ED lecture by John Mulhall

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RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1268
   Posted 6/3/2010 8:57 PM (GMT -6)   
For those guys with ED, or those looking at treatment for PCa, you might find John Mulhall's lecture of interst.  He's the doc who wrote, "Saving Your Sex Life".
 
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/3/2010 9:03 PM (GMT -6)   
Great link, thanks RCS
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 6/3/2010 11:24 PM (GMT -6)   
Enjoyed watching it. According to doctor I should not respond to Viagra without nerve bundles yet I do.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1268
   Posted 6/4/2010 8:11 AM (GMT -6)   
Ed C.
 
Congratulations! 
 
I guess I would have agreed with your doctor ... I am glad we were wrong.  Further, I suspect there is more art and individual luck involved in the treatment of PCa than I expected, and less science than I would have liked.
 
Again, congatulations on the Viagra victory.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 6/6/2010 8:09 AM (GMT -6)   
Very good reading and good news for newbees and oldies thanks for the link
DEERHUNTER
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 6/6/2010 10:21 AM (GMT -6)   
Hi RCS,

This was great! It is very much different than the advice I was given prior to my treatment. I was told that sex was over for me after my rad and hormone therapy. Wish I had seen this two years ago. Being single and not involved with a partner sex has not been a problem for me plus the hormone therapy left me with no real desire.

The comments on the hormone therapy and the relationship of testosterone were interesting as well. I found many research papers that reiterated the belief that T was fuel for the fire. Only three patients in the original research had the response. I suppose it is like a friend of mine in our QC department says... "If you torture the data long enough it will confess to anything".

Great link. Thanks for posting.
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 6/6/2010 10:41 AM (GMT -6)   
RCS,

I have seen many great articles in this forum but this one was absolutely the best. Thank you for sharing.

Len
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09 <0.1
2nd post op PSA:  1/25/10 <0.1
3rd post op PSA  4/19/10 <0.1
As of 4/26/10 Still Wet 3 pads per 24 hr. period


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/6/2010 2:47 PM (GMT -6)   
I just spent the afternoon watching the full video. That is an amazing presentation, one that every man who comes here, both before or after treatment should be sent to and strongly urged to watch. So many little facts that are overlooked by most docs and so much new data presented and explained. An absolute should be required viewing for anyone who is concerned about the ED Aspects of PCa. Thanks for finding this jewel for us.
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1268
   Posted 6/7/2010 7:52 AM (GMT -6)   
James C.
 
Can the URL somehow be added as a link to the prostate information section at the top of the forum?
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/7/2010 10:29 AM (GMT -6)   
Good idea, I placed it there, bottom post in the section. I would add it as a link to Ms Bluebirds post, but every time I try to add something I manage to mess her coding up, so it's hands off now... smilewinkgrin blush
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


reputo
Regular Member


Date Joined Apr 2010
Total Posts : 26
   Posted 6/7/2010 12:57 PM (GMT -6)   
For those of you who have had RP I'm curious to know how many months it took to regain "adequate" erectile function (if ever).
Age: 57
Biopsy: June 2009. Gleason Score: 3+3.
Zoladex 10.8 mg subq implant on Nov 2, 2009
da Vinci RRP on March 5, 2010
Pathology: margins clear
6-week post-op PSA .06
April '10, Cialis 10 mg 2xweek, 1/3 of the time results in partial erection
Bladder neck dilation May 2, 2010


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/7/2010 8:02 PM (GMT -6)   
open RP 33 months- still waiting for 'if ever'
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 6/8/2010 12:20 PM (GMT -6)   
reputo said...
For those of you who have had RP I'm curious to know how many months it took to regain "adequate" erectile function (if ever).


I am one of the fortunate ones who have never had an ED issue after surgery. My first erection was prior to having the catheter removed and by 6 months post surgery, I was having nocturnal erections. I was lucky to have excellent health with none of the conditions (like diabetes or high blood pressure) that would be predictors of ED. I also had a top surgeon and a most supportive wife.
63 yo
V10.46 Dx Feb-09

RRP 5-5-09

No adverse SE

PSA 6-19-09  -0-

PSA 9-21-09  -0-

1 year PSA 5-3-10  -0-



Thriving, not just surviving!


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1268
   Posted 6/8/2010 5:15 PM (GMT -6)   
Reputo,
DaVincied 14 months ago, and also still waiting for "if ever". Still doing the penile rehab and it seems my nerves may be starting to work again (knock on wood ... I wish). In the last couple of months I have become more responsive to viagra and cialis and to my injections. But nothing "adequate" on my own ... and no nocturnals ... that I know of.


Jacetch,
I'm jealous! Congratulations.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 

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