Trying to get preventative prostate removal

[hans-europe (imported)]

...indeed it's better to prevent risks. Especially if in family are such problems with health. In my family, the uncle died, because it was too late....

[Stumpycoon (imported)]

Thanks for that, if belatedly.

[Stumpycoon (imported)]

I don't have the links, but some time ago, I read a couple of articles online about preventative surgery related to cancer.

One story was about a lady who had a history of breast cancer in her family and also had the genes for it. She had a preventative mastectomy.

The other story involved thyroid cancer in the males of a family. The father had survived thyroid cancer, and doctors found the gene in both of his young sons. One of the boys had his healthy thyroid removed, while the other didn't. I believe one of the doctors was quoted as saying that the thyroid was a "ticking time bomb" for the men of this line.

I think this is what OP is getting at here.

Thanks for that.

[Stumpycoon (imported)]

Hi. I also was in a similar position. My father, his brother and his brothers son all died of pc within 9 months of it being diagnosed. I have repeatedly high PSA tests. I had one of 14, and was told I would 90% have PC and a biopsy would determine my Gleason and course of action. The biopsy found nothing. I told my urologist I knew all the complications and probable permanent side effects, but I wanted it removed. Not a chance in hell! I would have to be diagnosed with PC before they would offer any treatment, and prostatectomy was not a first choice. I brought up cases of women having hysterectomies and mastectomies as prophylactic measures, but I couldn't find a urologist who would even discuss it. I contacted some gender reassignment clinics, and again no one would consider doing it.

Good luck.

Thanks for that, and yeah I am in the same boat. "We'll keep testing for it until we can tell you it's too late"...great.

[Stumpycoon (imported)]

I checked with a couple of experts on prostate cancer treatment. Their response was that prostatectomy is a very invasive surgery with lots of potential complications. Recovery time may be very long and painful. It's difficult to preserve the nerves that run through it, resulting in a high rate of sexual dysfunction. Urinary leakage is quite possible, resulting in the need to wear an adult diaper or a catheter and urine bag afterwards. (All of this is also true for one of my cousins who insisted on the surgery, despite the warnings from his doctors.) Watchful waiting may well be your best option.

It is a worry, to be sure. If it were a risk not a certainty i'd be more willing to risk it. I'd also love more info on how invasive with verses without the prostate cancer (and the chance it will spread). On the other hand WHEN I get prostate cancer it will need to be done anyway, and I might or might not have had the cancer spread in the meantime. That happened to a few of my uncles, it wasn't detected until after it had spread...and they were screwed then.

Part of the problem is it's a question of when, not if. Is there an advantage to my recovery chances if I get the preventative surgery? Also "how much leakage", are we talking a few drops here and there or complete urinary incontinence? And I am facing the same side-effects if I get a cancerous prostate removed as a healthy prostate removed.

It feels so stupid that I can't get preventative surgery because there might be side effects...but I would face the same side effects after the same surgery once necessary due to cancer.

[Stumpycoon (imported)]

Well... you've come to the right place, only looking to remove the wrong part.

I'm not a doctor, but removing a prostate because you might get cancer is likely not your best solution.

I suggest medical castration as testosterone is associated with enlarged prostates and cancer which is why doctors recommend Orchiectomy to help prevent enlargement and cancer. Here is a link to help you do additional research.

https://prostatecancer.net/treatment/orchiectomy

Interesting, i'll need to look into it.

Wait...you're not just saying that 'cos this is a eunuch issues forum are you?

(kidding, kidding, thanks for the advice)

[Stumpycoon (imported)]

A good alternative to prostactomy is lowering your testosterone levels either via orchiectomy or chemical castration. During my short chemcastration trial my PSA level dropped 10 fold. Although PSA was not close to any problematic level, it still dropped significantly, and remained at 25% lower level even after a year after return of usual testosterone levels.

Over a longer period of castration prostate will shrink considerably. It is well known fact that in chinese eunuchs prostates had shrunk to such a small size that often times they weren't palpable.

Thanks and that does tie in to Biker's advice above.

Also sorry for the late replies everyone. The search function in all its wisdom didn't show me this thread still existed after a month. I thought the admins had erased it for some reason.

Thanks, all.

[ambiguous (imported)]

The only thing I can suggest is regular PSA blood tests.

Medichecks (UK based outfit) do finger prick hormone profile tests, I feel similar services available in the States and PSA is a measure they usually do.

Anything above 4 treat as suspicious.

Prostatectomies have a few side effects that you may want to consider.

Infertility.. pretty obvious, but it does make climaxing a much drier affair.

Incontinence. This does vary from person to person, due to the proximity of the urinary sphincter at the bladder neck some damage may occur but most folks will suffer from stress incontinence (you dribble a few drops when you cough , sneeze, or exert yourself. You may need to wear a pad for a while after the procedure, some folks may have to wear one permanently but this is rare. I can get by without wearing a pad most of the time but wear one when I'm doing weights down the gym.

Erectile Dysfunction. Pretty much down to the individual and how the procedure was done, the nerves that control blood flow for erections that pass through the capsule of the prostate may suffer trauma or simply be cut during this procedure. 3 Months in and I have had nothing that resembles anything like any action down there.

So a bit to think about. I think the cost of my procedure would have been in the region of £17,000 plus consultation costs so a bit to think about.

[WheelyCurious]

No direct personal experience (fortunately) but everything I've heard about prostate issues, including cancer is that removing the prostate has enough potential side effects / risks that it basically rates as one of the 'last resort' treatment options that doctors only want to use if all else has failed...

OTOH I've been reading a lot of scientific papers that I got from Jesus (see his list in non-fiction articles) and they say that chemical castration (and sometimes surgical) is VERY much one of the options - something like 40-50K guys a year get it....

One of the questions that may be worth researching if you can, is just what type of prostate cancer your relatives had. My reading says there are several types, and some are testosterone responsive and are helped by shutting down the T supply, but others are not, and those aren't impacted by hormone therapy at all, so other treatments are needed.

I'd see if there is a record of what type of cancer your relatives had and if it was one of the hormone responsive sorts, try talking to the doctors about shutting off the T rather than surgery... If your regular docs aren't willing to consider it (or give a good reason why they don't want to) it might be worth talking to a transgender clinic from the standpoint of being uncomfortable w/ your current state of concern.... I don't know if that would check the right boxes for 'gender disphoria' or one of the other acceptable reasons, but no harm in asking....

WheelyCurious

[ambiguous (imported)]

No direct personal experience (fortunately) but everything I've heard about prostate issues, including cancer is that removing the prostate has enough potential side effects / risks that it basically rates as one of the 'last resort' treatment options that doctors only want to use if all else has failed...

WheelyCurious

In the UK you are given a choice of options,.

I had stage 2 meaning the cancer was localised within the prostate with an intermediate risk of it spreading.

I was given 3 options.

Hormone therapy. Basically anti androgens with a bit of progesterone thrown in.

I like to work out so I was pretty quick to dismiss this, as I didn't want my body turning to jelly.

However the key to keeping in shape when on reduced T is lots of cardio and try to keep up the weight training.

Radioactive pellets planted in the prostate.

Over time these will lead to erectile dysfunction and you may also have to take androgen blockers as well.

I didn't like the sound of this (Although it is a popular choice) as I don't know fully what the long term effects of having these things inside me would be.

Radical prostatectomy was the choice I made weighing in all the risks this was the one to go for as hopefully the cancer is excised with my prostate and will not recur.

I am 64 so I was starting to get ED and was sterile anyway, The UK has its national health service so costs for the procedure didn't come in to it.

Clinics are now doing robot assisted keyhole stuff and that is what I had, and was in hospital overnight and discharged the following day with a couple of check ups from district nurses.

The incontinence fortunately for me was not an issue and I can live with the couple of drops that may dribble out when I sneeze,

This I'm told will improve over the next year , so all good.

But this all changes for a guy who is a lot younger than me, they may be in an active relationship, may want to raise a family, etc.

I did miss out the 4th choice of procedures as it was not applicable in my case,

Watchful waiting, This is as it sounds you have a biopsy but your condition shows the likelihood of not getting worse too quickly, so every now and then you have a blood test to monitor the situation.