Saturday 7 April 2012

Goodbye Prostate. Goodbye Old Friend.


Many of you who have previously read my Movember blogs or my post on Global Warming and My Prostate will know that my urologist and I have been actively, vigilantly and diligently watching a tiny, slow-growing cancer in my prostate for the last 5 years, and suspecting the existence of one for 2 years before that.

The time for mere vigilance is over.
I am scheduled to have a radical prostatectomy early  next month.
In theory this should remove all the cancer but we will only know that with reasonable certainty after the urologist gets the follow up pathology report which should confirm the grade of cancerous cells in the prostate and whether any cancer has spread to the surrounding lymph nodes - very unlikely but worth checking.
I expect to be in hospital for 2 days after surgery. Initial recovery time is 4 to 6 weeks. I am not supposed to do heavy lifting or vigorous exercise for 3 months. (I believe that includes mowing the lawn and washing the dishes.) For both medical and insurance reasons I should not attempt to drive a car for a full month after surgery.

The most significant side effects for me, which are supposed to be temporary, are incontinence and erectile dysfunction. In my case I'm not going to worry too much about infertility...
I'll have a catheter for about 2 weeks. The benefit of that is that I won't have to get up at night, even if I drink a couple of beers before going to bed, as the bag takes 2 litres. After the catheter comes out I'll be peeing my pants for a few months whenever I cough, sneeze, flatulate or otherwise exert myself. I've already started my Kegel exercises to speed up recovery but I guess I'll be relying on ultimate masculine hygiene pads for men for a while.

The ED is another story. The bad news is that this takes a lot longer to restore than the pee-control. The good news is that I am eligible for nerve-sparing surgery which gives me a better chance of recovering the ability for spontaneous erections or, more likely, erections with help from little pills like Viagra. Getting up in the morning will never be the same again, I'm afraid.

Why now, so quickly?

By doing it now I can have the nerve-sparing surgery. If the cancer is allowed to spread or become more aggressive then that window of opportunity will close.
If it were done when 'tis done, then 'twere well it were done quickly. - Macbeth

How do I feel about it?

...not very thrilled, as you can imagine, and somewhat disappointed that I could not continue the active vigilance stage a while longer. As Pooh Bear said of Eeyore and his tail, I'm very fond of it and definitely attached to it. (E.E. Milne. Winnie the Pooh, Chapter 4.) I know I will miss it. But it helps to keep things in perspective and remember that this is happening not because of the surgery but because of the cancer. All these side effects, and worse, will happen to me anyway, permanently, if I leave the cancer untreated.

Many thousands of men have been through this before me. I need to be grateful: my prognosis is excellent because we have been watching it so closely all this time. To the men among you let me say that if you are over 40 and have not had a baseline PSA test yet, please ask your doctor to order this test for you. In Canada 1 in 7 men gets prostate cancer and it is the most common cause of cancer death among men in Canada. Yet it is highly treatable if caught early enough.

To the women among you: if your man is over forty and has not had his baseline PSA test, get him to read this post. This is one area where a woman is allowed to nag. It is a known fact that a large number of men finally get their prostates checked just to stop their wives and partners from nagging. It's all good!