However, the blood test showed a PSA level of 4.6, which was high enough to raise suspicion with my doctor. He then gave me a referral for a transrectal ultrasound and a prostate biopsy.

The ultrasound did not reveal any serious anomalies that would require immediate treatment. However, the biopsy confirmed a Gleason score of 6/10 in 4 of the 6 samples taken. The cancer diagnosis shook me, as even though I considered myself a high-risk candidate, I had hoped to be spared. My wife showed incredible composure and gave me all her support to find the best solution.

My doctor then referred me to a specialist to decide the best course of action. The urologist explained that due to my young age and the nature of the cancer, the best solution was surgery, specifically a radical prostatectomy. He also mentioned other possible treatments, such as radiotherapy. He warned that subsequent surgery after this treatment would be very difficult due to the condition of the tissues. Furthermore, my surgeon offered a type of surgery that inspired confidence: laparoscopic surgery. This less invasive technique had a better prognosis for preserving the nerves controlling erection. It also reduced the risk of needing a blood transfusion during the operation.

I was fortunate to have a profile suitable for this type of intervention. It was a very difficult decision to make. After careful consideration, my wife and I agreed that the best thing to do was to eradicate all traces of cancer. This decision aimed to ensure a good quality and life expectancy.

Even though surgery was the most logical decision, I was still very nervous and worried. I felt no discomfort, and I had no symptoms. I feared I might come out of the operating room in worse shape, either impotent and/or incontinent.

The surgery lasted 4.5 hours, and I must admit I suffered more from the effects of anesthesia and pain medications than from other discomforts. The tissue analysis after the operation confirmed a Gleason score of 7/10.

Laparoscopic surgery was less invasive. I had only five small incisions, barely 2 or 3 centimeters each, including one at the navel. Twelve hours later, I was already walking. I was discharged from the hospital after three days, and on the fifth day, I returned to the hospital to have the catheter removed. I then started wearing a sanitary pad in my underwear to absorb urine leaks, only during the day. I never had a problem with leaks at night.

During the day, leaks occurred mainly during exertion, such as lifting weights, sneezing, or when the bladder seemed more irritated by alcohol consumption. The nurse taught me how to perform pelvic contractions to compensate for the lack of control. Six months after surgery, I stopped wearing a sanitary pad regularly, as it was barely damp on some evenings.

My surgeon had given me a six-week leave, and after about three weeks, I went back to work. I felt quite fit. My job was not physically demanding, and I was able to do a lot of office work from home. I started driving my car about a week after the surgery. I was told that driving restrictions were mainly to avoid loss of control in case of unexpected pain. I never experienced intense pain after my surgery, only slight discomfort in the scrotal area. The healing time was about two months. I found that if the intestines were not constipated, there was less pain in that area.

About three or four weeks after the surgery, I noticed that sexual pleasure was still present, even though I did not have an erection sufficient for penetration. I knew that the nerves had been preserved because I occasionally felt spontaneous erections. As explained by the surgeon and nurse, the nerves might take up to two years to regenerate at a rate of 1 millimeter per day. The doctor then prescribed Viagra and Cialis to help with the situation. With these medications, I felt I had a stronger erection, but not enough for penetration. I resigned myself to the side effects mentioned by the manufacturers, but the lack of results discouraged me. I believe these medications may be more effective in a year or two when the nerves have recovered.

Even though my wife showed me all her support, love, and understanding, I was afraid it might one day become an obstacle to our intimate life. I felt a certain frustration, possibly due to my own impatience. We attended a session on sexuality and prostate cancer as part of a support group meeting. Several solutions were presented, and the one that interested me the most was penile injection therapy. My wife wasn’t thrilled about the idea, but I decided to pursue it with the nurse and doctor.

So, six months after my surgery, I attended three training sessions with the nurse, where I learned how to administer the injections. On the first attempt at home, I managed to achieve a sufficiently strong erection for penetration. It wasn’t like before the surgery, as the erection was not sustained. After discussing with the doctor, he showed me how to gradually increase the dose. I trust that the nerves will regenerate gradually, and I need to manage my expectations, given the short time since the operation.

Since the surgery, I have had two blood tests, which have been negative. My specialist also advised me not to gain weight and to follow the dietary habits recommended by the Canadian Prostate Cancer Foundation.

In the end, I have never regretted for a single moment my decision to undergo surgery because I am convinced that my life expectancy and quality of life will be better in the long run. For me, living without cancer is less stressful than knowing I have it and that it could spread insidiously.

Early screening is certainly the best recommendation, especially for those at some risk. I also want to highlight that I was fortunate to have all the elements that contributed to an excellent physical and psychological recovery:

• Early screening by my family doctor.
• An exceptional surgeon who practices a less invasive technique.
• Excellent hospital nursing care with competent and available nurses.
• My work colleagues who gave me all their friendship and support.
• And especially my family: my three children who surrounded me with attention and my loving wife who continues to show me her love.

Today, six months after the operation, I can say that I have a life as fulfilling as before in terms of work, social, and family activities. I have travel and physical activity plans for the coming months.