Partial nerves removed during prostatectomy

[ChessAccordionist]

Hello,

I am 51 years of age, newly diagnosed with Gleason 9 prostate cancer. According to PET, there is no spread.

I will this week be having robot-assisted prostatectomy. Because the tumor is located only on one-side of the prostate, the nerves will be spared on the other side, while not on the tumor-side.

Is there a big difference in recovery, when only one-side of the nerves are spared?

Thank you.

[AlvinSD]

Are you also following up with a Radiation Oncologist and Medical Oncologist? Even if the PSMA PET scan shows no spread, with a Gleason 9 it is highly likely there is microscopic spread which the PET scan can’t detect. Because of that, proactively they often start on ADT now then add on radiation once you’re recovered. If your Urologist is saying you’ll be good with surgery and you can just watch it, I’d seriously question their expertise

I had a high volume Gleason 9. They would have had to remove all the nerves if I had surgery. I had radiation rather than surgery.

I know of guys who had only nerves spared on one side and are still able to get erections. However, it took a long time to recover function and they require meds.

Younger guys and those with good erectile function before surgery tend to do better.

Having a good plan for penile rehab before surgery and sticking with the plan will help.

[ChessAccordionist in reply to AlvinSD]

Hi Alvin,

Thank you for the reply, much appreciated.

I am in public healthcare in Europe, so it is not so easy to choose your own treatment. I got the options to choose between surgery or radition, but not both. If the PSA after surgery passes 0.2, then I will offered radition and hormone treatment.

I will look into penile rehab plans.

Thanks!

[ron_bucher]

I had non-robotic prostatectomy in 2006 (before there was enough robotic experience) so I don't know if this applies. My surgeon said if there was any doubt about whether to spare nerves he would get a pathology report in real time during the surgery to decide whether to spare the nerve(s).

Now is a good time to add to your medical time a medical oncologist who has had lots of prostate cancer patients.