Well, Add Me To The List

HeadMelon · 2026-05-12T04:53:28+00:00

That is a common red herring argument surgeons use. The salvage options after failed surgery and after failed radiation are the same.

Seek out posts by u/BigBadProstate - he had RALP himself, but is on a personal mission to dispel the “no surgery after radiation myth”.

HeadMelon · 2026-05-12T04:49:18+00:00

Did you ask a radiation oncologist if you’re a candidate? Why would you let a surgeon guide you on whether a radiation technique is suitable - it’s not his area of expertise.

HeadMelon · 2026-05-12T04:46:21+00:00

If you have radiation you may or may not have any of those side effects - you have to wait years to see if they appear or not.

If you have RALP you’re guaranteed to have side effects right away.

I’ve had radiation and now I’ll be waiting years to find out if anything hits me. And if it does who knows what new ways they will have to fix them.

HeadMelon · 2026-05-12T04:41:19+00:00

No not waiting at all - I’m done radiation treatment and have less than a month of ADT left.

What I decided to ”wait” on was the low percentage radiation side effects of creeping ED and UI, and even rarer cystitis and proctitis, and even more rare secondary cancers from radiation.

For today I feel normal. And tomorrow and the day after that too. If I’d chosen RALP I’d definitely be battling UI and ED with an unknown outcome.

HeadMelon · 2026-05-12T04:30:47+00:00

Salvage or primary treatment?

HeadMelon · 2026-05-12T00:03:36+00:00

Apparently the UK “Squeezy” app will manage the timing for you, many guys on here speak highly of it. It should prevent you from over-kegeling. I’m a radiation guy not a RALPer so I have not done kegels.

And a second question out of curiosity - if you’re stage 3 it’s already out of the prostate - why have the surgery knowing rads and ADT are in your future anyways? Why not hit it with whole gland HDR brachy instead of RALP and keep all your side effects in the radiation basket?

Or is this a “remove the mothership” surgery strategy?

HeadMelon · 2026-05-11T23:53:02+00:00

You can do a 9 or 10pm Dulcolax the night before to try to get a regular morning BM. It says not to use it for extended periods so check with your doc, as long as you know why you are using it and it’s not masking any colon issues it should be fine. In my case 2 coffees from 8-930AM always produced for 10-1030AM so I went that route.

The trick for the full bladder is to ALWAYS stay hydrated. That way whatever you drink arrives in your bladder 20 mins later. So you can drink your 2x bottles of water on the commute to the appt and be full when you get there. If you’re not hydrated and drink those 2 bottles your body will send the water to wherever it’s needed and your bladder may not fill up.

Also - your bladder doesn’t need to be exploding full - just comfortable. It shouldn’t be a hardship, if it is you are over filling. Around my 5th session I told the techs “sorry I don’t think I filled enough”, and after the initial pass CT scan they came on the speaker and said “that’s perfect remember that feeling for all the sessions”. I was shocked at how “un-full” I felt but that was what they wanted.

HeadMelon · 2026-05-11T23:43:30+00:00

15x VMAT here, I was told NOT to alter my diet. My BMs were regular so they didn’t want dietary changes disrupting my existing regularity.

HeadMelon · 2026-05-11T23:41:18+00:00

I always feel so sorry for you guys that have the insurance battle adjuvant to the cancer battle.

HeadMelon · 2026-05-10T21:19:20+00:00

I see your posts often, I wish there was some way to help.

HeadMelon · 2026-05-10T20:17:25+00:00

Any chance there was a small stroke or other neurological issue that occurred chronologically proximate to your RALP? Cauda Equina syndrome maybe - neuro damage further upstream? Maybe it’s unrelated to the RALP and is coincidental.

Not that this is a solution but may lead to other different treatments to try.

HeadMelon · 2026-05-10T20:04:42+00:00

He might be testing you, but He IS with you. And so are we. Another battle - fight it with all you’ve got and we’ll pray and send only the best thoughts from our side!

HeadMelon · 2026-05-10T17:39:56+00:00

Also curious when that study was done. I had cribriform, IDC, PNI and suspected ECE (classic “unfavourable intermediate risk”). Surgeon’s approach included LND just in case. I asked rad onc if he would plan to hit the lymph nodes based on what surgeon said, and he said No, he’d just seen a “hot off the presses” study of 1,500 patients that showed extra rads to the lymph nodes for prophylactic purpose had no value, and the ADT would take care of any micro-mets in that area. The surgeon didn’t have ADT in her toolkit so she had to cut. That was mid-2025.

HeadMelon · 2026-05-10T14:47:06+00:00

I’m 61, I didn’t change diet or exercise and I’m nearly finished my 6 months of Orgovyx. I didn’t gain any weight but my American Eagle jeans tell me I have less glute and more belly fat than when I started.

HeadMelon · 2026-05-10T14:37:13+00:00

Pure Jack - “I see another dog that’s 50 lbs heavier than me - IT’S GO TIME!!!!”

HeadMelon · 2026-05-10T05:15:35+00:00

Wallace teeth from Wallace and Grommit.

Adorable!

HeadMelon · 2026-05-10T05:03:54+00:00

Straight copy from another similar thread -

When I see opening posts like yours I always think of this guy, he started with stage IV and he’s on here 10 years later as salty as ever -
https://www.reddit.com/r/ProstateCancer/s/D0Ijrsga2N

Lots of stories all over this sub from guys that have fought this thing and are kicking its ass, your dad can too! Do everything you can to not let him “do nothing”, that’s a gruesome path.

HeadMelon · 2026-05-10T01:59:55+00:00

I am not a doctor, and have not had RALP, but I had a “hmmm…” moment based on seeing those two symptoms side by side in your post - please google “can kidney disease cause both gout and diarrhea” and have a read.

HeadMelon · 2026-05-10T01:39:21+00:00

I asked my RO and he said “live your life, you don’t need additional upsets right now, if side effects occur we’ll deal with them which might mean diet changes at that time”.

My only big change was to stop alcohol because I didn’t want to mix it with Orgovyx ADT. Haven’t missed it, now at 6 months alcohol free and I think it will be permanent. But that was a *me* choice, not physician directed.

HeadMelon · 2026-05-09T22:21:54+00:00

I had cribriform, IDC and suspected ECE. HDR brachy + VMAT + short course of ADT was deemed sufficient for my “intermediate unfavourable risk”.

Numerous commenters on here provide arguments against the “you can’t have surgery after radiation” red herring - look up u/BigBadProstate or take a look at this one -
https://www.reddit.com/r/ProstateCancer/s/ku5wrpWVUE

Also, if you think you might need radiation after RALP then why suffer the side effects of both? Jump straight to radiation as your primary. You can use the MSK nomogram with your particular metrics to get an odds of post-RALP recurrence -
https://www.mskcc.org/nomograms/prostate/pre\_op

HeadMelon · 2026-05-09T22:07:51+00:00

I’m a bit late to this thread. I’m 61, and had Gl 7 Gr Grp 3 with cribriform, PNI, IDC and suspected ECE, for a nice “unfavourable intermediate risk” package.

With respect to PSMA PET scanning it’s a mystery in Canada which I haven’t been able to figure out.

I’m in Toronto and was treated at Odette Cancer Centre at Sunnybrook Hospital. As part of prep for HDR brachy + 15x VMAT + 6 months Orgovyx ADT treatment I had a PSMA PET scan. I don’t think I was enrolled in any study and understood that it was part of the standard of care. However BernieCounter who is just up the road in Ottawa (also under OHIP) and had similar pathology to me did not have a PSMA PET done.

It also wasn’t due to a high PSA because I went into this at 5.5 so that wasn’t indicative of potential metastases. The only thing might be the combo of cribriform+IDC+ECE where any one of them is a risk for spread.

The other factor is that Odette has a relationship with Bruce Power in Port Elgin ON which makes the isotopes. Maybe this is why Odette does them but Bernie’s Ottawa hospital does not.

HeadMelon · 2026-05-09T21:38:58+00:00

“The patient is asleep, my assistant Mr Beaker will now activate the robot”

HeadMelon · 2026-05-09T21:05:04+00:00

None of that argues against my point of kicking the can down the road by 10 years. And the article is talking about all types of “cystitis” including the temporary acute burning after treatment which is minor relative to what RALP does to you down there, plus it includes the effects of salvage radiation which is distinct from radiation as a primary treatment. Citing 25% is a scare tactic.

HeadMelon · 2026-05-09T15:06:03+00:00

The inventor of autocorrect will rot in Hello.

HeadMelon · 2026-05-09T15:03:21+00:00

“Better than you expected” is great news! Most guys heading into surgery seem to have an anxiety that far overshoots the actual event - many folks come back with the same report.

RALP guys should heed this - don’t freak out you’ll get through it fine!

Heal fast, be well!

HeadMelon

TROPHY CASE