Patients will often ask me if there is anything they can do to improve erectile function after radical prostatectomy.
In general, I tell them that pre-operative function is one of the most important predictors of post-operative function. The old saying, "use it or lose it" actually does apply.
More recently, there is mounting evidence that prophylactic PDE5 inhibitors (Viagra, Levitra, Cialis, etc.) even in small doses every other day may help increase blood flow to the penile region and hasten recovery of erectile function.
I would encourage you to ask your surgeon if they or their colleagues have a program of "rehabiliation" for erectile function following surgery.View Thread
We use it in our practice and have been very happy with the tolerability and the improved survival data. It is impressive to think that the first "cancer vaccine" is in the field of urology. Sounds like your husband is in good hands.View Thread
Labs can vary. You should also inquire as to whether it in an ultra-sensitive PSA test or not. Different institutions use different PSA cutoffs to define BCR. HIstorically is was .4 and in some cases .2. In real life, we know on an ultra-sensitive PSA it should definitely be less than .1.
Bottom line is I would recheck it. a BCR will be obvious in that the rate will rise.View Thread
This is likely a side effect from hormonal therapy. When the testosterone is low that means the hormonal treatment is still giving a response. It will improve once the T rises. In the meantime you can ask your doctor if he can prescribe something such as Megace to help w/ the hot flashes.View Thread
That is a great question. Typically benign tissue left behind will result in an immediately detectable PSA after surgery which is usually very low (like in your case) and either stays stable or rises very slowly over time. A steadily rising PSA, however, should be considered cancer until proven otherwise.View Thread
The answer is yes. The only part of that story that is unusual is the psa of 24.6 -- that is a very high PSA for a supposedly small volume Gleason 6. Either the PSA was high for other reasons (prostatitis? infection? -- have you re-checked it recently) or the disease is understaged on the biopsy.View Thread
The slow rate of rise suggests a local recurrence as opposed to metastatic disease. Make sure they are checking an ultra-sensitive PSA. I would go ahead and get plugged in to see a radiation oncologist. You are young and you should treat aggressively. I would get an MRI and then start radiation therapy.View Thread
With all prostate cancer diagnoses you and your doctor should discuss:
1. active surveillance 2. radical prostatectomy 3. radiation 4. cryotherapy
The decision is made based on the aggressiveness of the tumor/PSA/Gleason score, etc as well as the patient's age and health. If you have more questions and want a second opinion do not be afraid to seek this out.
Take your time and make a decision you will be comfortable with.
Yes, Avodart and Finasteride both reduce the PSA by 50% or more in many cases. You need to double whatever your PSA is now to get the true reading. If the "high" reading was done while you had prostatitis I would wait and re-check in 2-3 months when the symptoms have resolved.
I would look back at the last several PSA values and take into account your age and health before determining if this PSA value requires further workup. (ie, a biopsy). A visit with a urologist might be the next best step.