Robot Assisted RP - here I am 9 days later

Full Story:
I'm 65, had a PSA of around 6 for the last two years. I had no other issues or indications. My GP had been insisting I see a urologist. I finally did... she went straight to "you should get a biopsy." So I lined one up for 11/10/22. A week later I hear the words, "you've got an aggressive prostate cancer (GS 4+5=9) and we need to take action ASAP.

She sent me for a PSMA PET scan which my COBRA BCBS insurance denied... I waited about 2 weeks later (I turned 65 in Dec) for my Medicare to kick in on (12/1/22)... (Part B, with Plan G supplement). No problem, and scan date assigned for 12/5/22). Scan results indicated that cancer was localized to the prostate. (Good news).

So after going through Thanksgiving, knowing I had an aggressive PC, and then finding out before Christmas that it appeared to be localized... I was both thankful and felt that it was one of the best presents I ever got.

The next phase was making a treatment decision. I first went to my radiation oncologist (I'd been treated for throat cancer by him back in 2019... that's all good now). He gave me the lowdown on the PC radiation treatment plan that would be combined with 2 years of ADT. He told me that my urologist had a very good reputation as a robotic surgeon and seemed to lean toward the surgery option if it were him in my shoes (although he didn't come right out and say that). But still, the choice was mine.

I visited my urologist a week later and we discussed the surgery and RT options. She mentioned that if I got RT first, that surgery would be more complicated later should the cancer recur, whereas with surgery first, RT would be a salvage option should the cancer recur. I opted to move forward with the surgery on 1/4/23.

I went in early Wed morning and spent one night in the hospital. The worst parts were getting the IV for the anesthesia (it took the nurse 5 tries to finally get it right!)... the other part was when they pulled out the drainage tube right before I was discharged... yoweee for about 10 seconds. For the most part, I eperienced soreness, not pain... and they were pretty stingy with pain meds.

Got home with the catheter in place, a nuisance, but not as bad as I'd imagined. For the week at home after the surgery, I was sore in places, but no real pain... I took about 6 Loratabs over the first 3 days, none afterwards. I really didn't leave the house during this period (walked around the back yard some each day). I took Miralax and Metamucil each day to prevent constipation.

Catheter removal day (1/12/23). I thought it might hurt coming out, but it wasn't bad (I'd taken one of my Loratabs just in case 😀. The PA filled my bladder (via the tube) with some saline water I assume , and then deflated the catheter... it just slid right out and I immediately peed out the 300ml she'd pumped into me.

Good news received after the catheter removal: my post-op surgical margins were all negative (no sign of cancer) as well as the 2 lymph nodes they'd removed. Seminal vesicles were negative as well. What a great day! Free of the catheter and cancer!

I left the urologists office with a Depends on, figuring I'd have no bladder control at all for a few days (maybe weeks). Amazingly, I only had some slight leakage (dribbles) for a couple hours after the catheter removal, and since then I've been dry. I slept last night with a depends on, had to get up and pee at least 4 or 5 times, but never leaked out. The Depends was totally dry this morning (remember the catheter was removed yesterday!) This was much better than I ever expected and I hope it continues in this direction!

I might mention that per my biopsy, the cancer had invaded the nerves on the left side of my prostate. The right side was clear and we discussed unilateral nerve-sparing, but in the end I decided that it was not worth the risk of leaving cancer (the rumor is, surgeons call it cancer-sparing surgery, half in jest). My urologist/surgeon didn't think saving the nerve on the one side would help me much anyway... who knows. But, yeah, sex probably won't be a player anymore. I'll look at a pump, etc in a couple months to see what happens there, but for now, just glad to be alive. (Dead men don't get erections!)

That's my story for now. It all went down very quickly and making treatment decisions was tough. I think for me, having survived one cancer already helped my not totally freak out with the PC diagnosis, because treatments are available and have a good prognosis if the cancer is caught in time.