So it’s been 90 months since my radical prostatectomy. How am I doing?
Status
With a continuously rising PSA, it’s time to face that reality that I have a biochemical recurrence and the cancer is back. Now it’s just a matter of trying to figure out what to do about it. Far easier said than done.
Emotions
Whether consciously or subconsciously, I came to terms with the idea of recurrence a while ago. What I’m really struggling with right now is how I’m going to make the decision as to whether to proceed with salvage radiation therapy now, later, or even at all. I have no idea how I’m going to make that choice and be satisfied that it’s the right one. When I chose surgery and my surgeon after my initial diagnosis, I was completely satisfied with my choice, had no regrets, and never second-guessed it once. I’m lacking that confidence right now.
Incontinence
On the whole, I’m still doing well with incontinence—well into the mid-90% dry range. I have noticed, however, a few more unexpected minor leaks popping up than what I’m used to. That’s concerning, especially if I choose salvage radiation therapy and its potential side effects.
The leaks usually happen when I’m more physically active (especially lifting something heavy), so if I know I have that kind of activity planned in my day, I’ll throw a thin pad in my underwear for good measure.
Sexual Function
It seems that my ability to achieve decent erections has regressed a little, too. I’m probably more in the 70%-85% range now. Good enough to achieve an orgasm, but questionable for much more than that. Of course, if I have salvage radiation therapy, those numbers will likely drop significantly, especially because only one nerve bundle was left behind.
Summary
My first ever visit to a radiation oncologist in May was a defining moment for me. It certainly took its emotional and physical toll from me. I was so mentally and physically exhausted from the research and constant thoughts that I just had to stop and step away. I know I have a major decision ahead of me at some point in the future but, for now, I’m content with not thinking about it at all at the moment.
I know I’ll get snapped back into reality when I go for my next PSA test on 1 August 2018.
Dan's Journey through Prostate Cancer 
I wish I had some insight that would help inform your decision, but you’ve done all the legwork and then some. It appears you’re just going to have to pick something with incomplete knowledge of whether it’s the right choice. I took course in college called Decision Making with Incomplete Information. It was a fancy mathematical class on guessing. Nothing more there. Hopefully, the next PSA test will help solidify your guess.
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I hit the > milestone back in about September 2017 almost 1 month short of 5 years after my RP. I then started and completed 33 days of Salvage radiation over the holiday season last year. I also had hormone therapy (Lupron) which is definitely not a fun trip unless you really want to have almost no libido. So I am 69 (until November :-)), in pretty good shape and working as best as possible to make sure it doesn’t come back a 3rd time. Realistically there is not really too much you can do, but the odds are in my favor. One thing that really helps me is exercise.
Durning radiation I saw that the Health and Wellness center at the Medical Campus in Denver (Anschutz) offered a seriously fantastic fitness program for cancer survivors called the Bfit Bwell program. For almost no cost ($59 per month) you a personal trainer twice a week for three months. I looked at that as an opportunity to do something good and joined up. All of the trainers are PTs and educated in working with all types of cancer patients, so they get the issues any type of cancer patient might have.
I did the first three months at Anschutz, got hooked on working out, then joined my rec center and have been going 5 days a week for about an hour a day since Feb 18. I recently joined a cancer research project, trueNTH, through the University of Oregon Med School which also specializes in cancer exercise programs. This is a program that takes in your data then spits out a program for you to follow for three months. Hey, you even get a fitbit for the duration!
I really recommend some sort of serious exercise for anybody who is a cancer patient or survivor. My new saying is “some endorphin each day keeps the cancer at bay.” At least it’s a good thought anyway.
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