Cycling after Prostatectomy or brachytherapy

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saudidave
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Cycling after Prostatectomy or brachytherapy

Post by saudidave »

After 16 months of a variety of tests including a clear MRI scan a year ago, I've finally been diagnosed with Stage 1 prostate cancer and need to have either a radical Prostatectomy (done robotically) or Brachytherapy which is radioactive pellets implanted in to the prostate to destroy the cancer cells.

My main fear with the Prostatectomy is incontinence, not erectile dysfunction as I'm 68 next week and I've had a good run!

Can anyone offer any words of wisdom based upon personal experience about either procedure and the relevant after effects please? I'm not worried about this thing seeing me off as statistically my odds of a complete cure are extremely good considering the stage and grade of cancer I have. I'm assured by my daughter who is a doctor that 5 year survival is well in to the high 90's in percentage terms, but the 5% chance of incontinence that a radical prostatectomy carries frightens me in a big way!
saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

Having now discussed the options with a variety of doctors (My daughter is one thus I know several), I'm now leaning towards brachytherapy and will make a final decision after mulling it over until Monday.

Has anyone on the forum had brachytherapy and can relate their experiences?
Dave R
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Joined: 27 Jan 2021, 3:00pm

Re: Cycling after Prostatectomy or brachytherapy

Post by Dave R »

I had RP three years ago. I was cycling for miles with no issues at all 8 weeks after op. Regarding the waterworks you're soon back to normal though don't get too confident too soon !!
Six weeks after my op I saw the surgeon for a follow up. It was the morning that the 'Beast from the East' blew in. I asked him if I was ok to ride my bike again...he smiled and said absolutely fine but leave it til the snow's gone cause we don't want you back with a broken leg :D

Best of luck with whatever treatment you decide appon.
saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

It's been a while since I posted about this but life has been crazy.

After very intense research I decided there was too little data available about quality of life after brachytherapy and lots about radical prostatectomy. From discussions I've had with several people who have had one or the other I've concluded that whilst brachytherapy appears to be a quicker and much less invasive fix than RP, the latter would appear to have less problems in the long term and if pelvic floor exercises are done diligently with RP then incontinence isn't a big problem and no problem whatsoever for a large proportion.

Since I am fortunate not too fear surgery, I've thus chosen RP and have been given a date of March 10th for the op. My surgeon appears to have massive experience with remote surgery, was one of the pioneers of it and now trains others as well as still operating himself, so that is a big confidence booster. From posts I've seen on this forum it seems that 6-8 weeks is perfectly feasible for a return to the bike so hopefully I'll be back on the saddle in early May.
LarryInBoton
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Joined: 21 Feb 2021, 10:52pm

Re: Cycling after Prostatectomy or brachytherapy

Post by LarryInBoton »

I was searching for total knee replacement posts and this post was at the top of the forum list. I just had to dive in:
1) I had a catheter with bag for 7 days, I presume that to be standard
2) Purchased a Nexride Pro noseless saddle. Highly recommended. Weird but remarkably natural for indoors riding. Would be nervous using it outdoors because you lose the bike-control factor of your legs against the nose.
3) Started riding indoors at 10 days, going easy for a few days, using the special saddle. No problem at all. I realized that they wanted me to walk a lot so indoor riding with the special saddle really couldn't be a problem. The 6-8 weeks recommendation is complete silliness.
saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

Larry & Dave R, Thanks for the responses it's encouraging. Also, Larry, let me know how you get on if you have a new knee, as I need one of those too!
MikeF
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Re: Cycling after Prostatectomy or brachytherapy

Post by MikeF »

Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.
"It takes a genius to spot the obvious" - my old physics master.
I don't peddle bikes.
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Cowsham
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Re: Cycling after Prostatectomy or brachytherapy

Post by Cowsham »

MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


My uncle had that done and it was a great success. Been cancer free for a good few years now. No chemo either.
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saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


Why should it be odd? There are two main choices when eradicating prostate cancer. You either cut it out or kill it with radiation. Brachytherapy is a form of the latter
saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

Cowsham wrote:
My uncle had that done and it was a great success. Been cancer free for a good few years now. No chemo either.


They do Chemo if it has broken out of the prostate and spread elsewhere, if it is self contained they don't have to thus Chemo may be needed if radiation (Brachytherapy)doesn't sort it, then they can't do more radiation on the same area. If the surgery route is undertaken and it is found to have spread then they can do radiotherapy to mop up the bits where it has spread.
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Cowsham
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Re: Cycling after Prostatectomy or brachytherapy

Post by Cowsham »

saudidave wrote:
Cowsham wrote:
My uncle had that done and it was a great success. Been cancer free for a good few years now. No chemo either.


They do Chemo if it has broken out of the prostate and spread elsewhere, if it is self contained they don't have to thus Chemo may be needed if radiation (Brachytherapy)doesn't sort it, then they can't do more radiation on the same area. If the surgery route is undertaken and it is found to have spread then they can do radiotherapy to mop up the bits where it has spread.


Yes his was got early -- I started getting tested about 7 years ago which was a few years after a friend who was 62 at the time he was diagnosed, spoke to me about his troubles.

His was got far too late so was deemed inoperable. The doctors told him it could have been with him from his early 50's. ( I took my cue from that )

He was having some hip problems and put it down to getting older but one day went to the doctor to see if he could get something done about it, thinking it was arthritis.

He had no p problems whatsoever

The cancer had spread to his pelvis and was in the bone, a spot or two in the lungs and one in his brain. He was told initially to make plans. 6 months to a year.

At the time they were trialing a new drug and he agreed to be part of the trial. The drug worked and brought down his cell count from 7 or 8 hundred to about 6. So it stopped the cancer spreading further and seemed to stop the growth of and even reverse some of the peripheral bits.

He lived another 15 years. It was more the treatment that eventually took him but up to his last year he enjoyed a good quality of life.
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MikeF
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Re: Cycling after Prostatectomy or brachytherapy

Post by MikeF »

saudidave wrote:
MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


Why should it be odd? There are two main choices when eradicating prostate cancer. You either cut it out or kill it with radiation. Brachytherapy is a form of the latter
Surgery is drastic and a slight error could leave you incontinent or with other problems. It's not usually a first choice. It sounds as though your cancer is not severe and that is why you have been offered brachytherapy, but you should also have been offered external radiation as well.
"It takes a genius to spot the obvious" - my old physics master.
I don't peddle bikes.
MikeF
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Re: Cycling after Prostatectomy or brachytherapy

Post by MikeF »

Cowsham wrote:
MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


My uncle had that done and it was a great success. Been cancer free for a good few years now. No chemo either.
Incredible machines for radiation treatment all lined up with lasers and much more.
"It takes a genius to spot the obvious" - my old physics master.
I don't peddle bikes.
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Cowsham
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Re: Cycling after Prostatectomy or brachytherapy

Post by Cowsham »

MikeF wrote:
Cowsham wrote:
MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


My uncle had that done and it was a great success. Been cancer free for a good few years now. No chemo either.
Incredible machines for radiation treatment all lined up with lasers and much more.


Yes Mike they just zapped the 3 or 4 lesions clean from outside I think.
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saudidave
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Re: Cycling after Prostatectomy or brachytherapy

Post by saudidave »

MikeF wrote:
saudidave wrote:
MikeF wrote:Seems an odd choice brachytherapy or surgery. I've had radiation treatment for prostate cancer after a biopsy confirmed its presence.


Why should it be odd? There are two main choices when eradicating prostate cancer. You either cut it out or kill it with radiation. Brachytherapy is a form of the latter
Surgery is drastic and a slight error could leave you incontinent or with other problems. It's not usually a first choice. It sounds as though your cancer is not severe and that is why you have been offered brachytherapy, but you should also have been offered external radiation as well.


Mike, I think maybe you are a little out of touch with Prostate Cancer treatments in 2021. The patient is given the choice to make; Radiotherapy or surgery. Radiotherapy for Prostate cancer is now carried out by inserting radioactive seeds in the prostate itself (Brachytherapy) not by external beam which relatively speaking is a scattergun approach. Prostatectomy (surgery) is carried out using microsurgery (via 5 holes in the stomach area) with a computerised machine called a Da Vinci. The surgeon does not wield the scalpel, he operates the Da Vinci on a computer screen from a remote position in the theatre. It is incredibly accurate and has revolutionised the surgery, which now carries approximately only a 5% chance of incontinence & it is the first choice for many people. My consultant was strongly in favour of it ahead of Radiotherapy. Radiotherapy of the prostate can cause bladder cancer, urine retention, cystitis and many other problems, often several years after what appears to be successful treatment. It burns the tissue, making further surgery a very difficult procedure, should it be required. It's a less invasive route initially but it carries quite a lot of unpredictable risk in the long term. Surgery is obviously much more invasive in the first instance but these days only requires one overnight stay in hospital. It also provides an assurance. If your prostate has been removed you can't get cancer recurring in it.

I researched the choices at length before I made my decision, aided by my daughter who is a surgeon. She and the majority of her colleagues were overwhelmingly consistent in recommending surgery ahead of radiotherapy and based upon the evidence and data, so was I.

Any form of cancer is serious and my cancer is a Gleason 3/4 b.t.w., which is at the turning point and going nasty.
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