OldTryGuy

Don't rush and follow instructions.

note for all PCa guys and family/friends Ispire and HealthUnlocked are outstanding Forums for information

dav57

Glad to hear you are staying in the undetectable range and going down. From what I have read on this thread it seems to be 8-12 weeks before riding again. Like you, I will try it on the trainer first and get comfortable with that first. Good luck with that follow up visit.

dav57

All set, surgery tomorrow April 19. Let's get this done.

OldTryGuy

Today is your day for good luck so GOOD LUCK!!!

Scan came back CLEAR so I got in a 100 mile ride on Sunday for celebrating the good scan result and the FULL MOON.

xenabr549

Good to hear..

xenabr549

Good luck hope it goes well

dav57

I’ve been slow to update this but all is going fine. Surgery this past Tuesday went fine, just a bit delayed by the one before me. Back home Wednesday afternoon. Outside walking the neighborhood on Thursday morning. Getting in 3 x 1 mile walks a day for now. Follow up is Wednesday April 27 to remove catheter. Then the real work starts.

xenabr549

Good to hear, Getting catheter out is a big relief..

jadmt

I did the watch and wait thing for 5 years with biopsies every 6 months. I had no symptoms except sky high psa numbers. after 5 years Urologist said I probably needed to make a move due to my gleason scores. I was 55 when first started the watch and wait and 60 seemed too young to go under the knife, which is what my urologist suggested altho he did tell me there were basically 3 options ie radiation and brachytherapy besides surgery (he did both robotic and traditional and said both had equal results) I decided to get some other opinions. Went to a radiation oncologist and he wanted to do radiation. I asked about Brachytherapy and he said I was not a candidate for brachy. my sister in-law runs a radiation unit at Mayo and she suggested I come to Mayo for a third opinion. Top Doctor in Mayo said I was a perfect candidate for Brachytherapy. I am over 3 years in and zero side effects, I was lucky and never had any of the usually post therapy issues. For those who are going through this research Brachytherapy. All 3 options have very similar long term outcomes so pick the one you are most comfortable with. We all have different desires and what works for one won't for some one else. The day after I had Brachytherapy I walked 6 miles and a few days later made love to my wife (I know too much information) only stipulation is need to wear a condom for the first month or two after treatment.

It is funny I never told anyone except my wife (I swore her to secrecy) I had prostate cancer and even going into treatment I never told anyone other than my wife's sister as she set the appointment up at mayo. 3 years later I have told only two close friends and only because they are my same age and they both told me they had high psa numbers and were doing the biopsy thing every 6 months. Not sure why it has been hard for me to talk about it.

dav57

Post surgery appointment today. Mostly good news and a little pre-caution news. Mid February biopsy was GL 7 (4+3). Pathology was now GL8 (4+4). Contained within capsule, lymph nodes clear and bladder neck clear. However some micro invasion of lymphovascular and perineural nerves. Since it went to GL8 and the lymph vascular and perineural invasion, I will do a short radiation therapy within 3-5 months. Otherwise I'm feeling great and walking as much as possible and walking much faster without that catheter. Hopefully back to running at 4 weeks and work my way back onto my bikes.

dav57

Second post-op appointment yesterday. PSA <0.1!I've been doing a little running with my walks but my legs don't care for it. No continence issues and doing most everything I did before surgery. Dr said I can start with some short session on the bike trainer and build back up. I set my appointment with radiation oncologist for June 29. I'll meet with him and hopefully get the short radiation treatments done in July.

OldTryGuy

dav57

I got started riding on the trainer June 9. Progressed outside on Father's Day June 19. Going fine so far, no issues, 60-80 miles a week.
Now the not so great news. Met with radiation oncologist June 29. He did not like the positive inner margin. Outside looked fine but he is concerned that it was so close to the edge of the back of prostate. Also dealing with some nerve and lymph vascular invasion, even though all of these were removed that were around the prostate. Due to those 3 unknowns, he has recommended pretty much a full regimen of radiation. I'll get a PET scan July 11 and have the fiducial markers placed July 13. Then a CT scan July 20. Then I will get my start date for my treatments. He is in favor of any exercise I want to do or what I can stand while doing treatments. Anyone out there had the follow up adjuvant radiation post surgery?

mr_bill

Everyone is different.

But I spent all of 2021 in active treatment. GG5.

Six months ADT+clinical trial, RALP in mid-July, then 35 radiation treatments beginning mid-September through early-November.

My radiation oncologist is an avid cyclist. So I was encouraged to bike as much as I was able. I had joked that I had barely even noticed the BU Bridge before ADT, and now it was a bit of a climb for me. He made me make a deal, if I dropped into the last cog, I should seek alternate transportation. Deal, but I didn’t say anything about my compact crankset and Shimano HG800 11-34 cassette.

So I commuted every work day to BIDMC in Boston. But the BU bridge did finally turn into a mountain on treatment day 28, so I walked a lot more, and took taxi rides sponsored by a wonderful local charity to BIDMC for the last seven treatments.

So, my only advice. My radiation treatment started out like riding the flats with a tailwind the first few weeks, then shifted into headwinds, then the BU bridge got real steep, not just the last week of radiation but a few weeks after that too.

I did as much as I was able, and had to listen to when my body told me to take a break.

So, listen to your body. It knows.


Oh, and an observation. I found everyone in radiation oncology wonderful. They put on WWOZ for me (the best radio station in the universe) while I was in treatment, and since I had to stay still, they let me pinky dance to the music. Some days I wanted treatment to go on longer because the music was so damn good. Oh, and I only nailed the mount once, but usually was pretty damn close. And I had to remember NOT to dismount until they gave the OK. (I was surprisingly high off the floor.)


Like you, they told me exercise would help. I found it really helpful.


Finally, my world has flattened out again.

-mr. bill

dav57

Thanks mr_bill. This is exactly the kind of feedback I was looking for. I had a friend that did just radiation last year (no RALP). He isn't a cyclist and said he didn't really notice any fatigue. Once I get started I'll do my best to pay attention and adjust my exercise according. Sounds like 3 phases with the last one going a bit beyond the last treatments. Glad you are back and doing well this year.

sweeks

I've just read this thread with interest, and I'm glad to see that all you guys are doing well. I have a sort of PSA ("Public Service Announcement", not the other thing ).
A couple years ago, my internist noticed that my PSA (the other thing) values were trending upward, though still within "normal range". This happened around the time I turned 70, when the normal range jumps a bit higher, but he was still concerned. I did a literature search and found an article in the National Library of Medicine that reports that long-distance cycling in men over the age of 50 can cause an increase in PSA values:
"According to the results of our study, cycling caused an average 9.5% increase in PSA, in healthy male cyclists over 50 years old, when measured within 5 minutes post cycling. This change is statistically and clinically significant." (Source: Long Distance Bicycle Riding Causes PSA to Increase in Men Aged 50 and Over)
I sent this to my doc and we agreed to a week-long suspension of my cycling (mostly commuting), then re-testing. The PSA level went down. The following year, after the same hiatus, the level had not changed. This information will hopefully be useful to those in the same situation.

I've had other prostate-related issues. An accidentally-discovered ("isolated self-test" ) finding of blood in my semen sent me to a urologist pretty quickly! It turned out to be bike-related, and a simple switch of the saddle eliminated the problem. Actually, I replaced the original saddle on a folding bike with a "Form E3" saddle. FWIW, the urologist told me that blood in the semen is not as worrisome as one might think. He said when you're on a bike you're basically sitting on your prostate. Much more worrisome, he said, is blood in the urine which often is a sign of bladder cancer.

Keep up with your recoveries!

dav57

Radiation starts today, 1 of 37. Scans and tests are done and time to start this phase. Hopefully all goes well and I will keep the words of mr_bill in mind. I will try to remember to update every couple of weeks with progress and if there are any side effects. Health wise I'm doing great and riding regularly, less miles than usual but riding. I intend to ride as long as I can during this phase.

dav57

First update since starting radiation treatment. I'm officially just over 25% done. So far all good and feeling the tailwind that mr_bill mentioned before. Riding is going good, actually have had my best weekly total miles that past 3 weeks. Concentrating more on steady ride and HR in zone2-3 rather than speed or milage. Next looking forward to Labor Day weekend which will get me to 50%.

cb400bill

Another update on my situation. I continue to get quarterly hormone injections. The last two were in early May and August.

Before each injection I get a blood draw for the PSA test. In May my results had dropped from 0.21 to 0.07. In August the number had dropped again, albeit only to 0.06. Other than needing a periodic tweaking of my BP meds, I feel great. The best that I've felt in over a year.

My doctor says I can ride as far and as fast as I feel like, with no restrictions. So far, I've been keeping my rides to 50 miles or fewer. I need to bust past that mental block.

cb400bill

On Saturday I did a gravel Metric Century. Felt great.

xenabr549

GOOD JOB, I need to get up to Kalamazoo and ride some day..

dav57

Congratulations on a gravel century. A century ride is an accomplishment on its own but on gravel is even more impressive. I've done several centuries on the road but haven't attempted more than 50 on gravel. Glad to hear the hormone treatments are working and that your PSA is staying down. I will have my next PSA check next week.

OldTryGuy

r.e. - bold -- PLEASE keep in mind that your PSA number is ONLY an indicator to a possible issue.

OldTryGuy

..

dav57

Another update on radiation progress. I'm now about 70% complete. Today was the last day to include lymph nodes in the treatment. So far so good, no real side affects, certainly nothing that prevents me from doing my regular activities. I'm riding regularly, just less miles and less intensity than usual. Keeping this in mind from mr_bill. I'm starting to feel the headwind.

So, my only advice. My radiation treatment started out like riding the flats with a tailwind the first few weeks, then shifted into headwinds, then the BU bridge got real steep, not just the last week of radiation but a few weeks after that too.