My Journey with Diagnosis, Treatment and Management

It’s been nearly seven years since I had my prostate removed, and I thought I would share my journey and experience.

I am now 72 years old. My father passed away at 94 and had a prostate cancer diagnosis, but this was not treated, and this was not the reason for his passing. I have an older brother who had a radical prostatectomy in his fifties and has not had any recurring issues. My Grandfather also had prostate cancer, but like my father, he had no intervention and passed away in his mid-nineties. With the knowledge of family history, I was carefully monitoring my PSA levels. I live in the country in WA.

In early 2019, my PSA levels started to increase rapidly, and in mid-February, my GP referred me to the Perth Urology Clinic (Dr Tan). Dr Tan completed a biopsy on the prostate, and a Gleason Score 4+4 = 8 adenocarcinoma was evident. A PET scan was then completed on my whole body, which showed no additional areas of concern.

It was decided to have surgery to remove the prostate (nerve saving), and this was done on April 26 by Dr Tan using Da Vinci robotic surgery at Hollywood Hospital in Nedlands. Before the surgery Dr Tan referred me to the Perth Men’s Health Clinic (Dr Yin Min Hew) to discuss the sexual health issues related to the surgery, he also recommended I have an appointment with a Physiotherapist to understand how to do pelvic floor exercises and to commence doing those exercises as early as possible before surgery (this I did and continued to do for a period of about 12 months post-surgery with a break of couple of weeks immediately after surgery during the initial healing period). Dr Yin Min Hew outlined the likely sexual health recovery scenario and recommended and prescribed low-dose Cialis (5mg) to be taken on alternate days from two weeks before surgery and then post two weeks of surgery, ongoing to assist with blood flow recovery to the penis. Before the surgery, I also had a meeting with a Prostate Nurse who provided great detail of the surgery and recovery process. She also advised there were options for reasonably priced accommodation for people from the country undergoing cancer surgery and ongoing treatments close to the Hospital – we used the Crawford House facility. The Prostate Nurses are an invaluable resource, and the nurse assigned to me (Francesca) provided a full rundown on what to expect from the surgery and through the recovery process, she provided her contact details and was available at all times. She did check in again post-surgery to see if there were any additional queries or needs.

I had not confided in anyone before the decision to go ahead with the surgery. I decided I would like to keep the surgery within the Family. As such, I penned the following communication to my siblings and children:

Just letting you know, I have recently been diagnosed with a prostate health issue. The problem was first picked up via routine PSA tests; the PSA level increased in blood tests over a six-month period. I saw a Urologist in March and have had scans and a biopsy.

I have decided with the Urologist to have a Prostatectomy. This procedure will be done via keyhole surgery using a Da Vinci Robot, so not overly invasive. The procedure is being done on April 26 and will require 1 to 2 nights in the hospital and about 7 days of lying low. Will be having a follow-up 2 weeks after surgery, and hopefully will be on our trip to the Eastern States and Europe later in May.

From the literature it appears that prostate issues can be genetic, and in our family, Grandfather, Dad, and John have all had prostate problems – John having a Prostatectomy around 12 years ago. I spoke with John last week.

I am actually feeling very good, with no other apparent health problems have been keeping fit and swimming most days.

I thought I would advise everyone via email so I could get the story straight. Will speak soon. I have only told our boys and yourselves, and would appreciate it if it could be kept within the immediate family at this stage.

Since the surgery, apart from the immediate Family, I have only told a few close friends of the journey.

Post-Surgery:

The most difficult period post-surgery was the two days in the hospital, the bloating of the stomach due to gases used in inflating the prostate region, and the pain as the gases worked their way out of the system. Also getting used to the catheter. The Anaesthetist and Dr Tan called in on their rounds whilst I was in hospital, and they advised surgery went well. The nurses at Hollywood Hospital were fantastic again; the discharge nurse, in particular, went into great detail on how to manage/look after the wound and catheter after discharge from the hospital. We booked into self-contained accommodation close to the hospital for the following week, daily walks, sunbathing, the wound, coffee, etc. Then, 10 days after surgery, the catheter was removed and the bladder emptied fully. Man, pads for minor leakage for the next couple of weeks, then all good.

Travels:

 Appointment with Dr Tan and Dr Yin Min Hew for check-up before flying to the Eastern States, May 17th (3 weeks post-surgery) and then onto Europe, May 24th, returning to Perth early September. In hindsight would have delayed the initial flight as sitting in one position for an extended period was still uncomfortable. Over the first 6 weeks post-surgery, I didn’t do any strenuous activities.

Sexual Health:

Appointment prior to travel with Dr Yin Min Hew; 2 weeks post-surgery, continue Cialis 5mg on alternative days and start using the penis pump 6 weeks post-surgery to keep the unit healthy. He also suggested not likely to see firmness in the unit for at least 4 months.

On return from Europe, mid-September 1919 had an appointment with Dr Yin Min Hew, still no firmness, and he suggested Alprostadil injections? The Alprostadil produced a solid erection at a dose of 0.12ml. Used the injections from mid-September a few times a week till mid-July 1920.

From April 2020 started trialling drugs for erectile dysfunction:

Have trialled Cialis 20mg (4 x 5mg tablets) a few times, works reasonably well, but there is a lag time between taking the tablets and the so it is not ideal.

Have trialled 100mg Viagra and it has been giving predictable and good results, now I mostly use half a tablet when required and that works well.

Have trialled the Stendra with little to no noticeable effect.

From early May 2020 (12 months post-surgery) noticed an occasional early morning erection without the use of the drugs; these have become more frequent as time has passed. Also, for the last 6 months can get away without using Viagra and have done so on several occasions, but still do use 50mg a good percentage of the time. Also still on 5mg of Cialis on alternative days, will not renew the script once the current supply finishes.

It is now November 2025 – the journey continues. Incontinence has still not been an issue. I have continued using Viagra to support my Erections. I now use ¼ of a tablet to achieve a good result, although I can achieve reasonable results without using Viagra. My PSA levels have been slowly increasing over the last year, and I have a referral and appointment back with Dr Tan in January 2026.

I have found this forum to be an excellent resource.

Thanks to many, including my GP, Dr Tan, Dr Yin Min Hew, the Prostate Nurse and finally and most importantly, my Wife and family.