phillygwm

Even 85% is lower than radiation or surgical options, which (last I looked) were ~93%. When I was deciding, I wanted the best survival rate, first and foremost. I was willing to sacrifice 1-2% if it meant preserving function but if it had been a statistically significant difference, I would have gone with surgery. One of the things that surprised me for a number of years after my treatment was the "Sword of Damocles": Every check-up was stressful. I'm sure it's no different than any other life altering diagnosis including HIV (especially back in the day.) My radiation oncologist warned me that my PSA would bounce around for 2-3 years. Noted. Then my PSA spiked higher than it had ever been and I lost my sh*t anyway. Ultimately, it was nothing but every movement in your numbers induces stress or relief. Funny you mention this. As I mentioned, I had urethral strictures, which is a risk with radiation. I woke up one day (several years after treatment) and couldn't piss. Wound up in the ER where they cath'd me. Forcing that in was the most intense pain ever. On a follow-up visit, the urologist attempted to cystoscope me. I couldn't tolerate it. They then tried narrower sounds to "widen the road", so to speak. Still no dice. They had to do it under anesthesia. Peripheral radiation damage is probably why recreational sounding isn't recommended. Of course, I suspect docs would try to discourage it, regardless of cancer status.

My treatment was 15 years ago and, as you noted, my LDR brachytherapy is now quite outdated. It worked reasonably well for me at the time. I'm now starting to have incontinence issues but not sure that has anything to do with my cancer; I was OK for years. Guess I'm just getting old now 😞 Radiation did leave me with urethral strictures several years later. That's an unrelated story but it was a small price to pay. I will tell you that my orgasms aren't always completely dry. It isn't urine; it has the consistency of precum and it's just a few drops usually, but it now shoots out if I've been building up long enough. If I'm alone and just want to squeeze a quickie out, it's usually dry. I don't think the lidocaine helped much. I don't have a basis for comparison but some of the cores felt like someone snapping a rubber band. It stung but was tolerable. Others made me scream and almost jump out of my skin. Guess he hit a nerve on those (literally.) I should also mention, your orgasms will be bloody for a couple weeks after. That was never mentioned so I panicked until I Googled it and found it was normal. Make sure you have someone drive you to the appointment and maybe self medicate beforehand, if you have a pain killer handy. My doc prescribed a Valium (IIRC) beforehand which didn't help. It worked to the extent that when I got home I totally crashed but I had too much adrenaline for it to have much effect for the procedure itself. Yeah, my initial PSA was 4.0 which wouldn't have been terrible for a 65 year old but I was 42 so it raised red flags. My father had somewhat advanced PC in his early 50's (which is when they usually begin testing.) After my diagnosis, I learned that my grandfather died of PC (I was an infant) at 57. I hadn't known that but it was even more evidence of early onset PC in my family. My doc noted the family history and ran what was supposed to be a baseline test. By the time I was treated I think I was into the 5's. It's been a while so I don't remember all the specifics. There are a number of things that can cause an increased PSA, prostatitis being foremost among them. Even a recent orgasm will spike you a bit. So it has a fair amount of false positives (and negatives) but it's the best diagnostic we have.

There are 3 NCI-designated cancer centers in NC: Duke, UNC, and Wake Forest. Obviously, I hope you come back with a negative biopsy. I had one as well, but my PSA kept going up and I came up positive a few years later. As an aside, not to scare the crap out of you, but the prostate biopsy was rather unpleasant. Imagine someone sticking a dildo in your ass. I'm a top so that itself was uncomfortable. Now imagine it shoots about 20 needles into you. Some were OK. Occasionally they (literally) hit a nerve. I was so hesitant the second time, the doc promised a "saturation biopsy" where they take twice as many samples...but you're under for it. I only had one treatment. It was a surgery where they implanted ~80 iodine 125 seeds in my prostate, called LDR brachytherapy (the seeds are still there but no longer radioactive.) As I mentioned above, that is no longer the standard of care. I chose that option for a couple reasons, sexual was the primary one but recovery time was another. I left my office at noon on a Tuesday and did colon prep. Same day surgery on Wednesday. I slept a lot Thursday and Friday but was checking my Blackberry (dating myself!) Went to a basketball game on Saturday (I'm so butch!) Back to work on Monday (albeit a desk job.) It felt like I was pissing shards of glass for a while but, given the same treatment choices today, I'd make the same decision. But ask about proton therapy and cyberknife. I've heard good things about both but haven't stayed informed on all the current options. I can still cum. If it's a quickie I won't shoot but I'll have the sensation. If I'm edging I actually shoot a bit. They had me on Flomax for a while and that causes retrograde ejaculation which is a really strange feeling. I was happy to discontinue that. IF you come up positive, you'll have a Gleason score, which ranges from 1-10. 1-5 is non-cancerous. 6 is early stage, if you're a 10 you might want to update your will. DO NOT make any hasty decisions. Get an opinion from a radiation oncologist. Different ROs have different treatment specialties so you may want to see a couple. After all that you may still opt for removal. That's fine, as long as it's an informed decision. You need to advocate for yourself because nobody else will. Good luck and keep us posted!

Sorry, I should have added this to my prior email but it's been a while and some things didn't occur to me immediately. I know this is long, especially considering the last post, but you'll want all the info you can consume if you wind up having PC. Hopefully, that won't be the case! I was on an online group for gay men with PC. They were very helpful. Google "Gay men prostate cancer". I should have stayed to pay it forward a bit but I wanted to get my mind off things. But the more people you speak with, both docs and patients, the better informed you'll be, medically and emotionally. I chose the 4th doc I spoke with. But you're correct: gay men have different issues than straight. For instance, you're probably familiar with the questionnaire you fill out at the docs every time. One of the questions is whether you can confidently get hard enough to penetrate. Well, that standard is different between an ass and a vagina and, in any case, someone may be a total bottom! I'd also recommend an NCI designated cancer center. Even if your case is routine, stuff happens. If it does, they've seen everything. That might not be the case in a community hospital. I was lucky to have 3 such hospitals in my area. I chose the smallest one. I didn't have a guy who specialized in gay men but if you find that, all the better. I mentioned radiation, which was an unusual decision that I'd absolutely do again. Not so much the permanent seeds, since that's no longer the standard of care. But maybe cyberknife, proton therapy, etc. I haven't stayed up on all the options but they're better than they were in 2011. Your doc will 100% recommend surgery because he can do that. You'd need a radiation oncologist for other options. Of course, the vast majority of folks opt for surgery because it's assumed that if you have it out and the biopsy shows clean borders, you're cured. I was speaking with a guy who was also 45 at the time of dx, with a young family. He was talked into surgery for this reason: He wanted certainty more than quality of life. I think there have been advances on the surgery side as well but I don't keep up on it. But ultimately, some people will require radiation anyway and he did (as did my father, which influenced my decision) so what did surgery buy him? My father was dead (not PC related) by the time I was dx'd so I couldn't ask him questions and he never went into a lot of detail at the time. In fact, I only learned from my aunt that my grandfather died of PC when I was an infant. He was 57 so he probably had it in his 40s as well.

I was diagnosed when I was 45; my doc had been monitoring me because of a family history of early onset prostate cancer. Thankfully, mine was caught very early. I opted for radiation rather than a radical prostatectomy because I was (or wanted to be, at least!) sexually active. So against the advice of friends, I got brachytherapy. This was 15+ years ago and that's no longer the standard of care but I'd definitely recommend radiation: Easier procedure (same day surgery), I was jerking off a few days after, back to work in 5 days, etc. Downside was that it hurt like hell to piss for a while after. And years later, I had urethral strictures. But minor compared to what might have been and I'm just as cured as someone without a prostate. Feel free to hit me up privately, if you prefer.

Hustlers were on the corners. Escorts were in the personal ads 🙂

I tend to agree and don't make a habit of paying for it. But occasionally a guy asks for a few bucks and it's pretty clear he could use it. In that instance, especially if he's drained me thoroughly, I'm happy to help. I even had a few FBs like that. I draw a line between that and an actual escort situation which is more of a business transaction.

Really strange. When I was younger, you needn't have told me twice. As I've gotten older, oral is easier and more enjoyable. Either way, there's nothing wrong with avoidance of doubt but I always do it as a statement, not a question: "I'm gonna get you pregnant" or "I want you to swallow my babies." In the off chance I've misunderstood, the bottom has a chance to tell me (and I have a chance to leave.)

I'd rather console Ilia Malanin but I wouldn't throw Jordan out of bed.

Dan Savage had a question similar to this where he invoked the "Campground Rule": Always leave the person in a better place than you found him. Not in a sugar daddy kind of way but emotionally. When I see a couple with a big age difference, I go to "sugar daddy" first, if for no other reason that there are many more 60 year olds who prefer 20s than vice versa. It isn't always the case but if the perception is that the younger's friends think he's a kept boy, I can see how that would affect his relationships, whether or not it's actually true. Plus, it's going to be more difficult for a drastically older guy to be accepted in a younger friend group.

I recognize I'm not everyone's type, especially as I've gotten older. That's fine; I have a type as well. I expect people to act like adults, which I know is asking a lot. Just don't lie, tell me if you're not interested, and give me accurate pics so I can do the same. In other words, let's not waste each other's time.

Agreed. Sansom St. Cinema is long gone (now a restaurant.) Danny's Adam and Eve is still there but the booths are gone, I believe. Adonis is gone. There's still a place in NE Philly (next door to Four Seasons Landscaping, if you remember that press conference). I don't live nearby anymore but that used to be a frequent stop when I lived in the Northeast. I feel too self-conscious walking around in a bathhouse but loved the bookstores and theatres. Most recently, last Fall, I went to the Fair Theater in Queens, which was a lot of fun but from Philly it's not exactly convenient.

I've historically been a top. Some medical issues over the past 15 years mean I can't always get hard enough to penetrate an ass (though Viagra helps.) So when I'm getting with a guy, I tell him I want head and will fuck him if the vibe is right. TBH, I much prefer to sit back and be serviced. And I don't really care how long I last; I just want to release down someone's throat and maybe take them down mine. It's funny, though: When I was younger, I'd shoot a big load and would be game over. Now I only shoot a few drops but I don't totally lose the mood when I do. It certainly drops off but I can finish a guy after I've cum, which used to be a big problem for me.

I've only completely fisted a guy once. He was a Mexican twink, maybe 5'3" 110 lbs. He took 2/3 of my forearm. It was one of those things where the fantasy was hotter than the reality (my arm literally fell asleep and it was a mess when I pulled out.) Then he asked me to fuck him, which was a non-starter because he was totally gaped. Years later, I'd like to give it another try, maybe after someone has done colonoscopy prep 🤣.

My first real job was minimum wage in a Radio Shack. I had a number of experiences where I locked the door and took a guy in the back. This was over 30 years ago. I have a much better job now and wouldn't dare chance it 😞