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MRI after PCa diagnosis

12 Jan 2011 16:03

Hi everyone

I was diagnosed with early stage prostate cancer after a biopsy in July at the age of 56 (I'm 57 now).  For those interested, my PSA was 5.6, Gleason 3+4, positive in 4 out of 12 biopsy confined to right side of prostate. I had an MRI the following week and the scans showed nothing of any significance.  I'd had numerous DREs, all of which were negative except for one after the diagnosis had been made, that was done by the surgeon who would be doing my surgery.

My RRP was delayed by a few months due to my having high blood pressure, but I finally had it three weeks ago on 21/12/10.  So far I'm recovering as well as can be expected and I really should be on top of the world.  But I'm not.  As the time for review gets closer I'm getting increasingly worried that the treatment (with the delay) was too late and the cancer has spread further.  How much faith can I have in the MRI last July which showed nothing?

I guess I'm looking for reassurance.

Bob

Re: MRI after PCa diagnosis

12 Jan 2011 17:16 in response to telemando

Hi Bob

Welcome to the forum.

Glad to hear that your LRP went well and that recovery is good. That is great news. Gleason score and PSA are within the curable bracket. Was a staging given to you? I would imagine something like T2cNOMO?

As far as your concerns re:- spread in the meantime, this is extremely UNLIKELY so please be reasurred. Surgery would not have been offerred or even attempted if there had been ANY evidence of spread outside the margins/capsule. MRI scans are as good as you can get, and if they say the result is negative, then negative it is.

The only possibility of the cancer remaining, is if there is any PCa tissue left that they were unable to remove during surgery. This can sometimes happen if its very close to nerve bundles, for example. If this was the case, then usually the team inform you of this post op, so that you are aware of it.

Generally. this is dealt with by a few sessions of Radiotherapy, to ensure that all the PCa cells are destroyed.

This is a VERY slowly growing cancer, and it is so very unlikely to have spread prior to surgery.

Do come back for a chat if you have any other concerns/worries. If you would like any further information, then do let me know, and I will paste in some links for you to look at. Alternatively, PM me via my profile page.

Best of luck, and hoping it all works out well for you - no reason to expect otherwise.

With regards and best of wishes

jadziadax

x

Re: MRI after PCa diagnosis

13 Jan 2011 16:48 in response to jadziadax

Hi jadziadax

Thank you very much for taking the time to reply, and for being so reassuring.  I wasn't given a specific staging, but in the letter sent to my GP it was described as Early Prostate Cancer, so I guess it would be either T1 or T2.  I know that it was only found on the right side of the prostate so the surgeon was able to save the nerves on the left - not that anything is stirring down below just yet, but I guess it's early days for that.  I got the impression he might have been overcautious in not saving the other nerves, but I decided I would accept that decision on the basis of better safe than sorry. 

I saw the surgeon on the day after the operation, and he told me that the surgery went exactly to plan. I estimate I was under anaesthetic from about 11.45 am to about 3.15 pm.  That seems a long time to me, but it also means that the team had plenty of time to remove everything that should go!

After reading your posting, I also feel happier about the possibility of radiotherapy.  I hope I don't need it but if I do then it's obviously not the end of the world.

Once again, many thanks for setting my mind at rest.

All the best

Bob

Re: MRI after PCa diagnosis

14 Jan 2011 20:40 in response to telemando

Hi Bob

Glad I was able to give you some reasurrances. ED [Erectile Dysfunction] is a common problem following this operation. At least you have one side of nerves spared, so some function should eventually be possible. There are all sorts of medications available, also equipment and some even use injections. Its an embarrassing subject for most men to try and broach, therefore difficult to advise. There is a lot of help out there, and your GP can assist. PM me for further information if you wish.

The amount of time spent in surgery is actually about average. I know of others who have been up to 8 hours on the table. You did well

You should be expecting a follow up appointment about 6 weeks post-op. There they should have all the results and biopsy of the Prostate available, and can give you the fuller picture on it all.

Always around if you want to chat more. Best of luck, and please try not to worry.

With regards and best of wishes

jadziadax


Re: MRI after PCa diagnosis

10 Feb 2011 23:49 in response to jadziadax

Hi jadziadax

I saw the surgeon today for my first post-op assessment. I was relieved to hear that the cancer had been confined to the prostate, the surgical margins were all clear and my PSA had dropped to an undetectable level.  The surgeon was also pleased with my recovery after the surgery, particularly how well I was doing with the bladder incontinence. He also prescribed some Cialis tablets to help the ED. 

Thanks for being there when I needed reassurance. I often returned to your posting to re-read them.  I can now think about returning to work in the next few weeks.

Thanks again and best wishes

Bob

Re: MRI after PCa diagnosis

11 Feb 2011 23:32 in response to telemando

Hi Bob

Pleased to hear that you got a great report from the Medics. It sounds like you have this beaten. Of course, you will still have the associated problems for now, but I am pleased to hear that Cialis was prescribed. Its really important to try and maintain function, and keep the blood supply going where it's meant to. If you find that this doesn't work, then do go back to your GP and ask for something different.

Hopefully you are keeping up with your Kegels excercises? I know they are boring to do [!] but it will make a huge difference to the incontinence long term.

I really do want to wish you all the very best. I am always around if you want to chat about anything, so please don't hesitate.

Best of luck.

With regards and best of wishes

jadziadax

x

Re: MRI after PCa diagnosis

12 Feb 2011 16:58 in response to jadziadax

Hi Jadzia

Still doing the Kegels!  The incontinence is slowly improving, except when I laugh - if I listen to "I'm sorry I haven't a clue" then I usually have to change the pad afterwards!

A friend of mine has told me that Cialis is extremely effective. Can't wait to try it out.

Bob

Re: MRI after PCa diagnosis

12 Feb 2011 18:44 in response to telemando

Hi Bob

Keep on with the Kegels. As to the Cialis, best of luck !

Take good care of yourself.

With regards and best of wishes as always

jadziadax

x

Re: MRI after PCa diagnosis

12 Feb 2011 22:24 in response to jadziadax

Thanks!