tumor in lymph node area
7/24/2008 PSA .21, free PSA .08, Percent free PSA 38.1, testosterone 14.6
8/1/2008 2nd Lupon Shot -- 10/27/2008 PSA <.01 -- 12/9/2008 3rd Lupon Shot
12/11/08 MRI Suspicious for Metastic disease L5 & S1 -- Bone Scan 12/19/08 Indicates No Bone Mets Spinal Stenosis and Neropathy in my legs
2/06/09 PSA = < .01  -- 4/09/2009  PSA <.01 --4th Lupron shot 7/02/2009 PSA <.01 Lupron
Our Journey is on WWW.GLEASONSCORE10.COM


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5668
   Posted 12/5/2009 11:24 AM (GMT -6)   
I've wondered that also, especially pre surgery. i agree with the moderator, with some exceptions, most men have that priority, cancer control, continence and erections. After surgery, with good pathology, continence from the jump, But definite erectile dysfunction. you think about it. At the risk of starting a war and putting myself out on a limb, I think the loss tugs at your whole concept of being a man. Its deep and true and is not just in relation to your wife. You really can't " lust in your heart " the way you used to. You may know that you shouldn't do this , but you do miss this. Most wives are not that concerned and if they were, we would, in a sense, fault them for that. There our many way s to skin a cat, but the one we are all used to is what , in our minds differentiates us as " MEN " You may disagree, but will semi quote Ralph Waldo Emerson, who said that what men feel in there innermost heart is true of all men and realizing this is true genius. I'm almost afraid to read some of the post replys to this, if any.
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
11% of prostate affected. gleason 3+4, I suppose thats a negative


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 12/5/2009 11:32 AM (GMT -6)   
James and others said it well. I discussed same with my doctor and was clear that his objective was in line with my expectations. Number one concern was the PC, #2 Incontinence and #3 ED.
Age 51
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
Mild ED. Levitra works well for me
PSA 0.00 at one year post op


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 12/5/2009 11:53 AM (GMT -6)   
  All steps of treatment and their complications are important.  I only suffered temporary and minor ED.  But, I was a "leaker" that eventually had to have the AUS installed.  The leaking was the worst thing to have to manage and deal with.  The ED is only dealt with in the privacy of your home.  The incontenance is with you every minute of the day.  Everywhere you go you have to be vigilant about being prepared with pads and facilities to change and dispose of them.  You would be surprised how you learn to adapt.
 
Good Luck with you treatment and decisions.
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
     Dec. 2006 â€“ Oct. 2008 Cystoscope, Two Collagen injections,Second Opinion   
    Consultation for Incontinance at OU Medical Center, Bio-Feedback       
    training, Chiropractic, Accupuncture , AdVance Male Sling, Two More Collagen 
    injections, AUS Installed and Activated (Dr. Morey at UT Southwestern Dallas TX)
    All to try to resolve incontinence (using 6-8 Depends Guards a day)

    To Date All PSA's 0.00.

   http://www.healingwell.com/community/default.aspx?f=35&m=721171

    http://www.healingwell.com/community/default.aspx?f=35&m=978691


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 12/5/2009 12:04 PM (GMT -6)   
logoslidat, I think I see where you are going with your carefully worded post. If I understand by reading between the lines, you are saying that there's some segment of men who can't adapt to the 'other ways of lovemaking', and that the age old ability and definition of a men is, for them, an erection, insertion, movement and ejaculation, the entire physical act of being a man and making love is intertwined. As opposed to the new approach lots of us have to take now, of adapting to making love and satisifying our spouse in other ways (cuddling, fingers, mouth, toys, etc) than with an erect penis. I know there's severe loss to be grieved for during the process of fighting PCa, and it's emotional toll may come months or years later. I read here of guys who still mourn and won't accept the idea that they will no longer have an ejaculation, nor a firmly erect penis that willingly will spring to action on the weight of passing thought. Maybe as time passes they can adapt and adopt the methods that might be needed for them to have a fully functioning and satisfied sex life, as dramatically altered as it may be.

If I miss read it, then don't worry- consider it as just me blowing smoke. I'm sure others will have comments to make...
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/5/2009 12:31 PM (GMT -6)   
If the question is "why do men (in general) care about erections?" then we shall probably have to wait until we can flag down a passing sociologist. If the question is "why do men (recovering from PC treatment) care about erections?" then I will tell a story.

My father-in-law was telling about his time in a Russian prison camp and how each day every two-person cell got one loaf of bread. Dividing that loaf equally became the most important part of the day.
"How was the bread?" I asked.
He looked at my wife with great pity that she had married such a fool.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


IKE-D
Regular Member


Date Joined Jun 2009
Total Posts : 77
   Posted 12/5/2009 2:16 PM (GMT -6)   
I think in general getting the cancer out is everyones first priority. On the ED front I believe that will depend on what season of life one is at diagnoses. With PSA revealing cancer at 39 and 41, yes of course ED is a big deal for people who have beem married not too long or yet to finish having children. Therefore a 60 somethings + point of view will certainly vary from that of a 40 year old's......
>Age 41 (At Dx-July 05) -Psa during annual physical went from previous 2.8 to 3
>Biopsy by 'primary' Urol Aug 05 - Gleason 6 low grade. 2nd opinion at  Hopkins confirmed Dx
>Chose Active Surv (AS)- modified diet etc.
>Around Oct 07 Psa moved up to 5.5. I decide to treat at Hopkins. Not sure what kind yet. My doctor decided on re-biopsy first.
>2nd Biopsy Dec 07 at Hopkins was NEGATIVE for Pca! Nothing found in 14 cores!
>'Primary' Urologist baffled. Planned a saturated biopsy (22 cores) to settle issue once and for all. I wasn't going to do 22 cores wide awake!
>July 07 - Did MRI just for comfort. Nothing significant found. No spread. I'd live! Still in AS mode.
>July 08 - Saturated Biopsy performed. Cancer confirmed again (of course, you took 22 cores)! Same Gleason score, same grade, similar numbers but Urol says treat very soon! I am thinking not so fast - numbers are same and you told me it means not aggressive! In any case I agreed with Urol that I will go the way of the Seeds. I research seeds more and I don't like it.
>July 08 - Dec 08 I re-lapse back into AS mode but seriously researching/considering treatment options beside surgery - went on to Mass Gen and Georgetown to explore proton therapy and Cyberknife respectively. Anything but Surgery! Both experts who are about my age were unanimous in strongly declaring they will chose surgery 'if they were me'. In addition, I learn that if either if these radiation methods (and seeds too!)  failed, no backup plan (or will be complicated)! I got the message!
>Jan 09. Went back to see my doc at Hopkins. I decide to put my fate in the hands  of the 'Da Vinci Robot' then!
> May 09. Had surgery. some Pain and discomfort but normal. Pathology all clear. Gleason 6 as before. Feeling very lucky. I gambled (based on my numbers and got 4 more years!) on the slow nature of the cancer and took my time. Very happy I finally did it. Hoping for a great recovery of all 'key' functions. Great wife and family helping out.
> Sept 09 - 3month PSA - Undetectable!


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5668
   Posted 12/5/2009 3:19 PM (GMT -6)   
James, you pretty much got the drift of my points, my only other point and the one i think may cause the most controversy, is the " lust in your heart ", remember Jimmy Carter. I think it is a valid point and even if we never ever,ever want to cheat on our wives, I believe somewhere in there, we mourn the loss, for this reason as well as the others. As far the view points having to depend on age,40 vs 60's, I totally reject that concept. One thing that probably surprises a lot of the "younger" men on this forum is how much the " older men" are in fact right up there with them on this loss. Sex drive is Sex drive is Sex drive. It may BE affected by age, but if it Ain't, Im telling you as a 66 year old, who once was in my forties, It Ain't. Thanks, I hope my reply, this and my first hasn't gone too far off track. Hope all of you have a warm and joyous season!
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
11% of prostate affected. gleason 3+4, I suppose thats a negative


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/5/2009 3:25 PM (GMT -6)   
THe "Lust in your heart" part really has no part of this discussion or thread, that is a moral or religious issue, not a physical issue. Even in my darkest recovery days, it never stopped me from looking over a beautiful woman. That's more like human nature. Doesn't matter that if she fell into my lap, I probably couldn't have done anything anyway, lol.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 12/5/2009 3:31 PM (GMT -6)   
Well, it may be bad to admit it, but I have lusted in my heart numerous times during my 41 year marriage, celebrated yesterday. Girl watching, mentally making love, lusting in our hearts, I feel it's all part of the male psyche to look at other women. I have looked, enjoyed, enjoyed looking and never once carried thru with it beyond, but noticing other women is too ingrained into our male psyche to keep it covered with a layer of civilization and polite manners. Boys will be boys and thank goodness they are... Sorry, David, I disagree, lust in your heart has a big part of our discussion. Lowered sex drive from surgery, or HRT or other things we endure really can affect us, more so maybe than the physical act of gaining an erection. So many guys say they now have no interest in sex, no more of the usual lifelong response to women, and such. It's a loss, for sure, in my opinion and part of the whole thing we are discussing. Moral or religious aside, even the best of us look, if for no other reason than to closely appreciate God's handiwork in a particularly attractive or well-built lady. smilewinkgrin tongue
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

Post Edited (James C.) : 12/5/2009 2:35:29 PM (GMT-7)


Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 201
   Posted 12/5/2009 4:14 PM (GMT -6)   
The priorities are clearly cancer, continence and then ED. But just because it is the last of the 3 priorities is not reason to minimize its importance. ED can be devastating and lead to severe depression.

I think we all strive to avoid ED, but it should not consume our lives like cancer and incontinence.
Age:54
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/5/2009 7:31 PM (GMT -6)   
A beautiful woman to me, is natural art at its best. Nothing more, nothing less.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 12/5/2009 8:08 PM (GMT -6)   
Interesting.  I figure the male member is there for two reasons.  To urinate and procreate.  I've done both.  Beyond that I think that it is in the male psyche to want to continue to procreate and visual stimulation of an attractive female brings out the male urge to, how do I say this, conquer what may, or may not, be attainable. The quest and conquering is the goal.  Needless to say, I'm way beyond even thinking about such a journey...certainly, I couldn't handle the question, "Is that It?  I have enough trouble just handling one female. I don't need the extra work.  Thanks, but no thanks.
 
Humorous regards,
 
Bob
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2  Doubled! Criminy!
 Started RT 10/28...one year since diagnosis.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/5/2009 8:34 PM (GMT -6)   
I am not talking about or advocating touching what I shouldn't. Happily married for almost 36 years, have never, ever strayed in any sense of the word. But its natural for a straight male to admire and/or desire and/or day dream about a beautiful woman. The closest I have to classic text book lust is when I am a car show and can see and touch a new Lamborghini P640 that I know I can never have, drive, or own.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 12/5/2009 8:44 PM (GMT -6)   

Thank you all for your responses. They were EXTREMELY interesting.

First of all, it obviously depends on where you are in this PC journey. Right now, ED is not even on the radar. In fact, I'm at the what to do next stage and I'm investigating that. I'm sure as I continue this journey and come out on the other side of surgery if I go that way, then ED might be an issue (although I really don't think I will be). But the deep thoughts are that ED is more than getting it up or not. It is looking at a beautiful woman and having those thoughts/sensations that we all have.

Thank you for all the very good points.

Mel

 


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/6/2009 7:27 AM (GMT -6)   
There are three basic concerns and goals with PCa.  In order of priority
 
1.  Survival -- Diagnosis, treatment, and recovery.  Some of those here are struggling with re-diagnosis and re-treatment. 
 
 
 
 
 
 
2.  And a distant second is Continence.  Sometimes also rectal function issues.
 
3.  ED/sexual function.
 
It is inevitable that if and once the fears of 1 subside, one's focus moves to 2, then 3 etc.  I'm grateful for life and a big fat zero PSA.  Life is good and a couple of drops in my pants now and again, or squatting on the loo squirting dribs and drabs for what seems like forever at the time, and having to pop a pill for Mister MoJo rising is a very small price.  It's natural that we should 'want it all', and darn it, we all should have it all! 
 
But the spectre of recurrence always looms in the background.  Those of us fortunate to have (currently) good outcomes and post treatment PSA's  talk about concerns 2 and/or 3 above, pray for our brothers fighting for survival and pray to god we don't move back up the food chain there ourselves.
 


51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4088
   Posted 12/6/2009 7:53 AM (GMT -6)   
Mel:
 
As a brachytherapy patient who has never had ED issues - either related to my procedure or otherwise - I am at a bit of a disadvantage in talking about the subject as compared to my surgery breathren.  However, I can tell you that when I was reviewing options, my priorties were the same as most here, i.e. cure, continence and ED in that order. Part of my logic when making my choice was that, for my particular stats/case, the cure rate was the same for surgery or seeds.  Once that particular issue was settled, it then became possible to focus on the other two priorities.  Then, at least for me, it became a pretty easy choice in that the urinary and sexual SE's for my treatment were milder than surgery.
 
As to your point about it not being on the radar at this point in your process, I think it absolutely should be on your radar.  Now is the only time you are making choices...later it's only about repair.  And, regardless of the replies to this thread, you only need to read the MANY posts about pumps, pills, shots, divorce and depression to understand that even if this is not an issue now, it is likely to be at some point...
 
Tudpock
Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 12/09.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 12/6/2009 8:07 AM (GMT -6)   
Long before PCa came along I had assumed that at some point in my life I was going to suffer from ED, simply due to old age, and by then my wife would be sitting in front of the fire smoking a pipe while I was knitting. And we'd have great memories, and bodies that might be too worn out from other things for real full on sex to be a big part of our lives.


The problem with PCa is the age at which you may get confronted with ED. My urologist was almost hesitant about suggesting any treatment that might cause ED due to my age.



And my trouble was that I knew that my father had still been fully potent when he was 68, because that's how old he was when I was born! and I had kinda hoped I was going to last as long as him, indeed my mother, (his much younger second wife) once hinted to me that he had only gone of the boil when he was about 80.



And even though I am not one of the guys with ED my sex life is very very unlike what it was before PCa. I have simply lost a lot of the lust. I'm sure used to be one of those "think about sex every 15 minutes" kinda men, but now it's much more like every 15 Hours. I have always been able to enjoy my wife's compamy without sex too.



I imagine that there may also be an issue with some men as regards the age their partners are, and how important an erection is for them, and how important what type of physical; relationship is.



I am so satisfied with my whole realtionship with my wife that I can hardly put it into words





Alfred

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/6/2009 9:28 AM (GMT -6)   
Afred, I agree with the sentiments of your last post exactly. My wife and I have been very best friends as well as being married since 1974. We have already been through a lot together, not counting various medical situations with one partner or the other over the years. PC now or in the future, will never change our relationship together, and that's just the way we want it.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 12/6/2009 10:02 AM (GMT -6)   
I was more concerned with the incontinece than ED. My doctor said I was in minority. he went on to say someone can see you with pee more than you have sex! I believe it came more of an issue for me after surgery and the continence was taken care of. I always remind myself I had cancer so it comes with a cost and I am happy where I am now. I still have ED issues but I am alive.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

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