I could use some advice in Tennessee

[Skander123]

I was diagnosed with prostate cancer in 2017 - Gleason 6 - Active Surveillance - Remained same until July 2022 when PSA jumped over 4 again. In July, showing Gleason 7 in 10 of 12 biopsies. MRI in December including prostate and pelvic floor shows contained in the prostate with no external lesions.

I had pretty much decided in 2017 to immediately have the Davinci robotic assisted prostatectomy should Gleason score show aggressiveness.

They have me schedule for surgery on 3/29. The Vanderbilt surgeon recommended Lymph Node Disection. When I researched it, that could mean anything from a few up to 20 lymph nodes associated with the prostate. Research indicated that if having ALL removed, could result in lymphedema in the legs. If I understood the research correctly, there is only a 7% chance of having in the lymph nodes. I know I will clarify this with the surgeon in the next week or so but pretty dang sure I don't want to have more than 3-4 dissected.

Any experience with this? Any recommendations to not have the surgery and to have radiation or other options?

My research had said that most men recover some ability for erections within a year or so. Has this truly been the experience of many? A very good friend had this done 4-5 years ago and has never achieved erection even with Viagra or Cialis. Can erections be achieved or is there significant work on my part to restore that?

I appreciate anyone who can take a moment to share their experience or encourage me in the direction that I'm taking, or to recommend other options (a little late for that but still in time to call off before 3/29).

[Tall_Allen]

Please read this before deciding:

prostatecancer.news/2021/12...

I know a guy who got off the gurney when he was being wheeled into the operating room, so it is not too late until they start cutting, or at least give you anesthesia.

Only 35% of men who were previously potent retain their potency after nerve-sparing prostatectomy, and only 4% of men who were ≥ 60 years old with functional erections pre-surgery achieved back-to-baseline erectile function (my guess is that drops to near zero for anal penetration).

ncbi.nlm.nih.gov/pmc/articl...

[tallguy86]

You stated you made your mind up at the onset. Have you really explored and considered other options? A surgeon is going to recommend "surgery." I was on AS for 5 years and reached the point where I needed TX. I chose SBRT because I believed it was the best choice for me. So, what I am saying is take your time to gather information about the choices at your disposal. My RO at West Clinic in Memphis was great! I never lost my ability to have erections. Very little semen present my orgasms are much more intense. Everyone is unique and different! Good luck!

[WaltM]

I think it depends on you. I had nerve sparing surgery on 11/14/22. Three weeks later I was getting erections. Three months later I topped someone successfully. This was using cialis and my doctor told me I had to continue stimulating 5x a week. Hopefully I won’t need pills after a while. For some guys using a pump is self stimulation. The idea is you need to exercise your penis to get blood flowing, at 53, I decided I wanted the cancer out of me completely and proceed. My three month check in showed me undetectable and hopefully it remains so.

[MarathonMan79]

greetings,

I have had the surgery but they did not remove any lymph nodes. Not sure why the doctor would want to remove so many. My doctor was on the other side of the coin wanting to save as much as he possibly could

Everyone is different after surgery. From incontinence to erections. Took me almost three months after surgery before I stopped wearing depends, meanwhile I have heard others say they never needed them

I had very strong erections before surgery, so afterwards they did come back, but not like pre surgery, plus once it was erect it was very easy to lose and once that happened I was done it was not coming back.

Drugs do work and also ask for a pump as that helps also. Don’t be shocked if you lose an inch off your length, no one really talks about that but it is a real possibility