Colin, 63 - Laparoscopic radical prostatectomy

My name is Colin and I am 63 years old. It comes as a tremendous shock to be told that you have prostate cancer. You know that it is quite common amongst much older people but you never expect it to happen to you, particularly when there was little or no obvious evidence to that effect e.g. difficulty and frequent passing of urine etc.

I had been taking statins (to lower my cholesterol levels) for some years and had had regular blood tests to monitor the situation. It was only by requesting that a PSA (prostate specific antigen) test be included as part of the blood test procedure was it possible to measure the PSA level and any change in the level over time. The PSA level remained constant and within acceptable limits throughout the period of the tests until the latest set of results showed a significant increase in the PSA level. My GP immediately referred me to a consultant urologist.

The PSA level was checked and confirmed and this was followed by a biopsy . This was not painful and there is absolutely no need to worry or feel embarrassed as I found that the staff were extremely helpful and sympathetic to my needs. You may have to leave one or two inhibitions behind when you go for the tests but it is all in a good cause! This also applies during any spell in hospital. The results of these tests confirmed the presence of a prostate cancer.

I was alone with the urologist when he gave me the news about the cancer and one of my first reactions was to bring my wife into the discussions. I felt that it was vitally important that she should hear, at first hand, the true situation.

The urologist then spent some time explaining the findings of the tests and the options that were available. How much of this registered is hard to say as I think both of us were reeling from the shock of the news. What certainly registered was that the cancer was at an early stage and treatment was possible. An explanation of the Gleason grade and staging system for cancers confirmed this. It was proposed that we had a further meeting at a later date to agree a course of action.

By the time of the next appointment with the urologist, I had had the opportunity to go onto the Internet and find out much more about prostate cancer. A word of warning though: do not get carried away by what you read on some of the sites. Stick to well established sites and I found CancerBACUP particularly useful in understanding prostate cancer. www.laparoscopicradicalprostatectomy.co.uk is also well worth a visit.

We had the opportunity to discuss with the urologist, the pros and cons of various treatments and even the possibility of a wait and see approach. All our questions were answered to our satisfaction. Thereafter, given my age, diagnosis, physical condition etc. the recommendation was that I should have the laparoscopic radical prostatectomy without further delay. This basically involves the removal of the prostate gland by keyhole surgery. My wife and I both recognized that incontinence and impotence were potential problems but the keyhole surgery was more likely to minimize the risk. I had had keyhole surgery on my knee some years previously and the benefits compared to the alternative open surgery were enormous. I had no hesitation in opting for keyhole surgery and it was agreed that we should go ahead as proposed.

The surgeon went through the procedure with us and again pointed out the possible pitfalls. In hindsight, he was almost duty bound to present the worst case scenario but we had the satisfaction of knowing that there were treatments for incontinence and impotence if necessary.

Having agreed the dale of the operation, I believe that it is vitally important and beneficial to start and continue with the pelvic floor exercises at an early stage. Women who have had babies will soon put you right on this aspect. I also believe that a healthier way of life m exercise, good food, etc will also help! It is equally important to keep yourself occupied and your mind off the operation if that is practical. There is nothing to worry about with the operation so concentrate on other matters.

Prior to the operation, I had the standard pre-operative tests. These may be carried opt before or when you are admitted. On the day of the operation, I was seen by the anaesthetist and surgeon, who went through the procedure again and answered a number of questions.

I was taken down to the operating theatre at the prescribed time and remember very little else until coming round in the Recovery Unit with my family at my bedside. The surgery must have had a major impact on me because my first reaction was to ask the Test score. Before the operation, I had been watching the England verses South Africa cricket match on TV and hence my comments! I had been in the operating theatre for about 4 hours and I was then taken to the Recovery Unit. The surgeon had telephoned my wife to say that everything had gone well. My family was then allowed to visit to me.

When I came too, I had two drips in my hand, a drain in my abdomen, a catheter and various measuring devices e.g. heart, blood pressure attached. The former were sore rather than painful though painkillers were available if I had needed them. I did feel nauseated at one stage but they gave me an injection to overcome it. After a while I was returned to my room where I was continuously monitored throughout the night. The following day only the catheter remained in situ as all the rest had been removed. I was allowed only water on the first day and required to keep a log of the amount of liquid intake and urine outflow. The nurses kept a watchful eye to ensure that I was taking plenty of liquid and recording it properly!

The catheter is more inconvenient and uncomfortable than painful. This is particularly true at night when an extension is fitted and a second bag is held on a cradle alongside the bed. I was recommended to take pyjama shorts into hospital and these proved to be very practical for coping with the catheter and the tubes. Similarly, I found that wearing jogging pants with elasticated or tied waistbands were far more practical during the day. Not only was it easier to get to the catheter bag but also the waistband did not rub against the five "keyholes" as a trouser waistband would. I was encouraged to walk up and down the hospital corridors and, once again, these pants proved ideal. The same attire proved equally suitable at home, with or without the catheter.

On the second day, I found that sticking to the mandatory light diet of chicken and fish helped reduce the possibility of constipation though Senokot was available if necessary but I preferred to drink prune juice, as this was less aggressive.

I left hospital on the third day with the catheter still in place though by then I was accomplished at positioning and emptying the bag and fitting the nighttime extension.

I returned to hospital a week later to have the catheter removed. This is not painful and takes no time at all. I was then required to drink water and sit around until I could pee. The first pee after having had the catheter removed is a real relief. More water is then consumed and after the next pee I was scanned to see if I had emptied my bladder. There was only a miniscule amount left. As a result, the surgeon allowed me to go home rather than stay in hospital overnight, which I had expected. At home, with no catheter, I was prepared for the worst. I had ordered adult nappies, pads and waterproof bed sheeting. Fortunately, all of this was unnecessary, as I had no incontinence problems. I kept a pad in place for a few days thinking that there might yet be a reaction but all to no avail so I am absolutely delighted. I cannot emphasise enough though the importance of continuing the pelvic floor exercises.

I saw the surgeon again four weeks after the operation. He was happy with the pathology report and my progress. At this stage it was still too soon to give a definitive statement regarding the return of erections. The early signs are promising and, in the future, I will take Cialis tablets that will undoubtedly assist the process. Already it has been possible to climax without an erection though it is quite a strange sensation as no fluid is ejaculated!

I am not due to see the surgeon again until 3 months after the operation. Just before that appointment, I will have a further PSA test.

It is hard to summarize my thoughts and feelings over the last few months but I still find it difficult to accept that I have had prostate cancer. I prefer to be positive and think of it as having had a course of preventive surgery. Having had the tests, diagnosis and operation for prostate cancer, I have spoken frankly and freely about my condition with family, friends and colleagues. It is quite surprising how many of them have either had some form of test or treatment or were thinking of doing so and have chosen to remain silent on the subject. Men are now talking more and more about prostate cancer but there is often a reluctance to do anything about it. I hope that by sharing my experience, it will prompt other men to take early and appropriate action.