Treatment AFTER surgury

[chf451]

OK, the deed is done, the prostate is in a jar. The cancer appears localized but who knows for sure, those cells may be setting up house somewhere else in the old bod. The after-effects (incontenence, pain, discomfort are pretty much nil except for E.D. and that's a work in progress). What now? Has anyone exercised a "one, two punch" of surgury immediately followed by hormone therapy or chemo? What advice as to which type "two punch" did you recieve? From what I've read, hormone therapy does not sound too fun.

[CapBob]

Originally Posted by chf451

OK, the deed is done, the prostate is in a jar. The cancer appears localized but who knows for sure, those cells may be setting up house somewhere else in the old bod. The after-effects (incontenence, pain, discomfort are pretty much nil except for E.D. and that's a work in progress). What now? Has anyone exercised a "one, two punch" of surgury immediately followed by hormone therapy or chemo? What advice as to which type "two punch" did you recieve? From what I've read, hormone therapy does not sound too fun.

When you say localized, how about some specifics? In current practice if you have:

Clear margins
Clear lymph nodes
Clear seminal vesicles
Clear bladder resection margins
No evidence of prostatic extension

And at however long after surgery your doc decides to check and finds:

An undetectable PSA

There is typically no follow-up treatment such as radiation and/or hormone therapy if all of the above are good, you simply monitor PSA leveles at regular and increasing intervals (not to exceed yearly). The issue becomes more complicated if any of the above are not optimal.

[chf451]

All the areas you mentioned were clean, clear with no identifiable extension of any kind. But inspite of the fact no additional treatment is typically done after a "clean" surgury there is some Doctors who advocate a "hit 'em while they are down!" attitude and encourage a session of additional treatment of either hormone or chemo. Thus the question...

[alibabba]

Hi guys,
I am afraid I have the same thing going on. I had the same path report, 3+3=6 Gleason. I am 3 years out as of 2/17/08, psa's been <0.04 for 3 years but this year it was 0.07 then a month later it was 0.08. My Surgeon/Urologist said the .07 to .08 was to close to worry about and he has me a psa set up for 3 months after the second one,(0.08) which will be 6/24/08. Just when I was getting comfortable with this thing here it comes again. Everything else was just fine, no problems at all. Erections came back at 2 yrs and are still improving. By the way I am 53. Good luck all.....

[jj1963]

Alibabba - thanks for the post. I wish you the best of health in the future. One thing i cant help but notice is the erection return at 2 years. i am 44, very good health and 13 months post op. Nerves spared. Very little return of potency. Yours is the first to note erection return between 12 and 24 months. I know this is more of a sexual dysfunction problem but i tend to hold that all us PC patients are brothers and belong in the PC Board. I am very interested in hearing how you achieved erection.