The initial diagnosis of cancer is established by having a biopsy, although the results are not always immediate. The small samples taken during the biopsy need to be examined to determine whether you have cancer and you will be asked to make an appointment with the urologist as soon as this is done. Expect to wait up to a week. This also tells the doctor the extent of your cancer since samples are taken from different areas of your prostate. This is then given a Gleason score. The higher the score, the more advanced the cancer. Your doctor will explain the extent in your particular case.
The Oncologist and Urologist will get together to discuss your options based on these findings. They will then call you into the office to discuss your options. If your cancer is in the early stages, it is quite possible that a localised treatment will be all that is required. In fact, introducing one treatment injected into the area of the prostate may be enough to kill off the cancer. If you have a more serious or urgent diagnosis, you will be asked to have a scan to determine if mets exist. What this means is whether the cancer has spread to other parts of the body. The scan is relatively painless though is accompanied by an injection to highlight any affected areas. These show up as dark black on the X Ray that is produced by the scanner but do not be alarmed if you see many areas such as this because arthrosis can also show up in the same way. The doctor knows the difference.
Your specialist will then be able to talk over what options you have. Since prostate cancer is usually slow growing, don't expect things to happen quickly. Unfortunately, doctors see this as an everyday illness, although it may mean more than that to you. Expect to be scared. This is normal since the word "cancer" is scary. Try not to make matters worse by reading too much medical information because you really can get confused by the complexity of it all.
Having the Prostate Removed
This option is used if your cancer justifies it. You will be told all of the potential side effects of the operation. Many hospitals provide a robot managed operation but all this means is that the surgeon works behind a screen and there is less likelihood of infection. When you come around from the operation, it is quite likely that you will be given painkillers and that you will have a catheter and draining tube to drain away the site where the surgery has taken place. You may also be given fluids.
After the Procedure
Expect discomfort. You may initially find that you are constipated easily although the hospital will give you a light diet until your toiletry actions are back to normal. You will be able to see the color of your urine in the sack that is attached to the catheter. Nurses will check the level and color regularly. What you can expect is that your urine will be cloudy or have blood in it. This is normal after surgery of this nature. You will have small incisions where the instruments accessed the prostate and these are located around the navel. The surgeon may have used small stitches which will be removed. When the drainage of the site seems to have slowed down, the drainage tube will be removed. An efficient nurse will do this quickly so as to cause as little discomfort as possible.
Treatment after the Operation
What has been removed will be analysed. The purpose of this examination is to stage your cancer so that the appropriate treatment can be given. Usually this will consist of hormone treatment to kill off remaining cancer which feeds from male hormones. You may also need to have radiation treatment in conjunction with hormone treatment, though there may be a delay in this treatment if you suffer from incontinence. The reason for the delay is that radiation treatment is precise and depends upon having a bladder half full. If you cannot retain urine or have little control over it, it may be too early for this treatment to take place. Retraining the pelvic floor muscles will be necessary in the case of incontinence. You may be referred to a specialist to help you with this. In the meantime, the hormone injections will help to kill off any remaining cancer and PSA blood tests will confirm their efficiency.
The hormone treatment has many side effects. Try not to read too much about it and merely report what you experience to your doctor. The main side effects are hot flashes and night sweats and placing a beach towel in the bed can help.
Dealing With Incontinence
While you are experiencing this, you will need to exercise the pelvic floor muscles. You may find incontinence lasts up to a year. The prostate was located just below the bladder and to some extent controlled the stop start action when you urinated. Now that it has been removed, you need to relearn this action and it can take time. Expect to use pads and if you need to go out for lengthy periods, you may be able to use bags with an external extension you are able to set up yourself. Bear in mind that the teets come is different sizes and it may take time to find the right one for you.
Having Radiation Therapy
This is complex because of the precision needed in an environment of the body that is ever changing. For example, the bladder and rectum will become your area of focus. Your bladder should be half full and the rectum empty. You will be placed on a diet to help control this and will be asked to use suppositories on each morning of your treatment. You will also need to empty the bladder as usual and then drink half a liter of water and retain it until after the treatment. An initial setting up process measures where the treatment is to be applied and this takes about an hour. During this setting up procedure you will be marked on your skin with a small tattoo in a single dot shape. This ensures that each treatment is exactly the same as previous treatments.
The treatment takes place over a number of days to be determined by the specialist. You step onto a bed and the scanner is only around the affected area, so you are not closed in. The actual treatment is shorter than the time it takes to set you up in the right position. Expect to feel a little tired. Many people go back to work after treatments although if you need time to rest, don't feel bad about it. Since treatments can last up to a month and a half daily - excluding weekends - you can expect a little tiredness and that's normal. You may find that you occasionally have difficulty with urinating or going to the toilet to pass stools. Report any difficulty to your Oncologist immediately.
Things to Expect
Expect to urinate regularly in small amounts. Drink plenty of water to keep the flow of urine regular. Expect to lose your sex drive. This is normal and there are treatments to help you in the future. However, you need to regain full control of your bladder and this can take up to 18 months. Expect your PSA level to be checked regularly. This should be low and your Oncologist should be informed if the PSA level rises.
it isn't all doom and gloom. There is life after Prostate Cancer and the earlier you get diagnosed, the easier the treatment will be. After the age of 50, have regular blood tests for PSA levels and make sure you tell your doctor if you are experiencing trouble with urination. That way, you protect your own interests and can be diagnosed fairly quickly. Trouble with urination is a symptom, but be aware that if this happens, it doesn't necessarily mean you have cancer. It may be as a result of something as simple as a urinary infection. Be safe, have regular checkups and even if you are diagnosed, be aware that the treatment is effective and even moreso when the cancer is detected early.