Prostate cancer at 55: A patient’s experience of nerve-sparing prostatectomy

Why having high-quality nerve-sparing surgery is so important. A patient describes his experience.

“I have a Well Man check every year through my employment. I’ve gone along to assessments routinely for the past five years and at my most recent check, everything seemed fine, as usual. But the next day, I got a phone call and the doctor told me my PSA test was a little raised and recommended further tests. I was referred to a private hospital close to my home in Staffordshire where I had an MRI scan and a biopsy.

I was 55 at the time, I had no symptoms and we’d been on holiday just before coming into hospital to get my results. I’d hardly thought about it and wasn’t particularly worried. I’ll never forget what happened when I walked into the consulting room. As I walked in, the consultant was looking at a screen. He pointed to a section on the screen, turned to me and said: “There’s your tumour.” That was how I found out I had cancer.

The consultant talked through my options: active monitoring, radiotherapy or surgery. He told me that if I chose surgery, I would be left impotent and I may be permanently incontinent. He said radiotherapy could leave scar tissue which may make it difficult to have surgery if that was required at a later stage. I asked what would he do if he was in my position? He replied it wasn’t his role to make recommendations; it was for me to choose.

I was left shell shocked, not only at the way the news was given to me but also with the choices I appeared to have. When something is really difficult to process, my initial reaction was to try to minimise its impact on my life and on that basis, I initially thought of active monitoring. But when I discussed it with my son, he said – do you really want to live with cancer, rather than addressing it now? It was quickly clear that we needed to see a different doctor and we spent the weekend doing online research.

We found Mr Doherty, called his secretary on the Monday and met him on the Thursday. Everything was different with Mr Doherty: he listened to my concerns and explained that he takes particular care to spare erectile function and continence. This is called a nerve-sparing prostatectomy. Mr Doherty explained he had changed his operating technique from keyhole back to open surgery because outcomes were better using an open approach (because he could more clearly see the erectile nerves running close to the prostate). He said that although I could go onto active monitoring, if my cancer spread, he may not be able to use the same techniques for a nerve-sparing prostatectomy at a later stage. Everything was impressive: the way he listened and communicated, the work he had done to audit and refine his own surgery.

I had my operation in May 2017. I wore a catheter for the first week after surgery, then as soon as it was removed, I was instantly dry; I had no incontinence whatsoever. In terms of erectile recovery, of course it takes time. What was really important was knowing things were improving gradually and Mr Doherty prescribed Cialis to support this process. By six months after surgery, I felt pretty much back to normal and fully recovered. Of course, cancer clearance is the most important priority and my blood tests show my PSA reading is now so low that my treatment can be considered curative.

I am 57 years old, still working at director level within the insurance industry, continuing to progress within my career. If I had not had a nerve-sparing prostatectomy and had been left incontinent, that would have been impossible. Our married life could have been completely altered by permanent impotence. I am immensely grateful to Mr Doherty for saving my life and for not only what he did, but how he did it: taking great care to avoid complications, his immense surgical skill and attention to getting everything right for each patient. Facing prostate cancer suddenly and unexpectedly at 55 was a very difficult experience but I am immensely grateful to have received the best possible care, treatment and support through every part of the process.”

*The patient wished to keep his name private