Aside from some forms of skin cancer, prostate cancer is the most common cancer among men in the United States. With September being “Prostate Cancer Awareness Month,” it is important to understand the nuances associated with the “silent killer.” Moreover, you should know and understand the severity of your cancer, to ensure you choose the best treatment for you.
Not All Prostate Cancer is Slow Growing
Prostate cancer is graded using a Gleason score which is based on the appearance of prostate cells under a microscope. In assigning a grade to a tumor, a pathologist will assign a primary grade to the pattern of cancer that is most commonly observed and a secondary grade to the second most commonly observed pattern in the specimen. Gleason scores are always a combination of these 2 numbers. Grades range from 1-5, thus scores range from 2-10. It is important to note whether your biopsy or pathology contains any Gleason 5, as this increases your risk of recurrence. Generally speaking, cancers with lower Gleason scores (2 – 4) tend to be less aggressive, while cancers with higher Gleason scores (7 through 10) tend to be more aggressive.
Samadi Modified Advanced Robotic Technique (SMART) Surgery
Unlike traditional prostate removal surgery that approaches the prostate from the outside in, SMART surgery accesses the prostate from the inside out. Without cutting or damaging three critical areas: the endo-pelvic fascia, the neurovascular bundles, and the urinary sphincter, Dr. Samadi optimizes post-surgery sexual function and urinary continence. Further, the dorsal vein complex is left unstitched until the end of the procedure, allowing Dr. Samadi to control the length of the urethra and minimize leaking after surgery. He uses only cold scissors and clips, never highly nerve-damaging cautery, and every surgery from beginning to end is completely in his hands. Under Dr. Samadi’s care, and with proper compliance to post-operative instructions, 96% of patients regain urinary control 85% regain erectile function 12-24 months after surgery. It is important to note that with robotic prostatectomy, urinary and erectile functioning improves with time compared to other forms of therapy (e.g. radiation, hormones).
Sex After Prostate Cancer Surgery
It must be noted and understood that after prostate surgery, you will be able to achieve orgasm; however, you will have no ejaculation since the prostate is no longer available to produce the fluid. If you encounter erectile dysfunction (ED) in the early months after surgery, there is still a possibility that normal function will resume in about 12 to 24 months. Even if you face ED during or beyond that amount of time, there are many treatments available to you.
Penile Rehabilitation with Oral Medications
You can start by trying the simplest method of treatment, the oral medications such as Viagra, Cialis and Levitra.
Penile Injection Therapy
If oral medications are not effective, don’t be discouraged. It is important to continue to be sexually active, or in other words to “exercise” the penis after prostate surgery. Until the nerves regenerate or recover sufficiently to respond to oral medications, penile injection therapy is the most effective and reliable way of restoring erectile function.
A vacuum constriction device (VCD) uses vacuum-like suction to help the penis become erect. A ring placed at the base of the penis helps maintain this erection.
A penile implant can be a permanent solution to your ED. A penile implant is an excellent option that is associated with a very high rate of patient and partner satisfaction.
Want to know more about men's health? See my column on talkingaboutmenshealth.com.