Prostate Cancer Treatment: A Cause for Erectile Dysfunction & Impotency - HOW CAN I TRUST ANYTHING?

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Regular Member

Date Joined Jun 2010
Total Posts : 416
   Posted 11/17/2010 10:50 AM (GMT -6)   
My 6 mo psa blipped to .13.
My uro tells me yesterday that with pos margins, he expected radiation would have been my move anyway.
Now it looks as it will be.
He suggests that since i'm 51, in good health and taking Cialis.. that I should simply continue same and deal with the radiation.
As if it's a no brainer, AND that it's not just presumed I will continue to have ED. The Rad Onc spoke of it similarly.
Yet I see these studies where they say "in 97% of the cases it turned into am long term condition..."
The people I am trusting to cover my back make like it's a no brainer and it'll be ok.
The studies suggest that having Rp AND Radiation is the worst case ecenerio for impotence.
So what the heck is a guy going to base his future on?

Regular Member

Date Joined Oct 2010
Total Posts : 91
   Posted 11/17/2010 11:19 AM (GMT -6)   
Sorry to hear of this event, Bob.

Have you paged through Patrick Walsh's book on prostate cancer? There are sections in there dealing with this.
July 1, '10
PSA 3.88
Gleason 3+3=6
2 out of 12 samples positive

DaVinci Oct 1 '10, UNC Chapel Hill
Cath/JP Drain out Oct.16, '10

Personal Statistics:
Age: 54
Weight: 184 lbs.
Height: 6 feet


Regular Member

Date Joined Sep 2010
Total Posts : 148
   Posted 11/17/2010 11:41 AM (GMT -6)   
Hope and faith buddy. Always has been;
and maybe a little Knowledge.
Sorry to hear the news. I really hope the treatment goes well for you.
Best wishes
Age 48 w/diagnosed
10/06 PSA 3.0
11/06 PSA FREE %13.2
10/07 PSA 3.4
12/07 Biopsy-neg
1/09 PSA 4.6
6/09 psa 5.8
2/10 psa 8.7
7/10 PSA 10.8
8/2010 3rd biopsy GG 3+3=6, one of eight cores -2%
Lap 10/22/10 Dr. Troxel
Path- Neg Margins, Gleason 6, Nerves spared, 85 gm
Cath out Nov 2, Ohh! lots of pads.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 11/17/2010 11:59 AM (GMT -6)   
"So what the heck is a guy going to base his future on?" <BobCape>

At 51, a very, very tough call...You could wait another 3 months to be sure the spike was real, get 3 more months of healing in...Ask yourself and your docs this question:

"What is my future if I reject further treatment?"

"You can't always get what you want, but if you try real hard you just might find, you get what you need...." <Rolling Stones>..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Regular Member

Date Joined Jun 2010
Total Posts : 416
   Posted 11/17/2010 12:19 PM (GMT -6)   
Thanks folks...
I have not read Walsh's book... all things told me that surgery was the move. Hoped that would be that, of course.

Af far as waiting 3 months.. my Uro basically said:
"look, you held off for an extra 3 mo to let yourself heal.. So you lucked out and your psa is below .2 (.13), With Pos Margins, your Gleason 4+3, Tertiary 5, and your psa #, your move is to get radiation and then have a good chance at many more years of zero psa.".

If I wait 3 months and my psa skyrockets, it'll be too late.. the horse will be out of the barn.. i'll have made my decision and will have effectively forfeited my ability to utilize my best possible weapon #2, Radiation.

I'm leaning towards "I have so many other good things in my life that if I had ed for life, would I not want to go on based on that alone?" - And the answer is no. So the question in reverse would be "Would I trade my life for an erection?".. I dont think so.

Because i've regained 90%+ of my continence, to me this really boils down to the ED question. I KNOW there are other potential ramifications (step back in continence, burning, and others)

But I also have faith that my Rad Onc is a wise, and decent man, using top of the line equipment, and will do what he can do using his expertise to help me.

At SOME point I have to assume that the people i've chosen to help me are giving me the same advise they would give their own.

Good luck to all of you. Bob F From Cape Cod.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 11/17/2010 12:58 PM (GMT -6)   
You stay on The Cape all winter??

When it comes to radiation and incontinence & ED, whatever you have now is what you will have to live with..No more improvement after radiation starts..JMHO....

Read Walsh's book...

Regular Member

Date Joined Jun 2010
Total Posts : 416
   Posted 11/17/2010 1:11 PM (GMT -6)   
Hi Fairwind.. ya, 21 years now, Trying like heck to get back to Las Vegas where I/we want to be.. then this got in the way...

I understand, generally speaking, that waht you got is what you get when you do the radiation.

However, they say it is usually up to a year after surgery that ED comes back.. and Asdjuvant radiation is obviously given to folks who had yet to regain continense and and still have ED. I haven't read where it was then stated that "all men having adjuvant radiation" will remain incontinenet and have ED for life"??????

Are you SURE no more improvement? I mean, if they burn the veins and muscles whilef using radiation, it seems to me that regardless of WHERE YOU WERE BEFORE RADIATION... you would have problems on both fronts.

I mean, I would think that the LAST thing we can be sure of radiating something, is that everthing will be the same.

To suggest "no change at all"... I dunno...?

Forum Moderator

Date Joined Jan 2010
Total Posts : 6849
   Posted 11/17/2010 1:46 PM (GMT -6)   
My Uro/surgeon made a very serious point that my IGRT would likely stall my incontinence improvement, so we did wait for a couple of months beyond his "minimum" time from DaVinci to start.
My bad news is that the incontinence actually has gotten a bit worse from the point at which I started IGRT, but that also was a side-effect warning.
Now, both my uro and gp refuse to say that I will never get any better. I think that the idea of freezing progress is not so absolute as it is generally made out to be.
As to ED, well, they took the nerves (I had G4+5 and EPE), so if there is ever a sign of life it will be a miracle.
I've seen a book where the author makes repeated reference to the idea that what is best for killing PCa is rarely the best for the patient. I have to say that I agree. I'm 57, and the idea last year was to get me cured. I should have bought stock in Tena and Depends. I may be (for now) "cured", but I've got more visible problems now than I did before my "cure". Since I had no symptoms or problems, and the PCa was discovered by accident, in terms of Quality of life, I've had a major, disastrous, setback.
In terms of Quantity of life - who knows.

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 11/17/2010 1:54 PM (GMT -6)   
Here's a huge generality, but I really do believe that doctors tend to gloss over side effects.
"This will sting a little", etc. etc.
I would put more faith in what you read, such as the studies.
I will probably be facing the same decision.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 11/17/2010 2:04 PM (GMT -6)   
Both the surgeons and the R-docs minimize side-effects and complications, that's for sure..

I have postponed (and a major surgical complication helped - staph infection) moving on to radiation as long as I can, call it adjunct or salvage, I was very lucky in that I had only minor incontinence. I hope there is no back-sliding there..My ED is complete although there have been glimmers of hope...But at 69 my days as a sexual athlete were pretty much over anyway...U-docs have a whole basket full of things to overcome ED if you just ask them..

The Cape has a beauty all it's own in the wintertime. I used to go out to Marconi and walk for miles on that wild beach, never see another human...But Sonora is MUCH better in January! But like you I'm a prisoner in Denver...
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