Steve, Just about
everybody gets the bone scan and CT scan prior to surgery, even when the biopsy shows minimal, low grade cancer. I think a lot of urologists order those scans to establish a "baseline" against which they can compare future scans if the cancer progresses. Unless the cancer is quite far advanced, it would be unusual for the scans to show anything.
What surprises me, though, and what I would be asking the doctor about, is why....knowing that you had an aggressive cancer and a high Gleason score and that most of the prostate gland was involved....why they guided you to surgery rather than radiation.....maybe it was because of your young age.....or why they weren't watching you very closely, ready to initiate salvage radiation if the PSA didn't fall to undetectable levels quickly after the surgery....or why they didn't opt for a combination of radiation and hormone therapy from the get-go....questions like that.
The fact that you had the first PSA test just a month after surgery kind of tells me that they were concerned and wanted to get an idea where the PSA was going. A lot of us didn't have our first PSA until 3 months after surgery. However, now that they see it's rising so quickly, I would surely think they will initiate further treatment to get a handle on it and get the PSA headed in the right direction.
As for the continence issue, that can take a while. You're not even 3 months post surgery, so be patient, do the kegel exercises, and hopefully you'll get that under control soon. As for feeling sick and tired all the time, depression can cause that, or there could be a medical reason (virus? infection?).
Stay positive, learn all you can about prostate cancer and its treatment. Get a copy of Walsh's book "Surviving Prostate Cancer" (latest edition). Read, read, read, but be advised that there's a lot of bad information on the internet. Most would agree that the educated patient is his own best advocate. Hang in there. We're with you.
By the way, what part of this world do you live in? Was your surgery open or robotic? How experienced was your surgeon? Has he done a lot of prostatectomies, and if robotic, how many has he done?
Right now, you should be thinking about leaving the urologist/surgeon behind and seeking treatment from an oncologist who specializes in the treatment of advanced prostate cancer. You've moved beyond the expertise of the uro/surgeon. You need an oncologist to evaluate your situation and guide your treatment. Bill
Post Edited (clocknut) : 9/15/2011 10:09:48 PM (GMT-6)