What is a Prostatectomy Like?

That about nails it, except...your urologist/surgeon may tell you that the cancer is gone forever, but that is the lie. We here are a large subset of men...the majority?...whose cancer keeps coming back, or we are told that it will eventually come back. We likely do not have contributions here from the men who were Gleason 3+3=6 and who had fully membrane/capsule-contained cancer with no perineural invasion, no extraprostatic extension ("EPE"), no surgical margins, no cribriform glands, no seminal vesicle invasion, no lymph node involvement, and no bone metastases. Those men were lucky and had their radical prostatectomy, and will likely go on to lead perfect, normal lives with no future recurrence. But then...there is the rest of us...the guys who were told "sorry, I didn't get all of the cancer out of you...you have surgical margins because you tumor broke through the membranous prostate capsule and caused surgical margins to include invasion into your seminal vesicles." "So...you are at minimum a pT3b whose cancer has a 25%-50% probability of recurring "within" five years."
Whenever that happens - if not before - your urologist will refer you to a radiation oncologist for a radiation therapy consult - either adjuvant (immediately after surgery within the first six months), or salvage radiation (six months or after surgery). Then if you have radiation, your bladder and urethra have likely been fried, and just when you regained full urinary continence 9-12 months after surgery - or anything close - you have now lost it for the rest of your life because your urethra is in fact fried from radiation. And...if you're really unlucky, you might fall into the 1-2% whose radiation caused bladder and/or rectal cancer later in life. Either way, when the radiation fails to have done the job thoroughly, your cancer will return yet again, and you will be put on hormone treatment and become a whining, emotionally labile woman who is unable to control your emotions and feelings, as you quite possible start developing small breasts. All this time, your doctor is just telling you that this will be your next treatment - whatever it is - all while hoping that you die of something else beforehand because prostate cancer grows slowly, because...they really do care enough that they do not want to see you go through the excruciating pain of bone metastases. That is kind of the likely reality for those of us here if you are kept alive long enough to go through all of these phases. Sorry...that was quite negative, but I have been in this blog enough to have read many stories that are subtle variations of all of the above...and that stinks. I empathize with everyone whose reality is any of the above or worse. I hope that you find peace and a pain-free existence for as long as possible.

That about nails it, except...your urologist/surgeon may tell you that the cancer is gone forever, but that is the lie. We here are a large subset of men...the majority?...whose cancer keeps coming back, or we are told that it will eventually come back. We likely do not have contributions here from the men who were Gleason 3+3=6 and who had fully membrane/capsule-contained cancer with no perineural invasion, no extraprostatic extension ("EPE"), no surgical margins, no cribriform glands, no seminal vesicle invasion, no lymph node involvement, and no bone metastases. Those men were lucky and had their radical prostatectomy, and will likely go on to lead perfect, normal lives with no future recurrence. But then...there is the rest of us...the guys who were told "sorry, I didn't get all of the cancer out of you...you have surgical margins because you tumor broke through the membranous prostate capsule and caused surgical margins to include invasion into your seminal vesicles." "So...you are at minimum a pT3b whose cancer has a 25%-50% probability of recurring "within" five years."
Whenever that happens - if not before - your urologist will refer you to a radiation oncologist for a radiation therapy consult - either adjuvant (immediately after surgery within the first six months), or salvage radiation (six months or after surgery). Then if you have radiation, your bladder and urethra have likely been fried, and just when you regained full urinary continence 9-12 months after surgery - or anything close - you have now lost it for the rest of your life because your urethra is in fact fried from radiation. And...if you're really unlucky, you might fall into the 1-2% whose radiation caused bladder and/or rectal cancer later in life. Either way, when the radiation fails to have done the job thoroughly, your cancer will return yet again, and you will be put on hormone treatment and become a whining, emotionally labile woman who is unable to control your emotions and feelings, as you quite possible start developing small breasts. All this time, your doctor is just telling you that this will be your next treatment - whatever it is - all while hoping that you die of something else beforehand because prostate cancer grows slowly, because...they really do care enough that they do not want to see you go through the excruciating pain of bone metastases. That is kind of the likely reality for those of us here if you are kept alive long enough to go through all of these phases. Sorry...that was quite negative, but I have been in this blog enough to have read many stories that are subtle variations of all of the above...and that stinks. I empathize with everyone whose reality is any of the above or worse. I hope that you find peace and a pain-free existence for as long as possible.