One year post RALP

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New Member

Date Joined Mar 2017
Total Posts : 6
   Posted 9/13/2017 11:38 AM (GMT -7)   
Today is the anniversary of my RALP. Amazing how the time flies by as I get older. As someone said on a recent post, progress post-surgery is non-linear, and I think that’s some of the best advice I’ve taken from this godsend forum. I was relieved last week that my one year post-op PSA test came in as undetectable, but my local uro is keeping a weather eye on me and given my pathology, I can expect quarterly tests for quite a while yet. He’s an old friend and I am glad he’s personally invested in looking after me.

The non-linear stuff has been fairly normal from what I understand. I was probably 90% continent when the catheter came out, but had occasional spurts and sloshes for a couple of months after that. Continence steadily improved, and now I only have infrequent stress incontinence. Just when I’ve gone a week or so with no dribbles and think I’m fully watertight, I’ll cough suddenly or reach for a doorknob, and a few drops emerge, but overall, I’m happy with where I am. I think bourbon at first made me slightly less continent, but thankfully I seem to have adjusted to that. ED is still a significant issue. Sildenafil works reasonably well for me, but neither my wife nor I are big planners in that regard, so mostly it’s chemical-free and a little wobbly, but things seem to improve slowly and unevenly.

The psychological part is the hardest for now. At a year out, I’m fairly sure the PSA risk grows higher, and the pre-test anxiety that so many have described here is palpable and intense. It’s difficult to focus at work for the week (or more) leading up to the blood draw. I try not to dwell on it too much at home. I think it creates a lot more anxiety for my wife than she lets on, and so we try to be strong for each other, without talking about it too much. Keep calm and carry on, they say. It’s hardest to know what to tell my three daughters, and what not to tell them. One is out of school, and two are in college. The youngest was still at home during the diagnosis and all the scans and tests, and because of that, and because her beloved rowing coach was at the same time succumbing to breast cancer, she has taken it the hardest. So I try to deliver information in measured doses so that they don’t get too anxious about all this. But the three of them are good listeners; I try not to burden them too much and try to appear as tough as they think that I am. It’s good to have them as a cheering section.

It’s also a relief to know that I’m not alone, and there’s a great deal of solace in the shared experiences in this space. Halbert, TA, Redwing, Todd1963, Prato and everyone else, thank you for being here for me. I don’t post much at all, but I’m here sometime every day to see how everyone is doing, and get some education and inspiration from you all.
Dx 6/16 @ 53yrs, PSA 10, 8/12 needles positive, G6
Negative bone and CT scans
Upgraded to G7 at JHopkins
RALP at JHopkins 9/16, LN-, SV-, Marg+(3mm), EPE, PNI
G6, G7 (3+4) <5%, G7 at margin, pT3a, Decipher 0.31
PSA 12/16 <0.02
PSA 3/17 <0.02
PSA 6/17 <0.02

Veteran Member

Date Joined Oct 2013
Total Posts : 686
   Posted 9/13/2017 11:58 AM (GMT -7)   
Hey, that's great, pintail. Congratulations.

You mentioned, "Sildenafil works reasonably well for me, but neither my wife nor I are big planners in that regard, so..."

You might want to consider an upgrade to your quality of life by switching to the daily dose (5mg) of tadalifil (active ingredient in Cialis) so that you don't have to plan or remember anything. I made the switch pretty early, and am glad I need to suffer through the unneeded additional frustrations.

Regular Member

Date Joined Nov 2016
Total Posts : 308
   Posted 9/13/2017 12:04 PM (GMT -7)   
Sounds like you're doing pretty well after one year. Your PSA looks good so far. I'm glad the ED is coming along. A man in his early 50's has a better chance of returning to his pre-surgery function than a man like me in his later 60's. I hope that continues to improve.

In the meantime, enjoy life. Deal with what comes next when it happens.
Age at diagnosis-66 Diagnosed 6/16
RALP 10/16 at U of Chicago, Dr. Shalhav. Experienced internal bleeding post op requiring transfusion of 2 units.
Pathology Gleason 3+4=7, tumor volume 15% Margins negative except for one focal margin, .1mm
PSA @ 6 wks <0.02;16 wks <0.02; 5/17 <0.02

Veteran Member

Date Joined Jan 2012
Total Posts : 7924
   Posted 9/13/2017 12:31 PM (GMT -7)   

I'll be in the shop.
Age 57, 52 at DX
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

Regular Member

Date Joined Nov 2015
Total Posts : 69
   Posted 9/13/2017 1:27 PM (GMT -7)   
Good report and congrats on the progress. As someone who is four weeks post RP, its helpful to hear about your experience over the first year.
Age 56
PSA 3.9=>7.4 2012-2016
5/13-1st biopsy 1 of 14 cores G6 at <1%; 7/13-1st mpMRI all clear
4/14-2nd biopsy 1 of 17 cores G6 at 5%; 8/15-2nd mpMRI all clear
4/17-3rd mpMRI one 19mm PIRADS 4 lesion in transition zone
5/17 - fusion biopsy 5 of 21 cores G6 at 20% to 90%; all 5 positive in target TZ lesion, 16 other benign
8/17 - RRP Surgery, pT2c margins-, EPE-, SV-, LN- Gleason 3+4=7

Bobby Mac
Veteran Member

Date Joined Mar 2016
Total Posts : 665
   Posted 9/13/2017 4:30 PM (GMT -7)   

Bobby Mac
Age: 69 at PC dx, PSA 6.7 Biopsy: 2/16 13 of 14 Positive, - RALP 4/16 Path:EPE, 2 + margins, Gleason 4+3=7, 50% of gland, Stage pT3a N1, nodes 2/10,+, 68 Ga PSMA 8/16 left node +, bed +, Lupron 8/16 - 6/17, Firmagon 7/17, uPSA 6/16, 2.41, SRT completed 12/16, PSA 6/2016, 2.6, 7/16, 2.2, 8/16 .6, 10/16 <0.1. 1/17 <0.1 T=43 5/17 <0.1 T=34, 6/17 <0.1 T=25

Regular Member

Date Joined Mar 2017
Total Posts : 206
   Posted 9/13/2017 5:29 PM (GMT -7)   
Pintail congrats on your psa report! Your one of the few guys that have mentioned how hard this is on your wife my wife is like yours it really has stressed her out but she does pretty good job of hiding it. It was gonna be her year to get both of her knees replaced as they are bone on bone but she passed to attend to me and my 3 surgeries this year and my starting radiation next month! I give a big hands up to all the wife's that are our nurses thru this darn disease!!! 👍👍👍

Male 61 DX age 60
Father had PC
2002. Psa. .08. Enlarged Prostrate
2014. Psa. 3.8
2016. Psa. 19
3-08-17 RP Mayo Clinic Mn
Path Report: Gleason 9, Seminal vessels and one nerve removed, negative on margins, 35 lymph nodes removed no cancer, tumor was pt3b. Prostrate 45 grams
4-20-17 Incarcerated Umbilical Hernia repair
6-13-17 1st psa check 0.13
7-19-17 psa 0.12 MRI clear
8-29-17 shoulder replacement

Regular Member

Date Joined Jun 2016
Total Posts : 73
   Posted 9/21/2017 7:42 PM (GMT -7)   
Glad to hear about your recovery and steady progress.
Congrats on your anniversary!
51 y/o @ dX and surgery.
No ED before RALP, not on any medication,
TRUS Biopsy 8/16 Gleason 7b (4+3) 1/12 cores 10% RALP 11/2/16 Gleason 7 (3+4) pT2c -LN, - margins,Organ contained.
Continent 99% at 3 months
Total ED, started Cialis @ 10 weeks, VED@4 months PSA<0.01 @7 weeks & 5 months, TRIMIX @6 months, nothing spontaneous at 10 months, 100% ED, lost 2+ inches of length, nonexistent orgasams

Tall Allen
Veteran Member

Date Joined Jul 2012
Total Posts : 8817
   Posted 9/22/2017 2:00 PM (GMT -7)   
It's challenging staying in the present when the mind wants to wander, but it sounds like you're doing a good job of it. As of today, everything looks good.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Regular Member

Date Joined Mar 2017
Total Posts : 57
   Posted 9/22/2017 2:52 PM (GMT -7)   
Sound like its going good for ya. I can relate to the piece regarding children. Mine are 6 and 8. I've had a great life and if it all ended tomorrow, i'd accept it. Its imagining my family at my funeral can bring me to tears quite easily and that keeps me in the fight more than anything. I would be happy to have enough time to see my children in college...definitely do-able, but you never know.

Last Sunday, I was feeling pretty lethargic, but told my kids i'd take them to the park. Dragged myself up and, for sh!ts and grins, i loaded up the balance bikes, and the new pedal bike. First go of it, and my daughter jumped on the pedal bike and, with minimal help, learned how to ride it in about 30 minutes. Smiles and high fives all around, and I thought to myself "Self, this is why we fight."
DOB: 1970
PSA: 05/16 6.2, 6/16 5.5, 08/16 5.4
Biopsy: 11/16 - 3 of 12, 3+4, Bone/CT: neg
01/17 PSA 8.5
RALP: 2/08/17, Dr. Dena Engel
PMs & ECE, Gleason 9 (4+5)...oh joy
6-week post-op PSA 3/17 <0.1
Erect: 90-95% functioning
Incont: 1-3 pads (after cath removal ~ 8-10)
2-wks Casodex, short course Lupron (6-mos shot 4/26/17)
7 wks IMRT/VMAT to come,
Plant-based diet
1st ultrasensitive PSA 0.02
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