Mysterious UTI Symptoms For 49-Year-Old Man Turn Out To Be Prostate Cancer— His Remarkable Recovery After Undergoing a Prostatectomy

He explained, “I was diagnosed with early-stage prostate cancer in 2019 at age 49. I’d been taking antibiotics for a sinus infection, and suddenly started getting a lot of painful UTIs. I never prioritized doctor visits before that, but my wife insisted I schedule an appointment. Thank goodness she did.

“After my doctor felt my prostate, everything was fast-tracked. I had an MRI and two biopsies. My Gleason score, which measures how aggressive the cancer is, was around three or four, high enough to consider treatment.”

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After explaining how he had been given “loads of options” in regard to treatment, he ultimately decided to go with a prostatectomy, a surgical procedure for prostate cancer, which is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland.

Butler had the surgery in the spring of 2020, followed by a year-long recovery.

“Aside from the pain post-surgery, which got a little better each week, I had issues with incontinence and couldn’t get an erection. This didn’t make me feel like less of a man, though. I accepted that if there were changes, then I’d deal with it, and it would be fine,” he explained.

“I’ve got a friend who doesn’t want any treatment because I think he’s worried about how it would change him as a man. So he just monitors his PSA levels, but is constantly worried.”

Not only did he experience incontinence during his post-surgery period, for about a year, that’s now something of the past.

However, his recovery did take a toll on his sex life. Butler told Business Insider, “Sex was something my wife and I had to get used to, again. Part of my recovery involved taking Viagra every day for a year to help get everything back in working order.”

“Physically, I’m almost completely back to normal, thanks to the incredible care I received and diligently following the recovery guidelines, like regularly walking, doing Kegel exercises, and staying positive,” he added. “However, this experience has changed my life.”

Butler, who also dedicates his time as an ambassador of a nonprofit organization called Raystede Centre for Animal Welfare, now makes time to go to therapy and a “rewarding” men’s group.

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He concluded, “You quickly realize that everyone’s had something going on …it’s not always cancer, it can be another form of trauma. We talk about masculinity and how you deal with trauma mentally, and how you communicate with each other. That’s been a really good way of making connections with people.

“I think that’s a big thing that’s changed in me. I’m better at keeping connections and being more open with my emotional side, which can be upsetting sometimes, but the benefits far outweigh the negatives. You get a lot back from people if you’re vulnerable.”

Understanding Prostate Cancer

If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.

RELATED: Prostate Cancer: Overview 

Prostate cancer begins in the prostate the walnut-shaped gland located between the rectum and bladder that produces the fluid that nourishes sperm. Outside of skin cancers, prostate cancer is the most common cancer in American men with about one in eight men being diagnosed with this disease during his lifetime.

It’s important to remember a prostate cancer diagnosis is not always preceded by symptoms. And even when symptoms do occur, they can be inconsistent and hard to pinpoint.

“Prostate cancer is a very odd disease in that it doesn’t have a particular symptom,” Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, told SurvivorNet.

Still, it’s important to note changes in urinary function, like urinating more or less often or waking up at night to go more than usual, could be a sign of prostate cancer. So, even if you think there’s nothing to worry about, always talk to your doctor about changes to your health when they occur.

There are many different treatment options for both early and later-stage prostate cancer including active surveillance, watchful waiting, surgery, radiation, cryotherapy, hormone therapy, chemotherapy, immunotherapy and targeted therapy. The disease is one where doctors may have differing opinions on the best treatment path to take, so don’t hesitate to ask lots of questions and seek out multiple opinions.

Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation

“I think it behooves the patient to have multiple discussions or second opinions, not only by the urologist who did the biopsy and diagnosed that man, but also with other surgeons and other radiation oncologist just to get a very circumspect view of what the treatment options are,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet. “Oftentimes, I think patients need to understand that our health system is based a lot on fee-for-service medicine.”

“And so therefore, a lot of physicians, I think, who are very well intentioned, will believe that their treatment is best for that particular man,” Dr. Hu added.

Treatment Decisions After a Prostate Cancer Diagnosis

Although there are numerous treatments available for prostate cancer, what your doctor recommends will depend on what category of risk your disease falls under. Sometimes that may mean doing nothing at all.

Prostate cancer is a slow-growing disease, so unless it’s been a majorly delayed diagnosis and in a more advanced stage, medical experts will sometimes suggest actively monitoring the growth, and the patient will go in for check-ups every six months or whatever timeframe the doctor deems best.

Dr. David Wise, NYU Langone medical oncologist, explains how Gleason score affects treatment and prognosis

The National Comprehensive Cancer Network (NCCN) guidelines divides prostate cancer into one of six risk categories based on how aggressive the cancer looks under the microscope and the chance of it coming back after treatment. These risk categories help guide treatment for the different subtypes of prostate cancers.

The main risk categories for prostate cancer are:

• Very-Low-Risk (VLR) and Low-Risk (LR)
• Favorable- (FIR) and Unfavorable-Intermediate-Risk (UFIR)
• High-Risk (HR) and Very-High-Risk (VHR)

Prostate cancers classified as VLR or LR represent the least aggressive forms of cancer. This categorization will be diagnosed depending on number of factors, including:

• Your doctor can’t feel the cancer on a physical exam, or it occupies one-half or less of one side of the prostate
• Your PSA is less than 10
• Your total Gleason (which is how the prostate cancer is graded) score is 6
• If your cancer is categorized as VLR or LR, your doctor may recommend active surveillance, which is sometimes called “watch and wait.”

Dr. Nicholas Nickols, a radiation oncologist at the UCLA Department of Radiation Oncology, summarizes active surveillance as follows, ‘We carefully monitor the prostate cancer for evidence of progression or not, and then initiate treatment later, if at all.”

During active surveillance, you won’t receive any treatment but your doctor will key an eye on your cancer with a series of tests including:

• PSA Levels
• MRIs
• Repeat biopsies

It’s possible that your cancer may never progress to more aggressive forms of prostate cancer. Active surveillance should help your doctor catch any changes or progression.

RELATED: What is Active Surveillance?

Patients on active surveillance can be spared the side effects of pursuing the traditional ways of treating prostate cancer. If and when the disease becomes more aggressive, as indicated by a rising PSA, development of aggressive-looking disease on MRI, or increasing Gleason score, it can then be treated with surgery, radiation, hormone therapy, chemotherapy, or a combination of these therapies.

Dr. Edwin Posadas tells you what clues might signal that you have prostate cancer

A Healthy Sex Life After Prostate Cancer

It’s not unusual for men to experience sexual side effects after surgery or radiation for prostate cancer. Some men struggle to get an erection. However, there are solutions to regain sexual activity according to Dr. James Brooks, the Chief of Urologic Oncology at Stanford Medicine.

“There are treatments that we can use, including oral agents. Viagra and Cialis and Levitra have been game-changers in this situation. They don’t work for all patients,” Dr. Brooks explained.

“There are other alternatives that a urologist can work with them to help them get back to being– getting erections and getting back to being sexually active,” Dr. Brooks continued.

Couples who are journeying to recovery after treatment are encouraged to seek counseling from a sex therapist.

There are several different medications on the market that work for prostate cancer survivors. Devices including the Vacuum Erectile Device (VED) and a prosthesis are also options.

WATCH: Coping with side effects after prostate cancer surgery.

Other side effects from prostate cancer surgery may include urinary incontinence. Dr. Stephen Freeland is a urologist at Cedars-Sinai Medical Center. He says, your care team will work with you to aid with any leakage issues.

“We’re going to work with you on some exercises to try and improve that, and the vast majority of people get to a point where they don’t really need pads or diapers or anything for leakage, but a sizable percentage of patients do,” Dr. Freeland said.

How Long Does It Take to Regain Sexual Function

It can take several months for most men to regain sexual function after surgery.

“When a patient has surgery, nobody can get an erection for about six months afterward. It’s rare,” Dr. Patrick Swift tells SurvivorNet.

Dr. Swift is a radiation oncologist at Stanford and points to differences in side effects for surgery and radiation.

WATCH: Preserving sexual function after surgery depends on several factors.

“If you’re using radiation alone, the risk of you losing sexual function quickly is very, very low. And in fact, with external radiation therapy alone, at two years, about 80% of patients are still getting good erections, but they make less of an ejaculate,” Dr. Swift explains.

Meanwhile, if you undergo surgery, your sexual function is more dependent on your surgeon’s ability to spare the neurovascular bundles which are small collections of nerve and blood vessels.

“If both neurovascular bundles are injured at the time of surgery, the chance of getting back sexual function without some kind of prosthetic device is very, very low,” Dr. Swift said.

Hormone therapy can also affect your sexual interest which may inhibit your testosterone level.

Questions for Your Doctor

If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:

• If I have elevated PSA levels, what could be causing that besides cancer?
• How long will it take to learn if my PSA levels warrant further testing?
• What are the treatment options that are best suited for me based on my risk level?
• What financial resources exist to help me with the costs associated with treatment?
• How long will my potential treatment prevent me from working or continuing normal activities?

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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