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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2005

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Radiation Therapy

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Smiley - 29 Dec 2004 14:52 GMT
Hello.  My husband had prostate surgery in 1997.  His PSA has been at zero for 7 years and we are very thankful.  His cancer was caught at a very early stage.  I think his PSA was somewhere around 5 or 6 when diagnosed.

Just in November 2004 I was diagnosed with breast cancer.  Also caught very early.  Lumpectomy with radiation to begin in January.  

OK.  While we were at the oncology clinic this week to get the info about the radiation therapy for me, the nurse was telling us that a few months ago her grandfather had been diagnosed with PC and was scheduled for surgery.  But she talked him into getting the radiation therapy first and when they checked his PSA again it was very low so he never had the surgery.

I know this is hearsay.  And I know that the information, at best, is very sketchy.  But I also know that my poor husband has been impotent and slightly incontinent since his surgery.  And it hurts me that he has to live with this because sex had always been very important to him.  He told his sister that he felt as if the surgeon took away part of his life.  And she told me.  If only this option had been available in 1997.  I do not believe that it was.  But.  BUT.  He is alive.  And we both believe that he will die of something else and not PC.  Old age is what we're shooting for!  smile

So I could try to get more information if anyone is interested.  But I especially wanted to tell you that this is a possible option and should be investigated before subjecting yourself to surgery.  In some earlier posts in this ng there was some discussion about whether or not surgery is the best treatment today.

[mounting soap box!]

Get your PSA checked!  Annually or whenever your doc says to.  And get that rectal exam NO MATTER HOW YOU FEEL ABOUT IT!  You could catch your PC early and live to die of old age.  And what about us wives who love you?  We don't want to see you suffer either.

[removing soap box]

My 2 cents worth.

Signature

Kathy
aka smiley

In God We Trust

Dick Smith - 29 Dec 2004 15:33 GMT
Perhaps I'm mistaken here, but I believe the chances are similar in
becoming impotent with either surgery or radiation. However, with
radiation it just takes longer.
Claude - 29 Dec 2004 16:52 GMT
It's very possible that had your husband had radiation instead, by now he might also be impotent.  And had the radiation not been successful, he could also be on hormones with all those side effects.  No procedure is without its risks.  One of the first important things I read on this forum is, that once you make your decision, don't look back.
 Hello.  My husband had prostate surgery in 1997.  His PSA has been at zero for 7 years and we are very thankful.  His cancer was caught at a very early stage.  I think his PSA was somewhere around 5 or 6 when diagnosed.

 Just in November 2004 I was diagnosed with breast cancer.  Also caught very early.  Lumpectomy with radiation to begin in January.  

 OK.  While we were at the oncology clinic this week to get the info about the radiation therapy for me, the nurse was telling us that a few months ago her grandfather had been diagnosed with PC and was scheduled for surgery.  But she talked him into getting the radiation therapy first and when they checked his PSA again it was very low so he never had the surgery.

 I know this is hearsay.  And I know that the information, at best, is very sketchy.  But I also know that my poor husband has been impotent and slightly incontinent since his surgery.  And it hurts me that he has to live with this because sex had always been very important to him.  He told his sister that he felt as if the surgeon took away part of his life.  And she told me.  If only this option had been available in 1997.  I do not believe that it was.  But.  BUT.  He is alive.  And we both believe that he will die of something else and not PC.  Old age is what we're shooting for!  smile

 So I could try to get more information if anyone is interested.  But I especially wanted to tell you that this is a possible option and should be investigated before subjecting yourself to surgery.  In some earlier posts in this ng there was some discussion about whether or not surgery is the best treatment today.

 [mounting soap box!]

 Get your PSA checked!  Annually or whenever your doc says to.  And get that rectal exam NO MATTER HOW YOU FEEL ABOUT IT!  You could catch your PC early and live to die of old age.  And what about us wives who love you?  We don't want to see you suffer either.

 [removing soap box]

 My 2 cents worth.

 --
 Kathy
 aka smiley

 In God We Trust
Alan Meyer - 29 Dec 2004 19:59 GMT
Kathy,

As others have said, impotence is fairly common with radiation as well
as with surgery.  Whether a man becomes impotent after treatment
depends on many factors including the skill of the surgeon or
radiologist, what the surgeon sees when he opens up the prostate, how
much radiation is administered, the man's age at treatment, and the
luck of the draw.  Also, impotence was more common years ago than today
because of improvements in both surgery and radiation - though it's
still very common.

But don't give up on sex.  I presume you've tried Viagra, but maybe you
haven't tried all of the other methods.  Many men in this group who
were completely impotent have used a vacuum pump successfully.  It's
cheap, non-invasive (no pills or injections involved), has no serious
side effects, and it works for many men.  Some have used strong drugs
like Caverject, or have even had penile implants (though that would be
my very last choice.)

Finally, sex is usually possible without an erection.  A man can have
an orgasm even without an erection if he is stimulated enough, and a
woman can certainly have an orgasm without penetration.  The mechanisms
of sexual stimulation and orgasm are separate from the mechanisms for
an erection.  Damage to the the erectile machinery generally doesn't
harm the other parts.

So, don't give up.  If you work together on this, you may find that you
can rekindle a very satisfying sex life in spite of the prostatectomy.
Keep trying.  Try oral sex.  Try manual stimulation.  Talk to each
other openly about it and give suggestions to each other about what you
like and what is working or not working for you.  If things don't work
perfectly, try again.  Try different things.  Take it slowly, but keep
working at it.  Enjoy the efforts.  Even if they don't work perfectly
from the first, and don't work every time, they can still be fun and
gratifying.

Best of luck.

  Alan
Leonard Evens - 30 Dec 2004 03:45 GMT
> Hello.  My husband had prostate surgery in 1997.  His PSA has been at
> zero for 7 years and we are very thankful.  His cancer was caught at a
[quoted text clipped - 10 lines]
> first and when they checked his PSA again it was very low so he never
> had the surgery.

Radiation is an alternative to surgery, not something you do before
surgery.  Its purpose is to kill the cancer, and most experts think that
with today's methods it is just as effective as surgery for many men.
However, in order to kill the cancer, the radiation also essentially
destroys the prostate, so the side effects of radiation are similar to
those from surgery.   There are some differences, but how they work
themselves out will generally depend on the individual man.

>  
> I know this is hearsay.  And I know that the information, at best, is
[quoted text clipped - 6 lines]
> both believe that he will die of something else and not PC.  Old age is
> what we're shooting for!  smile

Modern methods of radiation were available in 1997, but data on how
effective they were was just becoming available then.   In any case, men
 treated by radiation also suffer from impotence.   How likely that is
depends on the age of the man among other things.  With surgery the
impotence follows the surgery and may improve with time.  Wioth
radiation, there is usually not impotence right after treatment, but it
may develop over the next couple of years.

The important thing is that there is no need for you and your husband to
give up your sex life.  IMPOTENCE CAN BE TREATED.   For example, I was
impotent for 18 months following surgery, but my wife and I maintained
an active sex life using a "pump".  There are other methods for dealing
with impotence.   Your husband should see a specialists who deals with
male impotence problems.

>  
> So I could try to get more information if anyone is interested.  But I
> especially wanted to tell you that this is a possible option and should
> be investigated before subjecting yourself to surgery.  In some earlier
> posts in this ng there was some discussion about whether or not surgery
> is the best treatment today.

It is for some men and it isn't for others.

>  
> [mounting soap box!]
[quoted text clipped - 7 lines]
>  
> My 2 cents worth.
Smiley - 30 Dec 2004 04:17 GMT
Thank you to everyone who responded.  Actually I didn't mean this to be
about sex.  But about how life changing this terrible disease is.  If you
all tell me that radiation would have had the same effect well then I will
let him know that.  Because this isn't about sex.  It's about love.  And how
I feel about that man.  And how I hurt for him that part of his life is
gone.  Believe me we've tried everything.  Viagra.  Pump.  Injections.  The
only thing left is implant and neither he nor I wish for him to do that.
Sex is great while it lasts.  But I would much rather have my husband as he
is than not to have him at all.

I am so sad for each and every one of you who must face this.  But life does
go on.  My husband does not dwell on what was.  But on what is.  Yesterday
it was about him.  Today it is about me.  But always it is about the two of
us.  And I hope you all have partners who love you as I love him.

Signature

Kathy
aka smiley

In God We Trust

c palmer - 30 Dec 2004 10:58 GMT
From: smiley@cheerful.com (Smiley)
Thank you to everyone who responded. Actually I didn't mean this to be
about sex. But about how life changing this terrible disease is. If you
all tell me that radiation would have had the same effect well then I
will let him know that. Because this isn't about sex. It's about love.
And how I feel about that man. And how I hurt for him that part of his
life is gone.
============
hi kathy - i can understand how you feel for him, just as he feels for
you when you would treated for cancer.    and yes, sex does play a big
part of it.  love is the overall picture while sex is a just a snapshot.
look at it like a movie.  you can remove some of the frames and still
follow along, but the movie doesn't flow as well as if all the frames
were left intact.  and so is life.  
--------------

Sex is great while it lasts. But I would much rather have my husband as
he is than not to have him at all.

=========> i would say that most women would rather have their husband
alive with no sex, than dead w/sex.  your comments reflect the caring of
the marriage.  it was a good time while it lasted.   but it doesn't mean
that the ride has to come to an end.  it just means that things have to
change but who says the "sex" is over.  sex means different things to
different people.

-----------------

I am so sad for each and every one of you who must face this. But life
does go on. My husband does not dwell on what was. But on what is.
Yesterday it was about him. Today it is about me. But always it is about
the two of us. And I hope you all have partners who love you as I love
him.
Signature

Kathy

===========> sad???  i don't know.  my wife have been through a lot
together and life has beaten us up pretty damn good.  life took her
uterus before age 30,  her ovaries before age 35,  her back before age
40,  her heart by age 56.  and yet, when i see her, i wouldn't want to
be with anyone else and she certainly isn't any less of a person than
when i married her almost 39 years ago.   it pains me that my heart is
crapping out and the skin cancer and prostate cancer has attacked my
body, but - hey, that's life.  

i know that there are some who might read that last paragraph and may
feel sorry for us, but i would have to say that we both have lived life
well.  we traveled, raised 3 sons, experienced many things that people
only dream of doing.  i lived life as it's meant to lived - pedal to the
metal and enjoy every second of it.  when i was in air force training a
long time ago, a major said, "if you aren't hitting on all 8 cylinders,
you might as well be dead!!!"  i have found a lot of truth in that
statement.

i may not be able to do the things that i could do before.  times have
changed.  i can't bench press 200 lbs anymore.  do well to do 50.   but
does that mean i have to leave something on the ground or can i create
and think of ways to get that weight where i want it.  the same is true
in the love dept.  you are only stopped by the limitations of the mind.  

ever so often - for no reason at all - i will stop at the flower shop
and get one single peppermint carnation.  i could get more, but one says
it all.  and why???
 a carnation and not a rose.  well..... that flower has always been in
our lives, not roses.  it was carnations that we wore to the prom.  it
was a single carnation that i got for my wife-to-be, when we eloped.  it
was a single carnation that i would bring home to my mother in the dead
cold of winter - to see her face light up because of that single flower.
and it is that single carnation that i bring into our home and can see
my wife's face light up because she wasn't expecting anything.

i believe sex can be incorporated into love if given a chance to flower.

may i suggest the book, "making love again" by the lakens.

wishing you and yours a very happy and upcoming new year.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

Smiley - 15 Jan 2005 22:54 GMT
Hi Curtis,

This is from an old post but I never thanked you for your response.  You
have a very positive outlook and that sure means a lot.

Here's the thought of a carnation for you from my heart.

Happy 2005.

Kathy
aka smiley

In God We Trust

> wishing you and yours a very happy and upcoming new year.
>
> ~ curtis
Steve Kramer - 30 Dec 2004 14:07 GMT
 < But she talked him into getting the radiation therapy first and when they checked
 < his PSA again it was very low so he never had the surgery.

 Commonly, men have a choice between surgery and radiation.  There is also freezing.  But it all boils down to removing the prostate or destroying it in place.

 < But I also know that my poor husband has been impotent and slightly incontinent
 < since his surgery.  And it hurts me that he has to live with this because sex had
 < always been very important to him.  If only this option had been available in 1997.  

 Radiation treatment was available during 1997, but in destroying the prostate, impotence would probably still have followed.  I don't think there are any studies showing less chance of impotence with radiation than with surgery.  With nerve sparing surgery available today, it probably is just the opposite.

 One last note:  If you and your husband have had no further complications from PCa after seven years, you are very blessed indeed.  

 --
 Prostate Cancer Survivor (so far), not a doctor
 PSA 16 10/17/2000 @ 46
 Biopsy 11/01/2000 G7 (3+4), T2c
 RRP 12/15/2000 G7 (3+4), T3bN0M0
 PSA  .1  .1  .1  .27  .37  .75
 EBRT 05-07/2002 @ 47
 PSA  .34 .22 .15 .21 .32
 Lupron (1 mo) 07/21/2003 @ 48
 PSA  .07 .05 .06
 Lupron (3 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50)
 non Illegitimi carborundum
Smiley - 30 Dec 2004 22:58 GMT
   One last note:  If you and your husband have had no further complications from PCa after seven years, you are very blessed indeed.  

Oh yes, Steve, we ARE very blessed indeed.

Signature

Kathy
aka smiley

In God We Trust

sandi - 30 Dec 2004 23:48 GMT
And what about us wives who love you?  We don't want to see you
suffer either.

>From another wifes perspective I think I can relate to what Kathy is
saying.  In many respects the wives are the silent victims in all this.
We have to watch our husbands endure such inhumane treatments only to
be left with life altering side effects which not only affect them but
our lifes as well.  PCa is a "family disease" just like any other
cancer it affects the whole family but of course most significantly the
intimate lives of the husband and wife.

Although my husband was not cured with surgery and has had to endure
radiation and hormonal therapy he continues to feel like he made the
right decision and tries not to look back.  I really questioned whether
or not surgery was the right answer but ultimately knew it was my
husbands choice so I went with it.  I sometimes secretly play the what
if game myself so I know what Kathy is saying. Maybe its just a women
thing?!!?  Sure Kathy is grateful that her husbands (and her cancer)
were caught early but I think she sees the anguish in her husbands eyes
and would give anything to "cure that pain".  

Sandi
Smiley - 31 Dec 2004 00:58 GMT
> And what about us wives who love you?  We don't want to see you
> suffer either.

Hi Sandi,

Yes, you have stated everything very well.

> From another wifes perspective ... In many respects the wives are the
> silent victims in all this.
> We have to watch our husbands endure such inhumane treatments only to
> be left with life altering side effects

[snip]

> Although my husband was not cured with surgery and has had to endure
> radiation and hormonal therapy he continues to feel like he made the
> right decision

[snip]

My heart goes out to you and to your husband.  It sounds like he has a
positive attitude and that means so very much.  And I hope that the ongoing
therapy is helping him.

Both my husband and I have both done some second guessing over the past few
years but when I told him the reports from this ng about radiation also
causing impotence he recalled that his doc told him the same thing but he
had forgotten it.  Today, together, we renewed our belief that he made the
right decision.

[snip]

> Maybe its just a women thing?!!?

[snip]

IMHO I have always thought it was a "Mom" thing.  smile  Kissing away the
bumps and bruises for our children.  If only it could be that simple today.

My stepMother just passed away in November after having been diagnosed with
many cancers just in September.  She wasn't one to go to the doctor very
often.  And wouldn't have gone then if one of my sisters hadn't browbeaten
her!  And so it was too late to do anything when she was finally diagnosed.
At least we in this ng can be thankful that we have more options than she
had.

Signature

Kathy
aka smiley

In God We Trust

I.P. Freely - 31 Dec 2004 01:17 GMT
It sounds like both of you need to read a few PC books. They contain SO much
more information than you'll ever see here, hear from your doctor, or
REMEMBER hearing from your doctor. You still have some decisions to make,
and the more books you read, the more sound those decisions become. TOUGHER,
maybe, because your head will be reeling with data and opinions, but easier
to live with because YOU, not your doc, made 'em. The side effect list of
hormone therapy, for example, runs into two pages, and only a handful of
urologists even MENTION, let alone combat, one of the worst and most
likely -- osteoporosis, and its heightened risk of hip fractures. IMO, every
PC patient or person who loves a PC patient should read at least Walsh,
Strum, and Lange.

I.P.

> when I told [my husband] the reports from this ng about radiation also
> causing impotence he recalled that his doc told him the same thing but he
> had forgotten it.
sandi - 31 Dec 2004 05:31 GMT
IP,

I realize you've put alot of thought into your decision about whether
or not you should proceed with HT and I respect that. FYI, I do own Dr.
Walshs book and have read many more and have spent hours researching
data on the internet.  I have a medical background and have no
difficulty understanding the data.  But ultimately after presenting the
treatment options and pros and cons to my husband, it had to be his
decision.  My husband also has recently discontinued his hormonal
therapy after almost 10 months due to his "debilitating" side effects
disregard his oncologists protests.  The more I researched the long
term hormonal therapy, the more convinced I became that IHT would be a
viable option for him in hopes of maintaining a higher QOL.  We have
"fired" his oncolgist and have found a wonderful doctor who believes
and does IHT.  Once again, my husband wanted to "try" the hormonal
therapy  for at least 6 months post op.  His goal going into this was
to gain as much time as possible.  The main reason being that we have a
beautiful 8 year old daughter together and he really would like to see
her graduation high school. By the way, I'm only 44 years old - not
ready to be a widow just yet. After seeing the fatigue, cognitive
changes, depression, etc, etc, etc, I asked him to reconsider and he
did.  Suddenly, QOL has become more important than the "nightmare" we
were living with the hormones.  But you've read all about that haven't
you?

My husband religiously received his yearly physical including psa and
rectals per my insistence and his cancer still went undetected until it
was quite advanced.  As we all know, the 4.0 threshold does not catch
everyone's cancer in time.  My husband's psa had just reached 5 prior
to surgery with a gleason 7(4+3).  We received 4 "second opinions" and
every doctor felt surgery was a viable option.  My husband wanted it
"out" of his body and there was no convincing him otherwise.  But
ultimately the delayed diagnosis of the PCa only made me feel as if the
medical society had let me down and whatever "trust" I had in the art
of medicine was lost.  I went into high gear researching the disease
and I've never stopped. I'm quite aware of all the lovely side effects
from long term hormonal therapy and I do hope that intermittent is the
answer for us.  Although QOL is important, I also want to have my
husband around to see our daughter grow up for as long as possible.
Its not an easy decision, is it?  I know you've been struggling with
your decision for a very long time and I've been impressed with your
deliberate thought process and how you've tried to weigh all the pros
and cons.  I also think under the given circumstances, you've made the
right decision for you.

The response I had for Kathy had absolutely "nothing" to do with
medical data, etc.  and everything to do with "emotions".  I was
empathizing with her feelings of being a wife in a very difficult
situation.  I can't imagine how difficult it is for you but I can
"feel" Kathys pain because I feel it also.  It is extremely difficult
to standby and watch your spouse suffer and feel so helpless.  I think
the feelings of "what if" are normal to a certain degree and that was
my point to her.  Although I can't speak for all women, I think in
general women tend to "analyze" things more and maybe dwell on things
that we can't change and that was my point as well.

I guess I take personal offense to your comments in regard to us
needing to take a more "educated" approach whereby I have oversaturated
myself in this data for the past 2 years.  As you know, the more you
read the more confusing it gets because ultimately there is no one
right or wrong answer.  It depends on what specialty of doctor you
speak to and what studies you are reviewing and of course you own
personal expectations.

I really hope you do well without the hormones and hopefully never need
them.  By the way, my husband has been off them for almost 3 months now
and the hot flashes continue, libido is still nonexistent but thats to
be expected since his testosterone is only 66 at this stage.  Although
the fatigue has lessened, he definitely isn't back to normal.
All the best to you IP,
Sandi

 

I.P. Freely - 31 Dec 2004 06:59 GMT
Didn't mean to offend. Made an assumption based on your statement that you
guys didn't know that RT causes impotence. Sorry.

I.P.

"sandi" <sjbenton@earthlink.net> wrote >
> I guess I take personal offense to your comments in regard to us
> needing to take a more "educated" approach
sandi - 31 Dec 2004 18:05 GMT
> Didn't mean to offend. Made an assumption based on your statement that you
> guys didn't know that RT causes impotence. Sorry.
[quoted text clipped - 4 lines]
> > I guess I take personal offense to your comments in regard to us
> > needing to take a more "educated" approach

IP,

Apology accepted - but I never inferred or said anything about RT not
causing impotence??!!!?  I was only validating Kathys feelings, not her
medical judgement.

I think the thing that I took personal was the inference that my
husband and I went blindly into the hormonal therapy which was anything
but the truth.
Anyway, happy new year to you and everyone else!!

Sandi
I.P. Freely - 31 Dec 2004 21:31 GMT
I guess that's the danger of the written word. I don't know how else to
interpret your post

"when I told [my husband] the reports from this ng about radiation also
causing impotence he recalled that his doc told him the same thing but he
had forgotten it".

I was trying to help, not offend, and I quickly forget which names go with
which levels of knowledge, because I look at content more than I look at
names.

I.P.

> > Didn't mean to offend. Made an assumption based on your statement
> that you
> > guys didn't know that RT causes impotence. Sorry.

> > "sandi" <sjbenton@earthlink.net> wrote >
> IP,
>
> Apology accepted - but I never inferred or said anything about RT not
> causing impotence??!!!?
wanginator95 - 31 Dec 2004 18:35 GMT
Perhaps if you eat margarine or hydrogenated oils, it could also cause
you to develop breast cancer.
I.P. Freely - 31 Dec 2004 21:22 GMT
NOW yer makin' sense, Wangeroo, considering your "perhaps". Trans fats are
NASTY, man-made, body-confusing stuff. But pitching voodoo supplements to
people who need actual, you know . . .  MEDICAL TREATMENT for
life-threatening health problems is no way to make a living. Offer sound
advice, not unproven voodoo, and maybe you'll gain some respect.

I.P.

> Perhaps if you eat margarine or hydrogenated oils, it could also cause
> you to develop breast cancer.
 
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