Prostate Cancer...?

Soon, I will have radical surgery to rmove my prostate in a nerve sparing procedure. Is there anything else that I need to know that my doctor won't tell me especially about sexual intercourse after the procedure...

Prostate Cancer...?
Prostate cancer survivors need not kiss their sex lives good-bye, even if they do not qualify for the least invasive form of a prostatectomy.





Patients who use erection aids after a prostatectomy report levels of sexual functioning that rival those of patients who haven't yet had surgery.


Not everybody knows that these aids are readily available.This is something that a patient should get information about, but may not be raised in any detail by his doctor."





While rarely fatal, prostate cancer can damage a survivor's quality of life. Up to 90 percent of patients report impotency or some decrease in sexual functioning following standard radical prostatectomy, past research has shown. The incidence of these side effects drops to 50 percent with a relatively new surgical procedure that leaves intact the neurovascular bundles that allow for erections. However, only patients in the early stage of prostate cancer are eligible for so-called nerve-sparing prostatectomies.





Until recently, the main treatment for sexual dysfunction has been surgical implants, which initially inspired complaints but have improved considerably over the past 15 years. Pharmacological approaches have recently become available, with an oral medication to combat impotence expected to hit the market within the coming year. Despite such advances, research has shown that physicians are often reluctant to initiate discussions about sexuality





Sexual dysfunction is a side effect, and you're just going to have to learn to live with it.





For many men, erection difficulties cut to the core of male identity, so these problems can represent a significant loss. Erection difficulties can be equally devastating for the partner, not just because of the loss of intercourse, but because of a loss of physical intimacy and emotional closeness."





Perez, Meyerowitz, Skinner, Reynolds and two researchers from the School of Medicine looked at 294 prostate cancer patients, 45 of whom were awaiting a radical prostatectomy, 117 of whom had undergone a nerve-sparing radical prostatectomy and 132 of whom had undergone a standard prostatectomy. Of the patients who had undergone some form of prostatectomy, 74 used an erection aid, including penile implants, pharmacoerection program or vacuum constriction devices.





After controlling for age and ability to carry out daily activities, the researchers found no statistically significant differences in the likelihood of patients being aroused by a partner or the frequency of sexual activity the patients considered ideal, so any differences in performance could not be attributed to differences in sex drives.





In keeping with past research, the USC team found that patients who had undergone nerve-sparing surgery alone reported dramatically higher levels of sexual functioning than the group that had a standard radical prostatectomy alone.





When compared to the radical prostatectomy group, the nerve-sparing group reported higher levels of desire and sexual activity and greater frequency of orgasms.





But as impressive as the nerve-sparing surgery appeared when compared to a radical prostatectomy, it paled by comparison to erection aids in allowing patients to recover their sex lives.





When asked whether they were satisfied with their current level of sexual performance, 36 percent of patients who were using erection aids following a prostatectomy responded affirmatively, vs. 14 percent for the nerve-sparing patients and 8 percent for the standard prostatectomy patients.





When compared to the nerve-sparing surgical group, the erection-aid group was more likely to report having a "slightly to extremely satisfactory overall sex life" (73 percent vs. 39 percent), sexual activity at least once a week (55 percent vs. 31 percent) and orgasms through intercourse at least 50 percent of the time (89 percent vs. 53 percent).





Men are getting the less invasive surgery in the hope of protecting the quality of their sex lives, but erection aids appear to do just as good a job.





The researchers predicted that their findings would offer hope to patients who are not candidates for the less-invasive surgery.





It's not all over if you can't have the nerve-sparing surgery, . You can turn to the erection aid as a good alternative."





In











It's clear from the pattern of results that doctors should seriously and routinely discuss the use of erection aids for patients who are going to undergo prostatectomies
Reply:Prostate cancer is usually adenocarcinoma. Symptoms are rare until urethral obstruction occurs. Diagnosis is suggested by digital rectal examination or prostate-specific antigen measurement and confirmed by biopsy. Prognosis for most patients with prostate cancer, especially when it is localized or regional, is very good; more men die with prostate cancer than of it. Treatment is with prostatectomy, radiation therapy, or, for some elderly patients, watchful waiting.


Nerve-sparing radical prostatectomy reduces the likelihood of erectile dysfunction but cannot always be done, depending on tumor stage and location.


Orchiectomy (excision of testicles) alters hormone production and may be recommended for metastatic cancer. There may be some bruising and swelling initially after surgery, but this will gradually go away. The loss of testosterone production may lead to problems with sexual function, osteoporosis (thinning of the bones), and loss of muscle mass.


The drugs Lupron or Zoladex are also being used to treat advanced prostate cancer. These medicines block the production of testosterone. The procedure is often called chemical castration, because it has the same result as surgical removal of the testes. However, it is reversible, unlike surgery. The drugs must be given by injection, usually every 3 months. Possible side effects include nausea and vomiting, hot flashes, anemia, lethargy, osteoporosis, reduced sexual desire, and erectile dysfunction (impotence).


Other medications used for hormonal therapy include androgen-blocking agents (such as flutamide) which prevent testosterone from attaching to prostate cells. Possible side effects include erectile dysfunction, loss of sexual desire, liver problems, diarrhea, and enlarged breasts.


Your natural reaction to impotence may be to avoid all sexual contact. Don't fall for this feeling. Touching, holding, hugging and caressing can become far more important to you and your partner. In fact, the closeness you develop in these actions can produce greater sexual intimacy than you've ever had before. There are many ways to express your sexuality.


Please see the web pages for more details on Prostate cancer.
Reply:You can have the minimally invasive radical prostatectomy: the Laparoscopic Radical Prostatectomy, LRP, which will reduce bleeding, pain and recovery time. Good luck.
Reply:Your doctor will probably tell you just about anything you feel you need to know. The problem that I personally had was how to approach so many different subjects. The very first thing that I did was to contact my local prostate cancer support group. I wanted as much information from as many different sources as possible--and I wanted them fast. I knew the prostate cancer support group existed from my previous work with the American Cancer Society. It still took me 20 minutes to find a phone number here in Salem. I was able to speak to the person who started the support group many years ago. A great conversation we had. Biggest item I learned was not to panic, I had time to find out what questions to ask. I then went to the meeting and met with several prostate cancer survivors and their wives. I was able to learn to approach the sexual intercourse questions with my urologist, my oncologist, and my radiation oncologist, and most importantly my fiancee (now my wife). We came up with questions to help me make a decision for me and us. It is my body and I have to be able to be satisfied that I have made the best decision for me.


You have to feel that you are making the best decision for you in this place in your life based on the answers to your questions.


Best thing I can tell you is what I learned to do: find as many (legitimate) sources as possible, talk with others that have been there, make a notebook, take notes, ask questions, and listen.


If you need any more info, feel free to get back with me. I will be happy to give you more info, contacts, or phone numbers.
Reply:I'm not saying "don't have the surgery", but I think you should have this information, in case it comes back:





CANCER: There's a new Swedish study which shows that human breast milk kills cancer. On the news this guy who drank human breast milk (with a prescription) beat cancer. It was discovered by Swedish scientists that human breast milk (spilled into a petri dish) kills cancer. People who drink it have had some success in fighting off cancer.





You need a prescription and it's about $3 an ounce at a breast milk bank, but it works.





http://www.sciencenews.org/articles/2006...


http://news.bbc.co.uk/1/hi/health/418769...
Reply:Hi Lazar,





Research this. It is most likely that you will not function after the surgery..normally anyway. and that you may be incontinent also. good luck in everything
Reply:If you are determined to get it back after surgery, you will. It is a long road and may take a year, perhaps more, perhaps less. The main thing is to not become frustrated if it takes a long time to make progress.A doctor who is experienced with dealing with this normally prescribes a pump a couple of months after surgery as a form of rehab to help keep the muscles from deteriorating. Some urologists will give you a one time injection just to show you that it is still possible to get an errection, but this is not a permanent solution to the problem. There a lot of things available to help restore sexual function. You may discover that that a combination method works better, not just one alone. A good prostate cancer support group is another source for ideas. If your doctors knowledge is limited, consult with a specialist who can give you the information you need. Nerve sparing both sides is to your advantage and you will probably be successful in your therapy to restore sexual function. Another thing to remember is that it wont be anything close to what we had before. This is one of the prices we pay to cure our cancer and survive.





I was lucky to get it back with only one nerve spared. It was not easy. Take care and I hope everything goes well with your surgery.