PSA rising after treatment: like snakes and ladders

My PSA has started to rise, 18 months after my prostate cancer treatment.

Guest Post by Dr Rhys Leeming

I’m beginning to see later life in general, and Prostate Cancer (PC) in particular, like a game of snakes and ladders. Getting PC at all was like stepping on a tiger snake and getting bitten on the balls. You have to tie a tourniquet around them to stop the poison and then you notice you don’t feel like “sexy time” quite the same as before.

Today is the 18 month anniversary of the urologist trying to suck the poison out of my balls and simultaneously removing my prostate for my own good. Here’s my retrospective.

The long road to urine control

Getting over my incontinence has not so much been a ladder, but one of those really slow moving people movers at airports, the ones you can generally walk faster beside them. It took a tortuously long time with lots of small and a few big accidents along the way.

But at 18 months I have pretty much got there. I throw a shield in my undies if I’m going to an event or a really long bush walk, just in case. Otherwise, I’m free of the hassle and discomfort and can let my “man bits” breathe and swing once again.

Determined to address erectile dysfunction

I’ve been much luckier and more determined about the erectile dysfunction (ED) side of things. I got a pump straight away, read erotic stories while convalescing, kept arousal levels high with my wife, and did a course of acupuncture to settle the disruption to my nerves. Kept up my yoga and got back on the mountain bike.

The first six months I had impressive improvement off a very low base, but certainly slid down a few small snakes along the way in terms of mental health. Even with noticeable improvement, the whole ordeal can really get you down. I’m sure there’s a whole lot of other stuff (hormonal??? Who knows) going on to really ruin your “wa” at times. It requires a lot of focus which is really in quite short supply at “64 with a cancer diagnosis”.

Getting hard again at last

But from 6 months on, I could really see my ED getting better. A holiday to Queensland at the time saw me not having to use the pump for sex for pretty much the first time. I kept using it for rehab though.

That second 6 month period was better because I could see an incremental improvement. That slight weekly improvement let me work on the mind-game aspect of coitus…..avoiding disappointment, thereby maintaining erections better and for longer and concentrating on arousal strategies to help orgasms come a bit easier.

All the other nerve damage (other than the erectile stuff) was still there. Slight discomfort in the perineum and lessened sensitivity of the penis slowly got better too. Had to put up with the indigestion and headaches from the daily Cialis and top up Viagra, but sex was possible, mostly enjoyable and on the improve.

Retiring both vacuum pump and daily Cialis

Now at the end of my third 6 month period, I have retired the pump, given up the daily Cialis and replaced it with a couple of small doses of L-Citrulline at either end of the day, just to tweak my cardio/nitric oxide system.

Using a soft, stretchy cock ring is a total game changer now that I have 85-90% function. It brings my erectile function all the way up to 95% or better and makes true, spontaneous sex a possibility again. And it’s back to feeling good, like it used to.

PSA rising 18 months after prostate cancer treatment: like a death adder among the dry leaves

And just when I’d almost got to 100 on the S&L board, I got nailed by another snake. I’m currently on Magnetic Island visiting a son and some other friends. The friends were cleaning up their new property. Whilst picking up the last bundle of leaves, somebody almost picked up a death adder, common here on the island.

I think that is what got me early last month, a snaky little bite while I wasn’t looking, causing a rise in my PSA, which should be zero after prostatectomy. I no longer have a prostate to make PSA (=prostate-specific antigen). So if PSA is in my blood, it is a signal that at least a few prostate cells have found a way to live somewhere in my body and produce PSA. And they might be cancerous.

FUCK! So, on with the game.

PSA rising after prostatectomy: first line of action

This latest existential threat has seen me do what (of course) I should have done years ago. That is

• eat better
• get fitter, and
• lose more weight.

I’ve always been fit and not very overweight – my highest was 84kg. But now I have already lost nearly 7 kg, down from 81kg. I am exercising twice as much, eating very little free sugars and hardly any dairy. RIP my wheel of Brie cheese!

Support is what counts the most

It is what it is. The biggest thing that has saved my sanity this time around is the support groups and friends I now have. Thank you one and all…..and may all your PSA tests be zero! Especially the wives!

Read more: the personal action Rhys is taking to reduce the risk of his cancer returning. Also his earlier posts on navigating incontinence after prostate surgery:

• The road to dry nights
• Getting to dry(ish) days