Jonathan Aldred

Radical Prostatectomy – One man’s experience

I was first made aware that I had a prostate (never mind any problem) following a BUPA health check in 2006, when I was advised that I needed to see my doctor urgently as my PSA was 3.9, when the norm for men of my age (52) was in the range 0–3.0. Further testing found no evidence of cancer, but I did subsequently start six-monthly monitoring of my PSA level via my GP.

The magic number rose and fell over the years, with a low of 3.1 and a high of 5.3, until January 2014 when a spike to 7.4 caused my GP to refer me to the Portsmouth Queen Alexandra Hospital (QA) Urology team. I recall he was hesitant to do so as the vagaries of the PSA are well known, but I am truly glad that he did.

In July 2014, following an inconclusive MRI scan, I had a biopsy which identified the presence of cancer cells, and I was assessed as having a Gleason score of 6. We continued ‘active surveillance’ with the plan to repeat the biopsy after 18 months to two years.

My PSA jogged along at around 6, and this seemed to be acceptable. However, prior to each six-month review with the Urology team, my brain would go into a spin as I re-read all the articles and on-line forums to understand what was happening to me. When would ‘active surveillance’ stop? What if it spreads out from the prostate between PSA tests? If we knew from the biopsy that I had cancer, why not remove the prostate now? Would I be able to cope with the possible outcomes, especially urinary control?

I was re-assured during my appointments that we could safely continue with active surveillance, and have a biopsy probably in December 2015 or early 2016. In January 2016, however, my PSA result rose abruptly to 10.6, up from 6 in June 2015. My consultant was the most reassuring person you could wish to have sat in front of you to help you assimilate the significance of such a result. He spoke out loud the thoughts which had been swirling round my confused brain: Ok, we know PSA is unreliable, this spike could be caused by many things, but you have the biopsy result, and, like many men, you have this six-monthly emotional roller-coaster as each test result is considered. You’ve seemed minded in the past to have the prostate removed, so why don’t we do that?

Jonathan Aldred

It was such a relief to hear these words. We did agree to have a further MRI scan (techniques had improved dramatically since the previous scan in 2014), which identified a new growth within the prostate, and confirmed the decision to have a prostatectomy.

At this time, I contacted PCaSO and took great reassurance from the gentleman I spoke to on the helpline. He was especially helpful in putting some balance on the stories of urinary incontinence you can read about on various websites (even my GP had told me I would be wearing colostomy bag forever if I had my prostate removed!). He confirmed that very, very few men suffer with any long-term problems, and that even if you do, there are more elegant solutions than walking round with a bag strapped to your leg.

I had my prostate removed by robotic radical prostatectomy just two weeks ago, as I write these words. To say I feel euphoric would be an understatement. Due to the great care and skill of my surgeon and his team, the operation was relatively pain free. I left hospital two days later, on Thursday, and my catheter was removed on the following Thursday. I had a sleepless night before this removal, but when the catheter came out – nothing happened! No uncontrollable fountain, no sense of lack of control. A couple of occasional dribbles, but only when I laugh, which I am starting to do more of! On that day, I walked a few miles along the local foreshore with my wife, had a celebratory ice-cream, and felt almost as if nothing had happened.

I am due to have my first post-operative PSA test result in early May, and I hope that will demonstrate that I am free of cancer.

So, I am 62 years old, I never thought this would be happening to me, and I have come through this process (so far) relatively unscathed, with fantastic support from my wonderful wife, family and friends. I have written this article just to share the experience of an ordinary man, with a lot to live for, going through a worrying process, and hopefully having come out the other side. The most difficult challenge I face currently is remembering to do the pelvic floor exercises, and if you’d told me that two weeks ago, I would not have believed you!

GPs PLEASE NOTE

This is a story we hear repeated many times over from men undergoing this operation, so please don’t peddle the old mantra that men will be incontinent and impotent for life. Yes, there is always a risk, but nowadays this is very small.
Ed.

First published in PCaSO Updates 55