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My Dad just had RP and his catheter was just taken out 3 days ago. He experiencing quite abit of leakage and has been doing Kegals to help out...is there anything else that he can do help with his incontinance?
His pathology report come out with a Gleason Score of 8 with a positive margin on the right lobe of the prostate. Also with the just one of right lymph nodes being involved (0.5mm). They just started him on hormone therapy, what are the stats of survival with this? If he has radiation could he be "cured"?
1. There is no agreed definition of ‘cure’ for prostate cancer. That may sound weird to you, but as a recent report highlighted, there are more than 200 definitions of ‘failure’ – so it follows there must by as many definitions of cure. From the very brief information you have given us about your father, it is unlikely that the treatment he has had and will have will ‘cure’ him in the sense that he need never worry about the disease rearing it’s ugly head again. But in that he is no different from any man diagnosed with prostate cancer – not matter what their diagnosis was, no matter their choice of treatment, they cannot be guaranteed of a cure in that sense – a percentage of all men treated have a failure and progression.
2. So your focus should be on survival rather than cure. Regrettably there are no validated statistics that can give a clear answer for a specific man and his particular circumstances. There are studies that deal with median disease specific survival, but few of them give the range, a very important issue. What we do know, from the stories that men tell on this site that men with a worse diagnosis than your Dad have survived for many years: unfortunately some with what appears to be a ‘better’ diagnosis have succumbed to the disease. One of the first studies I came across on my journey showed that men with tumors that have Gleason scores of 8 to 10 and who do not have immediate aggressive treatment face a 60% to 87% chance of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis. If you’re a pessimist you’ll say that 87% is a very poor prognosis: on the other hand 60% is only a little over a 50/50 chance of surviving fifteen years. It seems likely that the odds would be on the lower side of this particular range for your Dad because he has had surgery and has gone on to ADT (Androgen Deprivation Therapy) as hormone therapy is technically known. Radiation, in addition to these two modes of treatment may help and should be investigated with a good radiation oncologist, but bear in mind that he has only recently had a major surgery and radiation may damage him in his weakened state.
3. The answer to how long incontinence lasts is the same as the answer to the old question “How long is a piece of string.” There are considerable variances between recovery times – and a small percentage of men never recover completely, but it would be a rare case where there is no leakage three days after the catheter is removed. I’d say your Dad is doing the right thing by doing his Kegels and the chances are good that as the months go by he’ll have less and less leakage.
Good luck to you both – I’d reckon that there is a good chance that you’ll have your Dad with you for many years to come, unless he has some other health condition that carries him off. I was almost ‘cured’ of my PCa two years ago when I had heart failure!!
Hi Alyssa,
I agree with the broad thrust of the explanation that Terry has given you.
Continency following an RP is very individual and often complicated by damage post op caused by scaring and stricture. Some men have permanent residual urinary incontinence but are able to lead a relatively normal lives using pads. The key aspect, is in maintaining the person's dignity.
Radiation post RP with positive surgical margins can be beneficial in halting progression. You really need to discuss your Dad's case with a Radiation Oncologist.
Hello Alyssa,
Terry has covered the pathology aspect pretty well as usual and the incontinence for the most part will usually take care of itself with time. It is often a gradually improving process which at times can be a little frustating. Usually the Kegal exercises help things improve more quickly. Tell him to try to be patient.
Bill
next week one year ago i had robotic sur at mt. sinai in ny. i still leak better than six mos. ago but by after noon with stress i will start to leak will decide in july , if i will have a sling applied , but that means another surgery i have been on this web sight before , have kegeled every day in the morning i can run or excercise hardly a couple of drops. i take drugs impromine and sudifed
