1) The prostate cancer is gone.

My doctor told me I had prostate cancer, and I’m a relatively young-ish guy (62) and in pretty good health and expect to live at least 20 years or more. Watchful waiting or active surveillance – no way, not for me. I chose the “gold standard” for treating organ-confined prostate cancer. That is, surgical removal (prostatectomy) by an experienced urologist with the assistance of a da Vinci robot.

It worked fantastically for treating my case of cancer, and how do I know that? Easy, I got my PSA tested after surgery and it went to zero, or undetectable, or <.01 ng/mL. Because my PSA level went to zero (or undetectable) after surgery and has stayed there – test after test, the cancer appears to have been completely removed from my body.

Think about it. I know some guys who have done very well with seed therapy, but all of the other (non-surgical) options that treat prostate cancer leave the gland in your body. You can fry it with radiation or freeze it with cryogenics, but it’s still in there, and it still makes some PSA. The PSA level will drop, but not to zero, so it could make it a little more complicated to monitor for future recurrences of prostate cancer.

2) I don’t take any drugs for BPH (benign prostatic hyperplasia)

No Flowmax®, no Avodart®, no Proscar®, no nothing. I’m sure these medications are very helpful in relieving symptoms in many men, but guess what, I don’t have any urinary blockage symptoms. None. Zero. I sleep all night and, I don’t get up. So no symptoms = no need for drugs.

3) I urinate like I was 18 years old.

The enlarged gland that was blocking my urine flow, making me get up at night, slowing me to a trickle, making me hesitate, is gone. Gone forever. It took a couple of months, but now I have excellent urinary control, and when I do have to urinate, it takes 10 seconds, and it’s a complete void job every time. There is nothing left in the tank.

Now I have read about some surgical patients who were not as lucky. They have serious incontinence issues after surgery, and that appears to be a real risk. I can’t pretend to know why that happened in their cases, but I do think it is fair to say that the skill level of your surgeon matters. And the 10x magnification and 3D camera of the da Vinci surgical system have to be of great value when your doctor is performing this procedure.

4) My erections are back.

This didn’t happen overnight. In fact it took about 18-24 months of slow and steady improvement to get to the point I am at now. And I believe I helped myself by following my doctor’s orders and was very pro-active in this area.

Again, here, I have read of many, many patients who never recover their erectile function and certainly that seems to be a clear risk with surgery. Without getting into too much detail, I can tell you that in my case, prostate cancer was detected early and was still contained within the “capsule.” I believe this allowed my surgeon the flexibility to spare both nerve bundles in my particular case. Every case of prostate cancer is different.

5) I don’t need any follow up treatment.

No trips to the radiation clinic, no chemotherapy, no proton beams, no hormones, no drugs, no seeds of any kind. I’m done. This case is closed. Yes, my doctor and I still monitor my PSA to make sure it stays at an undetectable level, but that’s a simple blood test.

When it comes to prostate surgery, Urologists often refer to the trifecta – that is, 1) cancer control, 2) continence, and 3) erectile function. I am proposing a new phrase or tag line for ten – yes 10 – goals to achieve after prostate surgery. You can read about it by clicking this link to my Urological Decafecta.