A Prostate Cancer Journey

Up until now I've stayed mainly factual, but my surgery is in a few days so I wanted to get down some of the hopes & fears that I have in the leadup. One of the hard bits is that the outcomes are so variable and it depends who you talk to and when. For example you can read that 'it's safe to return to non-physical work after two weeks' but also 'it could take a few months to regain bladder control' or 'avoid any heavy lifting, yardwork or strenuous exercise for 12 weeks'. But from what I have read -  Best case is getting home after one night in hospital, being relatively active (with caution) after a couple of weeks and back on a bike after 6-8 weeks. There will still be potential for bladder leakage so I'll need to wear pads if I'm out or stand in a bucket if I'm working from home. Erections won't be happening for a month or two even with the best case scenarios.  Worst case is 6-12 months to regain continence and no erections again....

Note - I'm writing this pre-surgery, and will be able to comment on the accuracy of it in a couple of weeks.  A radical prostatectomy is both relatively simple and absolutely horrifying, Basically what they do is remove your prostate (which sits between your bladder and the base of your penis) entirely. This is different to a non-cancer prostate operation, where they enlarge the hole through the middle of the prostate to allow for greater fluid flow.  Because the whole prostate is removed the bladder needs to be re-stitched onto the urethra (essentially the base of the penis) so that there is a path for urine to flow. This stitching can take time to heal which leads to the first uncomfortable situation - you will have no bladder control at first. In fact a catheter will be inserted for the first week after surgery so that any urine produced simply flows into a convenient bag strapped to your leg without any interaction on your part. This sounds a bit like drinking in a swim up...

Getting a diagnosis of prostate cancer is a surreal experience. You transition from a normal healthy person to a cancer patient in the space of a single phone call. You then get the gory details in a follow up visit to the urologist.  In my case the diagnosis was 7 out of the 13 cores were cancerous, primarily in the anterior of front of my prostate.  This gave me a 'Gleeson score' of 7 (3+4). The Gleeson score is an odd one, apparently most prostate cancers contain two grade of cancer cells and so the Gleeson is a combined score.  The two numbers indicate the primary cancer grade and the secondary cancer grade, so a Gleeson of 4 + 3 is a little worse than a Gleeson of 3 + 4 as there is a greater percentage of more dangerous cells.    The urologist told me that Gleeson was an old scoring system and that nowadays they use a newer grading system that starts at 1. With this methodology my cancer is an intermediate grade (2/5) cancer, but everyone else I have spoken...