Fifty days, seven weeks since surgery for prostate cancer. Ticking through the elements of recovery, I seem to be making very good progress, better than I expected given some of the information and individual stories I’d been reading.
Physical recovery from the surgery is almost in the rear view mirror. By this, I mean the common issues following any surgery. The five skin incision sites are still pink but have no other issues – no tenderness, no itching, no numbness, none of what I might expect to plague me for months afterwards. Inside, where my prostate was scooped out of the cul-de-sac (the hollow at the lower end of the abdominal cavity, between the rectum and bladder), I have never sensed any pain. I have had a very occasional feeling of discomfort, mostly associated with activity in the colon/rectum, and also with a very full bladder. This does not happen daily and for less than a minute when it does. The generalized weakness one feels after surgery – which I ascribe to the body spending most of its available energy to repair the damage done – is progressively improving, but there are still days when I nap 45-50 minutes, or decide to simply take a day off. I can go out, shop, meet with people, eat out, see a movie, attend a birthday party – all the social activity I would normally be doing.
I have an extra level of recovery, getting back to swimming/biking/running/gym work at the level I was before. I feel I’m half-way back. I swam 2000 meters for the first time yesterday in the lake. I am spending 35 minutes 3 times a week in the weight room, albeit at about 80-90% of the weight I used to manage. I’m running 3+ miles four days a week. But at surgeon’s orders I am still not biking, not for another month. I miss that, as it was the activity which allowed me to go at the highest intensity. I’ve never been a really fast swimmer, and my knees can’t tolerate long or hard running any more. So without biking, my heart rate never gets above 130, and I don’t really work up a sweat. It’s the final tier of High Intensity Training that keeps me at the fitness level to which I’m accustomed. My body and my mind miss that feeling.
My bladder control has shown steady, surprising improvement.
I’ve been keeping track of my urine loss by weighing the pads I wear to protect my clothing. The trend is clearly and steadily downwards, from over 80 ml (nearly three ounces) per day two weeks after the catheter was removed to an average of 10 this week. Even when I run for 40 minutes, very little comes out. Four weeks ago, I was losing nearly everything in my bladder when running – 40 ml or so – compared to almost nothing – 5 ml yesterday – now. And that despite going a bit faster, and spending more time running compared to walking. A month ago I started at one minute run, one minute walk; yesterday was ten minutes run, 1.5 minutes walking. (The big spike represents a 2.5 hour brisk walk I took along the “beach” in West Seattle – a typical Puget Sound shoreline trek with some sand, and a lot of rocks.)
The fourth and scariest element of recovery is, “Did the surgery work?” The idea of course is to remove as much of the cancer as possible. While the post-op pathology report gave me guarded hope, I knew that only the PSA level would be truly informative. Prostate cancer luckily produces Prostate Specific Antigen (PSA), and so treatments can be managed by following that lab value. It’s a test I’ll be getting periodically for the rest of my life. In the two years before the surgery, my test went from 3.54 in March ’21, to 5.72 in March ’22 to 6.2 in June, 6.8 in November to 8+ just before surgery. On May 22, 2023, the result was “Less than 0.02ng/ml”, meaning that essentially no PSA was detected. I was with Cheryl and daughter Annie when I got the report that evening. High Fives were exchanged all round.
I’m left with one final element of recovery, penile rehabilitation. Some of the nerves controlling the blood flow leading to engorgement underwent a bit of a shock as they were delicately stripped off the prostate during its removal. It may take months or years before they fully recover. In the meantime, it’s important to replace their action with alternatives to maintain periodic blood flow in the area. That’s done pharmaceutically and mechanically. I found an excellent program to follow out of Australia. For those who want to go farther down that rabbit hole, here’s the link:
While it’s harder to measure improvement in this area than it has been with my bladder, I’m satisfied with where things are at this time.
I’ll probably check back here after my 3-month visit with the surgeon.