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You might find it useful to visit YANA

- You Are Not Alone Now www.yananow.net

a site set up for newly diagnosed people. The first section gives some basic

information in plain language with links to more complex and technical sites. Many

people have found that the booklet “A Strange Place” has been helpful

– that’s at http://www.yananow.net/StrangePlace/index.html

The second section of the site is where men are invited to

tell their prostate cancer stories and how they arrived at their decisions

regarding treatment. Many people have mailed to say how useful they have found

this, especially because most of the men are happy to respond to specific

questions. The section of the site can be found by clicking the link labelled

Experiences or going to http://www.yananow.net/Experiences.html

There is a section dealing with the management of the disease,

including some dietary hints at http://www.yananow.net/MyersManagement.htm

there is also a section suggesting the questions that you should seek answers

to before making any treatment decision at http://www.yananow.net/questions.htm

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Guy

Sent: Friday, 29 May 2009 3:18 PM

To: ProstateCancerSupport

Subject:

Is it worth it?

As a new commer to this blog I of course have been

diagnosed with Prostate Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a

year from less then 1 which is why a biopsy was done. I have been told that I

have a small score and small tumor so why is my doc pushing to yank my prostate

by removing it. He doesn't do the surgery he is a urologist.

My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when

coming. I really can't imagine it feeling all that great. I have had times when

I didn't come and no it didn't feel great just was good for my partner as I did

last a very long time. :)

Thanks for your thoughts,

Guy

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Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would

be

> really helpful. As I know there is absolutely no actual ejaculation when

coming.

> I really can't imagine it feeling all that great. I have had times when I

didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)

>

> Thanks for your thoughts,

> Guy

Guy,

There are two main questions to consider, what will happen to you

if you get treatment, and what will happen to you if you don't.

Your PSA has gone up very quickly. That may mean that you have

an aggressive cancer that is growing very fast - though it's also

possible that you have a small and insignificant cancer and your high

PSA is caused by a prostate inflammation or infection.

Your sex life will very likely be affected by treatment. You may

become impotent, or you may not. You will likely see a decrease in

ejaculate - though the sensation of orgasm may change less than you

would think even though little or nothing comes out. Whether you

continue to have a good sex life after treatment will really

depend more on how you and your wife deal with it. You can

actually have a very good and very satisfying sex life even if

you are impotent - better than a whole lot of men who have all

of their physical functioning intact but never think about their

wife's pleasure, and their wives never think about their's.

Surgery is not the only choice. Radiation is another possibility.

If you do have a growing cancer, and if it does become life

threatening, it will end your sex life permanently.

Alan

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Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would

be

> really helpful. As I know there is absolutely no actual ejaculation when

coming.

> I really can't imagine it feeling all that great. I have had times when I

didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)

>

> Thanks for your thoughts,

> Guy

Guy,

There are two main questions to consider, what will happen to you

if you get treatment, and what will happen to you if you don't.

Your PSA has gone up very quickly. That may mean that you have

an aggressive cancer that is growing very fast - though it's also

possible that you have a small and insignificant cancer and your high

PSA is caused by a prostate inflammation or infection.

Your sex life will very likely be affected by treatment. You may

become impotent, or you may not. You will likely see a decrease in

ejaculate - though the sensation of orgasm may change less than you

would think even though little or nothing comes out. Whether you

continue to have a good sex life after treatment will really

depend more on how you and your wife deal with it. You can

actually have a very good and very satisfying sex life even if

you are impotent - better than a whole lot of men who have all

of their physical functioning intact but never think about their

wife's pleasure, and their wives never think about their's.

Surgery is not the only choice. Radiation is another possibility.

If you do have a growing cancer, and if it does become life

threatening, it will end your sex life permanently.

Alan

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Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would

be

> really helpful. As I know there is absolutely no actual ejaculation when

coming.

> I really can't imagine it feeling all that great. I have had times when I

didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)

>

> Thanks for your thoughts,

> Guy

Guy,

There are two main questions to consider, what will happen to you

if you get treatment, and what will happen to you if you don't.

Your PSA has gone up very quickly. That may mean that you have

an aggressive cancer that is growing very fast - though it's also

possible that you have a small and insignificant cancer and your high

PSA is caused by a prostate inflammation or infection.

Your sex life will very likely be affected by treatment. You may

become impotent, or you may not. You will likely see a decrease in

ejaculate - though the sensation of orgasm may change less than you

would think even though little or nothing comes out. Whether you

continue to have a good sex life after treatment will really

depend more on how you and your wife deal with it. You can

actually have a very good and very satisfying sex life even if

you are impotent - better than a whole lot of men who have all

of their physical functioning intact but never think about their

wife's pleasure, and their wives never think about their's.

Surgery is not the only choice. Radiation is another possibility.

If you do have a growing cancer, and if it does become life

threatening, it will end your sex life permanently.

Alan

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Guy,

Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist. You did not share how many cores were taken, how many cores had cancer and what percentage of the cores has cancer.  Let us know.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would be

> really helpful.Having surgery and being " neutered " is not the same.  Surgery will effect your ability to have an erection as well as your ability to ejaculate, but it does not neuter you.  The extent of your inability to achieve erections is unknown and we are unable to predict it prior to the surgery.  Some of us lose this ability completely while others never know we have any problem, these are the extremes.  Most of us fall within these two extremes.   My experience is that I am able to achieve erections adequate for vaginal penetration, if I had to put a percentage of my ability to achieve the hardness  prior to surgery I would probably put it at  about 60%, but still adequate to work.  As to the concept of being neutered, even if you have a total inability to achieve an erection you still have all your sexual feelings that you had prior to surgery.  Additionally, sex should include much more than just intercourse.  No, surgery does not neuter you it just changes how you have sex.    

  

As I know there is absolutely no actual ejaculation when coming.

> I really can't imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)  This is an individual and personal matter, some guys claim sex is better, my personal feeling is that it does negatively impact my feelings and I do very much miss being able to ejaculate, but it is not the end of the world. 

>

> Thanks for your thoughts, Guy, find a support group near to where you live and meet other men who have had treatment and ask them how they have experienced both surgery and radiation.  Speak to a lot of men prior to making any decisions. -  

 

 

Director, Advanced Prostate Cancer and Advocacy Programs for Malecare         

..

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Guy,

Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist. You did not share how many cores were taken, how many cores had cancer and what percentage of the cores has cancer.  Let us know.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would be

> really helpful.Having surgery and being " neutered " is not the same.  Surgery will effect your ability to have an erection as well as your ability to ejaculate, but it does not neuter you.  The extent of your inability to achieve erections is unknown and we are unable to predict it prior to the surgery.  Some of us lose this ability completely while others never know we have any problem, these are the extremes.  Most of us fall within these two extremes.   My experience is that I am able to achieve erections adequate for vaginal penetration, if I had to put a percentage of my ability to achieve the hardness  prior to surgery I would probably put it at  about 60%, but still adequate to work.  As to the concept of being neutered, even if you have a total inability to achieve an erection you still have all your sexual feelings that you had prior to surgery.  Additionally, sex should include much more than just intercourse.  No, surgery does not neuter you it just changes how you have sex.    

  

As I know there is absolutely no actual ejaculation when coming.

> I really can't imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)  This is an individual and personal matter, some guys claim sex is better, my personal feeling is that it does negatively impact my feelings and I do very much miss being able to ejaculate, but it is not the end of the world. 

>

> Thanks for your thoughts, Guy, find a support group near to where you live and meet other men who have had treatment and ask them how they have experienced both surgery and radiation.  Speak to a lot of men prior to making any decisions. -  

 

 

Director, Advanced Prostate Cancer and Advocacy Programs for Malecare         

..

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Guy,

Guy wrote:

>

> As a new commer to this blog I of course have been diagnosed with Prostate

> Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

> which is why a biopsy was done. I have been told that I have a small score and

> small tumor so why is my doc pushing to yank my prostate by removing it. He

> doesn't do the surgery he is a urologist. You did not share how many cores were taken, how many cores had cancer and what percentage of the cores has cancer.  Let us know.

>

> My problem with this whole business is how is anyone's sex life after being

> neutered? Anyone willing to share their sexually ability after surgery would be

> really helpful.Having surgery and being " neutered " is not the same.  Surgery will effect your ability to have an erection as well as your ability to ejaculate, but it does not neuter you.  The extent of your inability to achieve erections is unknown and we are unable to predict it prior to the surgery.  Some of us lose this ability completely while others never know we have any problem, these are the extremes.  Most of us fall within these two extremes.   My experience is that I am able to achieve erections adequate for vaginal penetration, if I had to put a percentage of my ability to achieve the hardness  prior to surgery I would probably put it at  about 60%, but still adequate to work.  As to the concept of being neutered, even if you have a total inability to achieve an erection you still have all your sexual feelings that you had prior to surgery.  Additionally, sex should include much more than just intercourse.  No, surgery does not neuter you it just changes how you have sex.    

  

As I know there is absolutely no actual ejaculation when coming.

> I really can't imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I did last a

> very long time. :)  This is an individual and personal matter, some guys claim sex is better, my personal feeling is that it does negatively impact my feelings and I do very much miss being able to ejaculate, but it is not the end of the world. 

>

> Thanks for your thoughts, Guy, find a support group near to where you live and meet other men who have had treatment and ask them how they have experienced both surgery and radiation.  Speak to a lot of men prior to making any decisions. -  

 

 

Director, Advanced Prostate Cancer and Advocacy Programs for Malecare         

..

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> As a new commer to this blog I of course have been diagnosed with

> Prostate Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a

> year from less then 1 which is why a biopsy was done. I have been

> told that I have a small score and small tumor so why is my doc

> pushing to yank my prostate by removing it. He doesn't do the

> surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life

> after being neutered? Anyone willing to share their sexually

> ability after surgery would be really helpful. As I know there is

> absolutely no actual ejaculation when coming. I really can't

> imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I

> did last a very long time. :)

>

> Thanks for your thoughts,

> Guy

>

>

They don't cut your nuts off, at least not right away, so you won't

be neutered. You'll still have the same drive, just no outlet. LOL.

I had 3/3 gleason and was projected T2b, turned out to be 3/4 gleason

and T3a when the thing was out. I " m almost two years out and sweating

out another PSA test, but so far they've been undetectable. Overall,

it's looking like surgery was a good call, since I was only 50. They

also took out the left nerve bundle with the prostate but I still

have the right one. No usable erections for a year and a half, then

got a solid one last Valentine's with Levitra. Improvement continues

and I can do pretty good without any drugs, but I still tend to lose

natural erections quickly. With a chemical helper I can get a really

solid one, but it's very tough getting back up for round two (so far

it's been impossible), when pre-surgery this was automatic. Climaxes

are very intense and it feels like your prostate is still in there

pumping away, but there is no ejaculate. Also, it's tough to gauge

when you're getting ready to go off, so you might go before she's

ready to blast off. That's a double problem for me, due to inability

to get my barrel back into battery. I'm still getting improvements.

One thing they minimize is the length issue. For me, this is a big

mental issue, you can always get an implant if you can't get hard,

but I'm actually down a full two inches from pre-surgery erection

length. Girth ain't right either. My wife claims to like the

reduction a lot. Wife is my one and only, so I have nothing to go by

other than what she says, but she claims she never liked getting her

cervix rearranged, anyway. But it's tough on my ego.

The big question that comes up is how old are you?

Ed

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> As a new commer to this blog I of course have been diagnosed with

> Prostate Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a

> year from less then 1 which is why a biopsy was done. I have been

> told that I have a small score and small tumor so why is my doc

> pushing to yank my prostate by removing it. He doesn't do the

> surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life

> after being neutered? Anyone willing to share their sexually

> ability after surgery would be really helpful. As I know there is

> absolutely no actual ejaculation when coming. I really can't

> imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I

> did last a very long time. :)

>

> Thanks for your thoughts,

> Guy

>

>

They don't cut your nuts off, at least not right away, so you won't

be neutered. You'll still have the same drive, just no outlet. LOL.

I had 3/3 gleason and was projected T2b, turned out to be 3/4 gleason

and T3a when the thing was out. I " m almost two years out and sweating

out another PSA test, but so far they've been undetectable. Overall,

it's looking like surgery was a good call, since I was only 50. They

also took out the left nerve bundle with the prostate but I still

have the right one. No usable erections for a year and a half, then

got a solid one last Valentine's with Levitra. Improvement continues

and I can do pretty good without any drugs, but I still tend to lose

natural erections quickly. With a chemical helper I can get a really

solid one, but it's very tough getting back up for round two (so far

it's been impossible), when pre-surgery this was automatic. Climaxes

are very intense and it feels like your prostate is still in there

pumping away, but there is no ejaculate. Also, it's tough to gauge

when you're getting ready to go off, so you might go before she's

ready to blast off. That's a double problem for me, due to inability

to get my barrel back into battery. I'm still getting improvements.

One thing they minimize is the length issue. For me, this is a big

mental issue, you can always get an implant if you can't get hard,

but I'm actually down a full two inches from pre-surgery erection

length. Girth ain't right either. My wife claims to like the

reduction a lot. Wife is my one and only, so I have nothing to go by

other than what she says, but she claims she never liked getting her

cervix rearranged, anyway. But it's tough on my ego.

The big question that comes up is how old are you?

Ed

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> As a new commer to this blog I of course have been diagnosed with

> Prostate Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a

> year from less then 1 which is why a biopsy was done. I have been

> told that I have a small score and small tumor so why is my doc

> pushing to yank my prostate by removing it. He doesn't do the

> surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life

> after being neutered? Anyone willing to share their sexually

> ability after surgery would be really helpful. As I know there is

> absolutely no actual ejaculation when coming. I really can't

> imagine it feeling all that great. I have had times when I didn't

> come and no it didn't feel great just was good for my partner as I

> did last a very long time. :)

>

> Thanks for your thoughts,

> Guy

>

>

They don't cut your nuts off, at least not right away, so you won't

be neutered. You'll still have the same drive, just no outlet. LOL.

I had 3/3 gleason and was projected T2b, turned out to be 3/4 gleason

and T3a when the thing was out. I " m almost two years out and sweating

out another PSA test, but so far they've been undetectable. Overall,

it's looking like surgery was a good call, since I was only 50. They

also took out the left nerve bundle with the prostate but I still

have the right one. No usable erections for a year and a half, then

got a solid one last Valentine's with Levitra. Improvement continues

and I can do pretty good without any drugs, but I still tend to lose

natural erections quickly. With a chemical helper I can get a really

solid one, but it's very tough getting back up for round two (so far

it's been impossible), when pre-surgery this was automatic. Climaxes

are very intense and it feels like your prostate is still in there

pumping away, but there is no ejaculate. Also, it's tough to gauge

when you're getting ready to go off, so you might go before she's

ready to blast off. That's a double problem for me, due to inability

to get my barrel back into battery. I'm still getting improvements.

One thing they minimize is the length issue. For me, this is a big

mental issue, you can always get an implant if you can't get hard,

but I'm actually down a full two inches from pre-surgery erection

length. Girth ain't right either. My wife claims to like the

reduction a lot. Wife is my one and only, so I have nothing to go by

other than what she says, but she claims she never liked getting her

cervix rearranged, anyway. But it's tough on my ego.

The big question that comes up is how old are you?

Ed

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Guy --

It's not quite as bad as you're imagining. You're in shock (a state we've all

been through).

First, a one-year increase from 1 to 14.5 is a lot. It makes me wonder whether

the '3+3' is right, or whether there's some higher-grade cancer cells that

weren't found in the biopsy.

How big is the " 3+3 " tumor? If it's small, " active surveillance " (used to be

" watchful waiting " ) might be a reasonable thing to do. If it's big --

especially with the PSA=14.5 result -- you should probably do something about

it. You don't have to rush into treatment; take some time to learn and think.

Second, you have to distinguish between:

.. . libido (sexual desire, which you keep after your prostate is removed);

.. . ejaculation (fluid release during orgasm) (you lose that when your prostate

is removed);

.. . orgasm (involving both pelvic muscles and a complex 'brain event') (you

keep that after your prostate is removed);

.. . erection (you may or may not keep that, or recover it, with either therapy

or radiation).

Get a copy of " Saving Your Sex Life " , by Dr Jim Mulhall, and do some reading

about both sex and choices for therapy.

For general prostate cancer info, " Prostate Cancer: The Empowered Patient's

Guide " , by Strum, is very good.

Some recent studies are finding that brachytherapy (seed therapy) gets long-term

" non-recurrence " results equal to surgery. It's less invasive than surgery, but

sexuality takes a hit over the long run.

My own situation, FWIW (men vary _a lot_ in their recoveries):

Open radical prostatectomy in October 2007, both nerves spared.

Now (about 18 months out) my libido is fine, my orgasms are fine. My erections

have been great since I started using " intracavernosal injection therapy " (which

should be a good Google search term). I have started to respond a little to

Viagra -- still working on that.

It hasn't been easy. One alternative was waiting around as my PSA increased,

wondering when would be a good time to do something. Or having brachytherapy,

and wondering whether all the cancer had been adequately irradiated. It's a

bitchy disease.

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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Guy --

It's not quite as bad as you're imagining. You're in shock (a state we've all

been through).

First, a one-year increase from 1 to 14.5 is a lot. It makes me wonder whether

the '3+3' is right, or whether there's some higher-grade cancer cells that

weren't found in the biopsy.

How big is the " 3+3 " tumor? If it's small, " active surveillance " (used to be

" watchful waiting " ) might be a reasonable thing to do. If it's big --

especially with the PSA=14.5 result -- you should probably do something about

it. You don't have to rush into treatment; take some time to learn and think.

Second, you have to distinguish between:

.. . libido (sexual desire, which you keep after your prostate is removed);

.. . ejaculation (fluid release during orgasm) (you lose that when your prostate

is removed);

.. . orgasm (involving both pelvic muscles and a complex 'brain event') (you

keep that after your prostate is removed);

.. . erection (you may or may not keep that, or recover it, with either therapy

or radiation).

Get a copy of " Saving Your Sex Life " , by Dr Jim Mulhall, and do some reading

about both sex and choices for therapy.

For general prostate cancer info, " Prostate Cancer: The Empowered Patient's

Guide " , by Strum, is very good.

Some recent studies are finding that brachytherapy (seed therapy) gets long-term

" non-recurrence " results equal to surgery. It's less invasive than surgery, but

sexuality takes a hit over the long run.

My own situation, FWIW (men vary _a lot_ in their recoveries):

Open radical prostatectomy in October 2007, both nerves spared.

Now (about 18 months out) my libido is fine, my orgasms are fine. My erections

have been great since I started using " intracavernosal injection therapy " (which

should be a good Google search term). I have started to respond a little to

Viagra -- still working on that.

It hasn't been easy. One alternative was waiting around as my PSA increased,

wondering when would be a good time to do something. Or having brachytherapy,

and wondering whether all the cancer had been adequately irradiated. It's a

bitchy disease.

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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Guy --

It's not quite as bad as you're imagining. You're in shock (a state we've all

been through).

First, a one-year increase from 1 to 14.5 is a lot. It makes me wonder whether

the '3+3' is right, or whether there's some higher-grade cancer cells that

weren't found in the biopsy.

How big is the " 3+3 " tumor? If it's small, " active surveillance " (used to be

" watchful waiting " ) might be a reasonable thing to do. If it's big --

especially with the PSA=14.5 result -- you should probably do something about

it. You don't have to rush into treatment; take some time to learn and think.

Second, you have to distinguish between:

.. . libido (sexual desire, which you keep after your prostate is removed);

.. . ejaculation (fluid release during orgasm) (you lose that when your prostate

is removed);

.. . orgasm (involving both pelvic muscles and a complex 'brain event') (you

keep that after your prostate is removed);

.. . erection (you may or may not keep that, or recover it, with either therapy

or radiation).

Get a copy of " Saving Your Sex Life " , by Dr Jim Mulhall, and do some reading

about both sex and choices for therapy.

For general prostate cancer info, " Prostate Cancer: The Empowered Patient's

Guide " , by Strum, is very good.

Some recent studies are finding that brachytherapy (seed therapy) gets long-term

" non-recurrence " results equal to surgery. It's less invasive than surgery, but

sexuality takes a hit over the long run.

My own situation, FWIW (men vary _a lot_ in their recoveries):

Open radical prostatectomy in October 2007, both nerves spared.

Now (about 18 months out) my libido is fine, my orgasms are fine. My erections

have been great since I started using " intracavernosal injection therapy " (which

should be a good Google search term). I have started to respond a little to

Viagra -- still working on that.

It hasn't been easy. One alternative was waiting around as my PSA increased,

wondering when would be a good time to do something. Or having brachytherapy,

and wondering whether all the cancer had been adequately irradiated. It's a

bitchy disease.

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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Just remember you are dealing with cancer and for me I didn't want to take

chances! I have to say my experience 11 days out has been better than I ever

imagined! I know it is and will be different but want to be around as long as

possible to enjoy life. Be careful about listen to negative experiences, if you

have a good surgeon things are often much better than in the past!

Try to hang, do know how hard this is, I can only say as I did in my post

yesterday that I'm glad I did what I did, not happy I had to face it but know

with time things will improve even more.

Good luck to you!

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Just remember you are dealing with cancer and for me I didn't want to take

chances! I have to say my experience 11 days out has been better than I ever

imagined! I know it is and will be different but want to be around as long as

possible to enjoy life. Be careful about listen to negative experiences, if you

have a good surgeon things are often much better than in the past!

Try to hang, do know how hard this is, I can only say as I did in my post

yesterday that I'm glad I did what I did, not happy I had to face it but know

with time things will improve even more.

Good luck to you!

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Guy,

I am sorry to hear of your diagnosis. My husband, Gregg was diagnosed a little

over 2 1/2 years ago at the age of 57. His numbers were; PSA 4.9, Gleason 3+3

stage T1c with 2 cores out of 12 positive. We both got busy doing research. I

did far more research than Gregg. We had about 3 weeks from diagnosis to the

initial consult with Gregg's urologist. This doctor turned out to be a one of

the enlightened doctors who did not push any particular treatment. We are Kaiser

HMO members, so this doctor has nothing to gain by pushing surgery. He

suggested that Gregg was a candidate for Active Surveillance. We reached the

conclusion that all of today's FDA accepted treatments have virtually equal

success rates, and the doctor confirmed this.

Neither of us wanted Gregg to have his prostate removed. He is a very active

man, who was actually more concerned about incontinence than impotence.

I have an uncle who had his prostate cancer treated at Loma University

Medical Center in southern CA. The treatment is a very accurate form of external

beam radiation using protons. The more we learned about proton beam radiation

therapy (PBRT) the more we leaned toward this treatment for Gregg.

Gregg is now a little over two years out from treatment. He is fully continent

and potent. His latest PSA came in at 1. He had 3 or 4 episodes of minor rectal

bleeding during bowel movements starting about a year after treatment began,

spread out over about a year. Two months ago he had a small amount of blood in

his urine. Nothing since. The doctor checked that out as Gregg has also been

treated for bladder cancer. The doctor could not find the source of the blood in

his urine. He did say that type of symptom is not uncommon ot radiation

patients. It was very likely a one time event.

If you are interested in learning more about PBRT a good place to take a first

look is at www.protonbob.com There you will find links to the 5 centers in the

US which have proton equipment. There is a yahoo group by the name of

protoninfo.

If you have questions for me, I will do my best.

Laurel

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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Guy,

I am sorry to hear of your diagnosis. My husband, Gregg was diagnosed a little

over 2 1/2 years ago at the age of 57. His numbers were; PSA 4.9, Gleason 3+3

stage T1c with 2 cores out of 12 positive. We both got busy doing research. I

did far more research than Gregg. We had about 3 weeks from diagnosis to the

initial consult with Gregg's urologist. This doctor turned out to be a one of

the enlightened doctors who did not push any particular treatment. We are Kaiser

HMO members, so this doctor has nothing to gain by pushing surgery. He

suggested that Gregg was a candidate for Active Surveillance. We reached the

conclusion that all of today's FDA accepted treatments have virtually equal

success rates, and the doctor confirmed this.

Neither of us wanted Gregg to have his prostate removed. He is a very active

man, who was actually more concerned about incontinence than impotence.

I have an uncle who had his prostate cancer treated at Loma University

Medical Center in southern CA. The treatment is a very accurate form of external

beam radiation using protons. The more we learned about proton beam radiation

therapy (PBRT) the more we leaned toward this treatment for Gregg.

Gregg is now a little over two years out from treatment. He is fully continent

and potent. His latest PSA came in at 1. He had 3 or 4 episodes of minor rectal

bleeding during bowel movements starting about a year after treatment began,

spread out over about a year. Two months ago he had a small amount of blood in

his urine. Nothing since. The doctor checked that out as Gregg has also been

treated for bladder cancer. The doctor could not find the source of the blood in

his urine. He did say that type of symptom is not uncommon ot radiation

patients. It was very likely a one time event.

If you are interested in learning more about PBRT a good place to take a first

look is at www.protonbob.com There you will find links to the 5 centers in the

US which have proton equipment. There is a yahoo group by the name of

protoninfo.

If you have questions for me, I will do my best.

Laurel

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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how does sex include more than intercourse ? I find your answers are very informative in the long run

To: ProstateCancerSupport From: tnowak@...Date: Fri, 29 May 2009 12:51:11 -0400Subject: Re: Is it worth it?

Guy,

On Fri, May 29, 2009 at 11:48 AM, Alan Meyer <ameyer2> wrote:

Guy <guy373comcast (DOT) net> wrote:> > As a new commer to this blog I of course have been diagnosed with Prostate > Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1 > which is why a biopsy was done. I have been told that I have a small score and > small tumor so why is my doc pushing to yank my prostate by removing it. He > doesn't do the surgery he is a urologist. You did not share how many cores were taken, how many cores had cancer and what percentage of the cores has cancer. Let us know. > > My problem with this whole business is how is anyone's sex life after being > neutered? Anyone willing to share their sexually ability after surgery would be > really helpful.Having surgery and being "neutered" is not the same. Surgery will effect your ability to have an erection as well as your ability to ejaculate, but it does not neuter you. The extent of your inability to achieve erections is unknown and we are unable to predict it prior to the surgery. Some of us lose this ability completely while others never know we have any problem, these are the extremes. Most of us fall within these two extremes. My experience is that I am able to achieve erections adequate for vaginal penetration, if I had to put a percentage of my ability to achieve the hardness prior to surgery I would probably put it at about 60%, but still adequate to work. As to the concept of being neutered, even if you have a total inability to achieve an erection you still have all your sexual feelings that you had prior to surgery. Additionally, sex should include much more than just intercourse. No, surgery does not neuter you it just changes how you have sex.

As I know there is absolutely no actual ejaculation when coming. > I really can't imagine it feeling all that great. I have had times when I didn't > come and no it didn't feel great just was good for my partner as I did last a > very long time. :) This is an individual and personal matter, some guys claim sex is better, my personal feeling is that it does negatively impact my feelings and I do very much miss being able to ejaculate, but it is not the end of the world. > > Thanks for your thoughts, Guy, find a support group near to where you live and meet other men who have had treatment and ask them how they have experienced both surgery and radiation. Speak to a lot of men prior to making any decisions. -

Director, Advanced Prostate Cancer and Advocacy Programs for Malecare

..

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how does sex include more than intercourse ? I find your answers are very informative in the long run

To: ProstateCancerSupport From: tnowak@...Date: Fri, 29 May 2009 12:51:11 -0400Subject: Re: Is it worth it?

Guy,

On Fri, May 29, 2009 at 11:48 AM, Alan Meyer <ameyer2> wrote:

Guy <guy373comcast (DOT) net> wrote:> > As a new commer to this blog I of course have been diagnosed with Prostate > Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1 > which is why a biopsy was done. I have been told that I have a small score and > small tumor so why is my doc pushing to yank my prostate by removing it. He > doesn't do the surgery he is a urologist. You did not share how many cores were taken, how many cores had cancer and what percentage of the cores has cancer. Let us know. > > My problem with this whole business is how is anyone's sex life after being > neutered? Anyone willing to share their sexually ability after surgery would be > really helpful.Having surgery and being "neutered" is not the same. Surgery will effect your ability to have an erection as well as your ability to ejaculate, but it does not neuter you. The extent of your inability to achieve erections is unknown and we are unable to predict it prior to the surgery. Some of us lose this ability completely while others never know we have any problem, these are the extremes. Most of us fall within these two extremes. My experience is that I am able to achieve erections adequate for vaginal penetration, if I had to put a percentage of my ability to achieve the hardness prior to surgery I would probably put it at about 60%, but still adequate to work. As to the concept of being neutered, even if you have a total inability to achieve an erection you still have all your sexual feelings that you had prior to surgery. Additionally, sex should include much more than just intercourse. No, surgery does not neuter you it just changes how you have sex.

As I know there is absolutely no actual ejaculation when coming. > I really can't imagine it feeling all that great. I have had times when I didn't > come and no it didn't feel great just was good for my partner as I did last a > very long time. :) This is an individual and personal matter, some guys claim sex is better, my personal feeling is that it does negatively impact my feelings and I do very much miss being able to ejaculate, but it is not the end of the world. > > Thanks for your thoughts, Guy, find a support group near to where you live and meet other men who have had treatment and ask them how they have experienced both surgery and radiation. Speak to a lot of men prior to making any decisions. -

Director, Advanced Prostate Cancer and Advocacy Programs for Malecare

..

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Dugger wrote:

> how does sex include more than intercourse?

The very question Bill Clinton asked, or at least implied, when

accused of " having sex " with Lewinsky :)

The answer, of course, is that oral and manual sex are also

included by many people as part of their relationships.

Alan

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Dugger wrote:

> how does sex include more than intercourse?

The very question Bill Clinton asked, or at least implied, when

accused of " having sex " with Lewinsky :)

The answer, of course, is that oral and manual sex are also

included by many people as part of their relationships.

Alan

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Maybe I'm in the minority... I was treated at RCOG in Georgia - seed implant and

then radiation on top of it almost 5 years ago.....

I don't have this issue. Erections are less than they were (gee, I'm getting

older) Erections are a little less hard many times (gee, I'm getting older) but

I still have the drive and still ejaculate (minimal amount of fluid but it still

happens)

But as others have said, WHY is your Doctor only recommending surgery? (and go

to RCOG web site and look and / or call them)

Just,

Bob

>

> As a new commer to this blog I of course have been diagnosed with Prostate

Cancer. My Gleason score is 3+3=6 PSA 14.5 went up in a year from less then 1

which is why a biopsy was done. I have been told that I have a small score and

small tumor so why is my doc pushing to yank my prostate by removing it. He

doesn't do the surgery he is a urologist.

>

> My problem with this whole business is how is anyone's sex life after being

neutered? Anyone willing to share their sexually ability after surgery would be

really helpful. As I know there is absolutely no actual ejaculation when coming.

I really can't imagine it feeling all that great. I have had times when I didn't

come and no it didn't feel great just was good for my partner as I did last a

very long time. :)

>

> Thanks for your thoughts,

> Guy

>

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Any " sex manual " will have extensive discussions. See (for example):

" Guide to Getting It On " --6th Edition -- by Psy.D. Joannides and Daerick

Gross Sr.

That book was recommended to me (in a lecture) shortly before my surgery. It's

nice to know that what used to be " perversions " are now just " variations " .

Especially nice, when intercourse is difficult or impossible.

--

>

> > how does sex include more than intercourse?

>

> The very question Bill Clinton asked, or at least implied, when

> accused of " having sex " with Lewinsky :)

>

> The answer, of course, is that oral and manual sex are also

> included by many people as part of their relationships.

>

> Alan

>

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Any " sex manual " will have extensive discussions. See (for example):

" Guide to Getting It On " --6th Edition -- by Psy.D. Joannides and Daerick

Gross Sr.

That book was recommended to me (in a lecture) shortly before my surgery. It's

nice to know that what used to be " perversions " are now just " variations " .

Especially nice, when intercourse is difficult or impossible.

--

>

> > how does sex include more than intercourse?

>

> The very question Bill Clinton asked, or at least implied, when

> accused of " having sex " with Lewinsky :)

>

> The answer, of course, is that oral and manual sex are also

> included by many people as part of their relationships.

>

> Alan

>

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