Newly diagnosed prostate cancer for partner

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britecolor
New Member


Date Joined Feb 2010
Total Posts : 1
   Posted 2/12/2010 10:08 PM (GMT -6)   
My SO was just diagnosed with early stage prostate cancer (age 56) and has a history of family prostate cancer. We are having it removed by Dr. Kia Michel at Cedars Sinai in L.A. in 12 days. His PSA is 4.8. It is in both lobes (max 15% in one biopsy sample). Just looking for support and info re: incontinence and ED after surgery and anything else I need to know. Have been researching online as much as possible. Surgeon does not believe it has spread to lymph nodes. I'm sure I'm just being a drama queen but am very worried. They say 2 days in hospitall and about 2-3 weeks to return to work. This is a silly question but what product is best for the possible incontinence when he returns to work? Specific brand names?

Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 2/12/2010 10:27 PM (GMT -6)   
Brite,
Wow. Welcome. He sounds like he will be just fine. My numbers almost exactly, as I recall. Any of the Male pads are just fine. You are several weeks away from that, however. Meanwhile, enjoy each other. have a lot of sex and stay close. It is a crazy period of time for you, but do not worry, it will be nothing you can't handle. After surgery it is all uphill. Expect several months of pads and about a year for ED - those are ROUGH figures and everyone is different.
Welcome to HW
Paul
www.franktalk.org ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/12/2010 10:33 PM (GMT -6)   
Hello britecolor ,and welcome to HW Prostate Cancer. Your SO is just a year younger than me, so makes him the same age as when I got my PC dx. Is he having open or robotic surgery? You said 2 days in the hospital, I was in for 4 days with open, and many men here that have had robotic are only in for one day. He certainly is having his surgery with a good surgeon at a good hospital.

Until the surgery is over, only the post surgical pathology report would let you know if there was any spread to the lymph nodes, and thats assuming some, many, or all were removed for examination.

The two to three weeks returning to work would really be pushing it for most men, and again, makes a big difference in the type of surgery performed, and how your SO reacts to it.

On the incontinence product question, there are many choices and you will get as many answers here too. My incontinence lasted less than a month, so I don't have a lot of experience in dealing with it. When I was buying pads and pull-ups, I had the best luck with the real Depends brand, even though they cost more. You can go to their web site and print off discount coupons once a month, I believe. I tried using some CVS brand generic products, but to me, they were inferior in quality and weren't worth the little in savings.

Please keep us posted, and ask as many questions as you wish.

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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 2/13/2010 12:15 AM (GMT -6)   
britecolor,
Welcome, as it were. Sorry to see that you have to be here, but you are joining a group that will step up to help. I am also 56, and had DaVinci in October 09. My stats were a lot worse, so I am not the ideal model for you, and tend to offer the "half-empty" point of view for now. So read on knowing that most do better than I have.
Because I can work from home, I was back to some semblance of normal the following week, but burned out after a few hours. I will say I have become a lot less tolerant of people who waste my time, and that has created a little tension. I would guess that actually returning to a workplace would be at least two weeks after catheter removal, probably more. A lot will depend on the job - office work, there is the issue of more unpredictable trips to the toilet, and dealing with co-workers (can they know what is going on?). Physical work will be much more limited, as there should be no lifting or stress for some weeks (it was suggested to me that 5 weeks was a minimum, 8-12 better). The surgeon will have to say that after surgery, as each one is different.
As to ED, I can't say much, as they took the nerves, and we are not yet at the point of dealing with it.
On incontinence products, the short story is that Depends is the best general solution from a functional point of view while leakage is a real issue (in my brutally experienced opinion - DaVinci + 16 weeks, and still flowing like, well... ).
I chose the male pant and the guard as an insert. The guard gets changed as needed, and once in a while, if I really miss the signals, the pant picks up the "overage".
I like the weight on both the Tena pant and guard better, but unless you find a sale, they are more expensive.
The Target (Affirm) / Walgreen (Certainty) / Kroger Guards are all virtually identical, more absorbent, but bulkier; a good choice for the first week or so. The store band pants just are not comfortable. Well, none are comfortable, but I can get out and walk a mile twice a day with the Depends pant (with any of Depends/Walgreens/Target/Tena guards). The store brand pants are not cut as well, and result in some unpleasant irritation.

Go to both the Tena and Depends sites - they will each send a sample of either the pant or guards if you are in the States and include a coupon on next purchase. You can also ask good friends to register and ask for samples. I have not been deluged by junk email from them (yet). And yes, they have coupons that you can sign on and get get once a month.

----------------
Some "guard" comments I've posted on other sites:

I found the Depends to be good, but the Walgreens house brand holds more. Downside is that it gets very heavy and very uncomfortable if you wait until it must be changed.
Just because I have no confidence yet, if I am out and find it 30% wet, and I have a place to change it, I do, as one major accident was enough. At home, you can push the envelope a bit. My signal is whenever they get uncomfortable/ wet.

Here is my experience on ranking (prices compared in TX/AR area):
-Tena guards are thinner and smaller, but probably a different material, as they seem to match the Depends. They are the most expensive.
-Depends guards are a bit larger, but manageable with normal clothing. Middle of the price range, but they just repackaged reducing the count from 52 > 48. The Tena and Depends will fit unnoticed in a jeans hip pocket, the Walgreens will not.
-Walgreens "certainty" are largest and most absorbent I've tried (appears to be about 2x Depends). That gives you a little more margin. The Target 'Affirm' and Kroger house brand guards appear to be a different external wrapper, but exactly the same stuff as the Walgreens, at a slightly lower 'list' price. Walgreens runs enough various sales that they are by far the best buy.

Both Tena and Depends will send a sample pack (2 pads) if you go to their web sites.
Friends at a prostate cancer support foundation have given me samples of coloplast pads, but they are clearly for those with a lesser problem. It will be a while before they will work for me.

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 2/13/2010 5:29 AM (GMT -6)   
britecolor and SO - welcome to HW - this is a great site for questions and answers and lot of support - and the occasional humour posting to help relieve the tension and stress.

In Canada we have the Shoppers Drug Mart generic "life brand" extra absorbent male guards - fits neatly in his underwear and does not show in pants - mind you , track pants for the first while are a great way for post-op care and fashion statement.
We also have Walmart generic brand but check on the absorbency level - I went cheap one time and it just didn't hold enough fluid.

It is good to have a set doctor now - you can write down your questions and worries and he can address them before surgery. A good dialogue with the surgeon can help relieve stress too.

Wishing you and your SO all the love and support you can handle in this difficult and confusing time period.

Hugs.
BRONSON ( and Steve)
..........
.................
Age: 54 - gay - with spouse, Steve - 59
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis
location: Peteborough, Ontario, Canada
............


MrsGFM
Regular Member


Date Joined Feb 2010
Total Posts : 115
   Posted 2/13/2010 11:49 PM (GMT -6)   
Hi Britecolor - I was in your shoes about 2 years ago. My husband was diagnosed at age 50, his father also had prostate cancer so he was careful about getting it checked.

Robotic surgery, home the next day. Very minimal urinary incontinence - maybe for a week or less after the catheter came out. ED resolved pretty quickly. Meds helped.

From one woman to another - keep the lines of communication open open open. Talk about anything he is feeling or fearing. Let him make his own decisions.

Good luck and take a lot of deep breaths!

architectman
New Member


Date Joined Feb 2010
Total Posts : 5
   Posted 2/14/2010 2:04 PM (GMT -6)   
While I was freaking out about the surgery and the side effects, my incredibly supportive partner was secretly researching ways to help me out, found the best products, bought them ahead of time and had them waiting for me! BY FAR, in my opinion and experience, the Tena pant is WAY better than the big puffy, diaper looking Depends. It's slim fitting, comfortable, strangely stylish, and unnoticeable under clothing. (My catheter leaked so much, I had to wear these 24 hours a day while it was in, so have them ready.) The Depends guards for men, insert pads to wear with jockey shorts, are very good though, and I predominantly used these once I was done with the continual dripping stage. I'd say don't waste your time on Tena serenity ultra thin pads, unless you're at a stage where you really don't need to wear a pad at all, and it's just for psychological security. These pads are so narrow that if you move at all, you'll miss the target and end up peeing down your leg, and they're so thin, that they don't hold much more than a drip. At 3 1/2 months, I finally was able to go to work without a pad. It's a frustrating, disgusting time, but if you have decent pads handy all the time and change them regularly, it's bearable, though at times for me, barely. Good luck to you both!

Architectman
Diagnosed July 2009 adenocarcinoma of the prostate, T1c,PSA 4.5, biopsy (July 13, 2009) showed small focus of prostatic adenocarcinoma, gleason score 3+3=6 involving 1% out of 1 of 12 cores.DaVinci Surgery (October 19, 20009, Northwestern, Nadler, "excellent bilateral nerve sparing was carried out" (his words)) pathology showed no cancer at all!! PSAs at two weeks, one month and three months 0.0. Pad free (mostly) finally at 3 1/2 months. Total ED from surgery, with no sign at all of any pending return of life at four months. No response at all from V, L or C at full strength & empty stomach with plenty of manual and visual stimulation. No response to early use of MUSE.


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 2/14/2010 4:44 PM (GMT -6)   
Architectman's observations on Tena being the slimmest and least noticeable are "on the nose", and the pant is the least bulky of all. But, .. there had to be one ..., the material is more fragile, and after having changed out 2 or 3 pads in a day, would fall apart. So I was using two + pants a day, and they are the most expensive out there (at least in my area).

The Tena guards are the least cumbersome unless you get down to the Coloplast "drip guards", which are just that, only enough for drips. But the tena guards are smaller (than depends), so I would be using more than I do of the Depends, at least today. So back to the cost factor.

I expect that the Tena will be the long term product of choice if I get to the point that they are sufficient. I hope....

As to wearing a pant with the catheter, (I had to also, due to bladder apasms) it calls for a different pant because of the bag - try the Depend Adjustable (unisex) Underwear. That splits on the sides, making it useable without fighting with the catheter. I didn't use the whole pack, but it beats a "trail of drops" around the house, and there are cancer support groups that will take unused parts of the packages as donations.

Again, if you are in the US, send off for samples. Get family to sign up another address so you can get pant & pad samples from both Tena and Depends, which will help in the choice. They also had coupons off a single pack enclosed.
You can also get a coupon on line every month from Depends, which may be on the order of $2 off a purchase of two packs.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/14/2010 4:58 PM (GMT -6)   
If you want a total heads up on PCa and surgery and information-English Alf posted one a couple days ago here on the board, lengthly reading, but tells you more than you probably wish to know. Probably one of the better heads up on what you as a patient or his loved one relaying info to him, will be facing. It is more than you can likely imagine. Might as well get prepared.


Youth is wasted on the Young-(W.C. Fields)


MaxBuck
Regular Member


Date Joined Jan 2010
Total Posts : 75
   Posted 2/15/2010 9:33 AM (GMT -6)   
With respect to the back-to-work question: I'd say that's extremely variable. Some men take at least a month (or even more). In my case, I was ready a week after open surgery (I know I was a lucky, rare case). But my job is sedentary; if you are a laborer or have a physically-demanding job, the time could well be several months. There's a lot of variation from person to person, also.
Dx at age 56: Oct 09; PSA 5.8, followed up by 9.9 two weeks later (reproducibility of test - ?)
Biopsy ind cancer in 8/12 cores: Gleason 8 (4+4)
open radical retropubic prostatectomy Dec 4 09
Post-op pathology: 56 g weight, cancer in 21%, Gleason 7 (4+3, tert 5); margins clear, no lymph node involvement (0/9), perineural invasion present, T2c N0Mx (but showed clear from distant metastasis in pre-op bone scan and CT scan)
Continence data: essentially no incontinence 9 weeks post-op
ED pretty complete: some erection possible but current non-functional

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