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Robotic nerve saving surgery for prostate removal
I am 56 years old and I was diagnosed with prostate cancer in 2022. I had a biopsy in 2022 and 2024 that both confirmed cancer. I just had an MRI done this week and I got a PI‑RADS score of 5. Last year, my score was a 2. I do have prostate cancer, but my PSA levels were just checked last week and they are a 1. I am considering just having my prostate removed so that cancer will not spread, but not being able to perform sexually again is scary. Is there any insight on this. I live in St. Louis, MO and I am open to hearing anything concrete of definitive and will gladly give my phone number to anyone who can help. Thank you. 314-324-3451 Chris
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@kailuaflow That is where I am going.
@chippydoo @kujhawk1978 @jeffmarc
Does the removal of the prostate carry a chance of bowel/urine leakage? Are the PI‑RADS scores accurate? How can they differ that much from my PSA score of 1? I am going to ask my urologist about getting this group of tests. Is it as simple as just asking for these tests? I wonder why she wouldn't have suggested them already?
4K score test
PHI (prostate health index)
The EpiSwitch® Prostate Cancer Detection (PSE) test
Multiparametric-MRI in diagnosis of prostate cancer
@christophers
Some people who have their prostate removed, have a real problem with Incontinence. About 10% of people have no problem at all, I was one of them. For most people it’s just lasts for a few months. For some it goes on for a year or more.
You should be doing Kegel exercises before surgery to try to strengthen the Pelvic floor, And do the same thing after surgery as soon as it’s safe according to your doctor. You can also see a physical therapist who specializes in pelvic floor exercises.
Bowel problems are pretty much not an issue.
You can get your MRI reviewed by another company, but the PIRADS Scores are Usually very reliable. Even if it was a four, you would need a biopsy to find out if the cancer was a higher Gleason score.
The PSE test is probably unnecessary. You said they found cancer in your biopsy last year. Were you able to get a hold of that biopsy and see what it said your Gleason score was? If that test definitely found cancer the PSE test is not necessary. It is used to decide whether there is Cancer in your system, And if there is then you get a biopsy. In your case, you need a biopsy because of the MRI results.
Another MRI makes no sense. A biopsy is what you need after the MRI you just had.
You can get a 4K score or PHI test But it is designed to find out whether or not you need a biopsy, Your MRI says you do. The PSE test is much more accurate. I’ll include a photo of all the tests that are used for cancer screening, But you are beyond the need of a screening test.
You’re better off getting a decipher test to find out what your chance of reoccurrence is.
@chippydoo - Sorry to hear of your radiation repercussions and problems. I'm in a similar boat. RP (not nerve sparing) but PCa was extensive. Now 16 months later it's IMRT time. All the Docs say no bowel should be harmed. I have positive margins and possible lymph node issues. So radiation in all possible locations.
Did you have a faster treatment schedule or up to 39 with lower Ga doses?
I had 25 sessions. In addition to radiation proctitis I developed bladder urgency after 15 sessions. Oxybutynin helped. Best wishes with your treatment. So far 6 months undetectable post radiation.
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