Prostate Cancer Sucks-But good to celebrate victories big and small

Posted by fritzo @fritzo, May 20 8:59pm

I just had my post-surgery pathology consult with my doctor today after my radical prostatectomy surgery four weeks ago. Talk about apprehension and worry.

The doctor entered and asked if I had read my pathology report, which posted on MyChart earlier. I said I had, but didn't know if I was reading it correctly.

With a big smile he said, "This is as good as it possible could be." Negative margins, tumor was organ confined and seminal vesicles are negative for carcinoma.

So, a huge sigh of relief and a huge hug for my wife, who has been amazing through this journey. She admitted that she felt like she might able to breathe again.

I was also worried that my post-surgical PSA wasn't as close to zero as I hoped (it was <0.064). But, he said not to worry and that anything under .1 is a great place to be. I haven't been able to figure out what specific lab is actually processing my PSA results (used to be Abbott, but it looks like my local clinic has changed vendors).

I know I’m incredibly fortunate and I feel so indebted to everyone on this forum who has helped me navigate the emotional tsunami, as well as help me make a decision on what treatment path to follow. And then, the surgery recovery period has been a real adventure. So much advice. I feel so connected to everyone.

Things I'm still sorting out; stress incontinence, which is definitely an ordeal. I got a referral for Pelvic Floor therapy...so hoping that helps.

I also had a pre-existing inguinal hernia that definitely feels bigger post surgery. So, still looking for advice on how not to make that any worse than it is.

Prostate cancer sucks. I've had small victory moments....figuring out how to navigate catheters, overcoming rolling waves of intense abdomen pain, post-surgical bowel issues that were a big challenge, huge emotional turmoil about my surgery decision when a support group moderator (not a doctor but calls himself a doctor because they have a phd) who pushed me hard not to cancel my surgery (just four days before my surgery date),....or figuring out how to overcome intense muscle aches induced by Tadalafil,....and more.

But, I'm going to celebrate because this one seems like the big one. Feeling very grateful!

What was a surprise to me was that my staging didn't change at all. I was pretty convinced that it would come up worse because my final surgeon said the earlier trans-rectal biopsy under-sampled (even though they took 24 cores) because the location of my tumor was in a position that the trans-rectal probes couldn't reach.

I was also surprised that since my Decipher score was .61 that the pathology didn't show more serious cells than the "Prostatic adenocarcinoma" in the report. This topic is probably more complex than my limited knowledge.

Here is a section of my pathology report:
Final Diagnosis
A. Anterior fat pad, excision:
One lymph node and mature adipose tissue, negative for carcinoma.
B. Prostate, radical prostatectomy:
Prostatic adenocarcinoma
Gleason score 3+4=7 (Grade group 2, with 30% Gleason 4 tumor).
Tumor is on the left as a 1.2 cm dominant nodule.
Tumor involving 2% of prostate tissue examined.
Tumor is organ-confined.
Both seminal vesicles are negative for carcinoma.
All surgical margins are negative for carcinoma.
Benign prostatic hyperplasia, weighing 66.9 grams (including carcinoma).

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for tuckerp @tuckerp

good job. So far you have had to take what you were handed. Make lots of decisions. Lets hope your Dr did his job well. Now its time for you to do your part. I was an emotional mess after getting to this point and took 5 years off. None of that helped with the next two phases. ED and INC. Some are lucky enough its no big deal but best to keep after it . Great news.

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@tuckerp Yeah, ED and Incontinence. Not fun....I'm working on setting up a Pelvic Floor therapist and do have an appointment with a sexual function therapist. Hoping that helps.

Funny thing, for the incontinence referral yesterday, they gave me the number for the rehab hospital where my son works....which is kind of crazy. I had never thought I'd have a chance going there because Shirley Ryan Ability Lab is the best rehab hospital in the country and the world (ranked that high for like 30 years). So, hoping maybe they have some magic fairy dust or something to help.

Hope things settle for you tuckerp....none of this stuff is easy.

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Profile picture for melvinw @melvinw

Glad to hear that all is going well, and that the cancer was organ confined. The Odds are with you!

I also had a pre-existing inguinal hernia going into my RARP in April 2015. I maxed out my insurance OOP from the prostatectomy, so in consultation with my urologist, I scheduled a hernia repair surgery for six months after the RARP. Cost me nothing, and improved my life tremendously. Another multi-week recovery, but by 2016 I was fully back to normal physical activities.

Regarding the stress incontinence: even after PT and all the Kegels, I was still going through 1-2 pads per day. My urologist offered urethral sling surgery early on, but it wasn’t until 2023 that I had the procedure. Pretty simple outpatient surgery. Instant and 100% continence as a result. Again, QoL took a huge upturn. Even after my salvage radiation last year, I am still getting by without pads. Perhaps very slightly more drippy than before, but as my 50-something urologist said, I’m doing better than him (I’m 73). So, take heart that if the stress incontinence persists, there are ways to fix it.

Now go forth and enjoy the day!

Mel

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@melvinw Hmmmm, that's super helpful information about your hernia repair. I really hope I don't have to surgery again so soon and miss more work-but I guess work doesn't matter when it comes to health.

Wow-sling sounds like there is a light at the end of the tunnel if things don't progress. Eight years is a long time to wait, but you did it.

And at 73, outdoing the 50-year-old youngsters. You're my hero!

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Profile picture for mjp0512 @mjp0512

This is pretty good stuff. Relax and get back to life. 👍

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@mjp0512 Breathing easier now-shoulders are not as tense all the time. Not back there yet-but working on it. Thanks @mjp0512 !

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Profile picture for Jeff Marchi @jeffmarc

Definitely time to celebrate.

You could very well be one of those people that never needs to come back to a forum like this because you’re cured.

A real positive biopsy result.

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@jeffmarc Jeff-I'll be back. I really loved this forum because it had a good mix of positivity amid the really tough sitatuions. I also figure it's good to hear from people where things might have worked out.

And to be candid, navigating all of this was intense and the recovery process is pretty intense.

But yeah, hoping I can just stay focused on being helpful on surgery posts.

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Profile picture for fritzo @fritzo

@melvinw Hmmmm, that's super helpful information about your hernia repair. I really hope I don't have to surgery again so soon and miss more work-but I guess work doesn't matter when it comes to health.

Wow-sling sounds like there is a light at the end of the tunnel if things don't progress. Eight years is a long time to wait, but you did it.

And at 73, outdoing the 50-year-old youngsters. You're my hero!

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@fritzo Like you, I was pretty averse to another surgery after the RARP and the hernia repair. Hence the delay on the sling procedure. Looking back, I would have been smart to have done it sooner. It was not a difficult recovery. Some ice packs the first couple of days, then taking it easy on physical activity for a couple of weeks. No bike riding for 6 weeks. The worst of it is that your privates get rather bruised and swollen— was not a pretty sight. But no pain really.

If your PSA stays below 0.1, you are in good shape. With these ultra sensitive tests, your numbers can bounce around. Less than 0.064 is a good place to be, as your doc said.

Now I’m off for my next PSA test in a bit.

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Profile picture for melvinw @melvinw

@fritzo Like you, I was pretty averse to another surgery after the RARP and the hernia repair. Hence the delay on the sling procedure. Looking back, I would have been smart to have done it sooner. It was not a difficult recovery. Some ice packs the first couple of days, then taking it easy on physical activity for a couple of weeks. No bike riding for 6 weeks. The worst of it is that your privates get rather bruised and swollen— was not a pretty sight. But no pain really.

If your PSA stays below 0.1, you are in good shape. With these ultra sensitive tests, your numbers can bounce around. Less than 0.064 is a good place to be, as your doc said.

Now I’m off for my next PSA test in a bit.

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@melvinw Yeah, we're learning as we go. Wish I had the knowledge I have now a couple of months ago. But, we got to live it to learn.

Good luck with that PSA test. I've heard it described by some fellows as a "Patient Stress Attack" test...but sounds like you're a pro and roll with it.

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Guess I shouldn't complain as my surgeon repaired my inguinal hernia when he did the RARP. I was upset about it as I knew I had it since the 1990s and it never got worse or bothered me. I lift lots of weights and still never did bother me, wouldn't even know I had it except back when doctors really did a complete physical.

This sling thing sounds good, wounder how long a person has to wait to get one??? I had surgery on 4/30/26 at 12:15PM took 4 hours, I guess the added inguinal hernia he found. Then at 2AM on May 1, had another emergency surgery as lots of bleeding and they went in with robot again and found a bleeding artery. Still having lots of incontinence issue, usually stress. During the day the only time I can pee if getting up from chair or something and then go to toilet and nothing happens much a few dribbles. Even today I did almost 3 mile walk, bladder felt full no peeing. Worked a bit in yard and every bending over a big squirt.
However laying on couch reading a book or watching TV, I do get an urge to pee and can have a small success. Especially at night I wake up and have an urge to go and shoot a stream out like a teenager. But during day when sitting around and walking nothing but dribble and stress incontinence, never a feeling of I need to go. I drink lots of water up until around 8PM, even a couple cokes. Doesn't make sense to me, I know I have a bladder pretty full, but only lying down and especially at night in bed do I get they feeling to get to the toilet and have success like a race horse peeing on flat rock.

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Congratulations. Enjoy yourself. The pathology was great news. Wishing you and your family happiness always.

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Profile picture for diverjer @diverjer

Guess I shouldn't complain as my surgeon repaired my inguinal hernia when he did the RARP. I was upset about it as I knew I had it since the 1990s and it never got worse or bothered me. I lift lots of weights and still never did bother me, wouldn't even know I had it except back when doctors really did a complete physical.

This sling thing sounds good, wounder how long a person has to wait to get one??? I had surgery on 4/30/26 at 12:15PM took 4 hours, I guess the added inguinal hernia he found. Then at 2AM on May 1, had another emergency surgery as lots of bleeding and they went in with robot again and found a bleeding artery. Still having lots of incontinence issue, usually stress. During the day the only time I can pee if getting up from chair or something and then go to toilet and nothing happens much a few dribbles. Even today I did almost 3 mile walk, bladder felt full no peeing. Worked a bit in yard and every bending over a big squirt.
However laying on couch reading a book or watching TV, I do get an urge to pee and can have a small success. Especially at night I wake up and have an urge to go and shoot a stream out like a teenager. But during day when sitting around and walking nothing but dribble and stress incontinence, never a feeling of I need to go. I drink lots of water up until around 8PM, even a couple cokes. Doesn't make sense to me, I know I have a bladder pretty full, but only lying down and especially at night in bed do I get they feeling to get to the toilet and have success like a race horse peeing on flat rock.

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@diverjer Yeah, I asked the surgeon if they could fix my inguinal hernia at the same time and he said they would never do it unless it was causing issues. I had hoped it was an option for me, but not to be. So, I'll have to see if it gets worse and then do follow-up surgery. It sounds like they would most likely do open surgery rather than repeating a laprascopic robotic procedure after a prostatectomy.

Sling? Not an expert, but you and me are both super early in the continence process. Thinking that is if continence doesn't improve after 3-6 months or longer, then they think about sling as an option. But, I'll let the experts chime in.

I'm basically the same as you. I do fine if I'm sitting or laying down. Yes, I now have to get up three times a night to pee, but I'm basically dry in the morning. But, as soon as I do activity...drive, walking, getting up and down and such, tons of stress incontinence. I do a two-mile walk daily and I fill up a heavy pad almost full on a 40 minute walk.

Drinking plenty of fluids is good. I know some people reduce fluids thinking they will have less leakage. But, the bladder is like your stomach. A bladder will shrink over time if you don't drink enough liquids, which just makes everything that much worse. You'll have to go more often.

Oh, watch out for those Cokes, they are a hard core diuretic due to its caffeine content, which increases urine production ....gonna make you have to pee all the more (just like alcohol).

Hope we both make good progress- good luck on your recovery!

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I bet we all wish we could smash those three buttons ten times over for you! Great news, congratulations!

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