Quality of life issues after RP

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John T
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Date Joined Nov 2008
Total Posts : 4171
   Posted 4/22/2011 6:45 PM (GMT -6)   
Posted on the New Prostate Cancer Info LInk
A prospective study of QOL after surgery by Treiver et al
  • The authors were careful to define their quality of life endpoints for certain key criteria.
    • Potency was defined as the ability to have an “erection sufficient for intercourse upon most attempts with or without a phosphodiesterase type 5 inhibitor.”
    • Continence was defined as “wearing no pads.”
    • Return to baseline quality of life was defined as the achievement of 90 percent of both baseline physical and baseline mental quality of life as experienced pre-surgery.

    So given these important factors, here are the key findings of the study:

    • At 1-year of follow-up
      • 75 percent of patients had returned to baseline physical health.
      • 73 percent of patients had returned to baseline mental health.
      • 75 percent of patients were continent.
      • 26 percent of patients were potent.
    • Mental health recovered more slowly than physical health.
    • Preoperative PSA levels < 20 ng/ml, nerve-sparing technique, no intraoperative or postoperative complications, no adjuvant treatment, and attendance at a postoperative rehabilitation program were all significant factors that positively influenced outcomes in regard to post-surgical health-related quality of life, potency, and continence

    Regular Member

    Date Joined May 2010
    Total Posts : 264
       Posted 4/22/2011 7:32 PM (GMT -6)   
    I am shocked that the potency rate was only 26 percent.

    But that figure isn't detailed enough since it lumps all age groups into the one group and doesn't specify what degree of potency the men had before the operation.

    The big problem I see is that a doctor pitching a non-surgical treatment (or AS) can tell a just-diagnosed fit and (otherwise) healthy 50 year old with excellent erection capabilities that there is a 74% chance he will have potency problems---and that just isn't true because the study lumped together 50 year olds with 68 year olds and also appears to have lumped together guys with pre-surgury preexisting ED with guys who can perform like they are 18 years old.

    Here are some of my stats:
    Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
    My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
    DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
    PCa diagnosed 4/6/10 after biopsy on 4/1/10
    1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
    Gleason 3+4
    Da Vinci surgery on 6/1/10
    Pathology report shows cancer confined to prostate and all other tissue clean
    PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

    Forum Moderator

    Date Joined Jan 2010
    Total Posts : 6848
       Posted 4/22/2011 7:43 PM (GMT -6)   
    Doesn't much matter to me what they lump together for statistics. When, at 18 months post-op, you need pads and have total ED even with the meds, you sort of toss all that in the crapper.
    I would rather be in that 80+ group while writing this post.

    Veteran Member

    Date Joined Jul 2006
    Total Posts : 669
       Posted 4/22/2011 8:13 PM (GMT -6)   
    Hi April6th
    Actually using the criteria for potency .. getting an erection with pill help or without pill help levels the playing field so to speak.  There is no doubt that a younger man (40s-50s) with no prior ED has the edge, as he should.  I am sure statistics will bear that out.  It appears then that the 26% rate is accurate.  
    I am older, but never had an erectile failure before surgery.  Post surgery I am batting 000% with or without pills. However my surgeon lists me as a success because I get 100% success with injections. Using those figures I am part of the 74% failures.  The problem is getting everyone to use the same definition.
    PSA July 2006 4.7 , Nodule found
    biopsy 10/06 very agressive gleason4+4=8 identified
    DaVinci surgery, January 2007
    Post Ob confirms, gleason 4+4=8 with no extension or invasion
    no long term continence problems
    post surgery PSA continues to be undetectable at 4 years
    ED problems continue, using bimix
    born 1941

    Elite Member

    Date Joined Oct 2008
    Total Posts : 25355
       Posted 4/22/2011 8:22 PM (GMT -6)   
    Always the trouble with stats like these, the devil is in the details.
    Physical:   50%  (at best, despite 6 1/2 months physical therapy)
    Mental:     How does one quantify that?  I was nuts before and after, lol
    Incontinence:    Prior to urostomy - 100% continent
                             With urostomy device - 100% continent
                             Without urostomy device - 100% incontinent
    ED:   100% ok - before surgery, post surgery, post SRT, all natural

    Post Edited (Purgatory) : 4/22/2011 8:45:06 PM (GMT-6)

    Ed C. (Old67)
    Veteran Member

    Date Joined Jan 2009
    Total Posts : 2457
       Posted 4/22/2011 8:28 PM (GMT -6)   
    I'm in the 75% for physical, mental and continence, however, without the nerve bundles I have 100% ED but trimix does the trick.
    Age: 67 at Dx on 12/30/08 PSA 3.8
    2 cores out of 12 were positive Gleason (4+4)
    Davinci surgery 2/9/09 Gleason 4+4 EPE,
    Margins clear, nerve bundles removed
    Prostate weighed 57 grams 10-20% involved
    all PSA tests since (2, 5, 8, 11, 15, 18, 21, 2 years <.008? ) undetectable
    27 months: .005
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