Reflections: One Year After Surgery

Journal entry, May 1, 2019: Saw my urologist for quarterly PSA check. Good news: less than 0.04. Incontinence closer to being a non-issue. Gave me a sample of Stendra for ED; signs of life below the belt!

My official journey with prostate cancer started with a biopsy on March 15th, 2017. A week later I received the results: cancer cells found in 10 of 12 core tissue samples, a Gleason score of 3+3. Follow-up soft tissue and bone scans indicated that the cancer was contained in my prostate. My PSA at that time was a 7.

Following some quick education and discussions with my urologist, I chose active surveillance as my treatment: PSA tests and a DRE every three months, another biopsy at the end of one year.
Over the course of the next several months, I learned more about prostate cancer and treatment options, joined a support group at a local cancer resource center and talked to friends who had already been diagnosed and gone through treatment.

Deciding on surgery

In January of 2018 my PSA went up to 8.3 and along with it my mental state about having cancer became more acute. After discussions with my wife and family, I decided to pursue more aggressive treatment. At first I was leaning toward radiation, but eventually I chose a radical laparoscopic prostatectomy to be performed locally by my urologist who was also an experienced surgeon. I was well aware of the potential side effects but felt confident that I could deal with those while at the same time be relieved that my cancer was being managed.

I had my surgery on April 16, 2018. The first few days of recovery were rougher than I expected, but I improved steadily. I experienced the two main side effects of the surgery, incontinence and erectile dysfunction. The incontinence improved gradually. As of now I still use protection in specific situations, usually involving rigorous exercise. My erectile dysfunction has also improved, but not to the point that I can get or maintain a full erection.

One year reflections

With the passing of my one-year-since-surgery anniversary, I’ve done quite a bit of reflection. I keep in mind that I’m now seventy years old, that I’ve survived coronary artery disease, including one heart attack; that I have two stents; that I had major cervical spine surgery in 2018 to remove a disc, fuse two vertebrae and shave bone spurs that were making my life miserable; that I’m still fit enough to do the things I love: traveling, hiking, backpacking, rock climbing, golf. I may no longer be running 10Ks and half marathons, but all of my joints are still original and they all work well. My weight, blood pressure and heart rate is the same as it was when I ran track in college. I’m planning a multi-pitch climb on Half Dome in Yosemite with my oldest son in September.

So given a broader perspective, and understanding that time takes its toll on everyone, I feel pretty good about where I am in my life. In addition to physical well-being, I have a great relationship with my wife and children, I have three beautiful grandchildren, and I have a group of friends with whom I can share anything and who are always “on call” if I need them. My wife and I still share intimate moments, just a little differently than before, my children no longer worry about me having cancer (I tell them it’s managed not necessarily gone), and I live in a place of great natural beauty, the Central Coast of California. My dog loves me. She told me so.

Only looking forward, not back

There are days when I think, “I should have stayed on active surveillance.” But that’s hindsight at work. When I look at the big picture, I feel both fortunate and grateful that my life is in such good order. My May 1st meeting with my urologist reinforced that feeling. And this month I’m having cataract surgery on both eyes! I’ll be able to see again!