17 Moolman that they start an email support group. New patients were invited to join as they were scheduled for the RALP. This enabled the men to be better prepared for what was coming. Paddy's unique ability to make new members feel welcome and to encourage open honest discussions has been one of the key ingredients for the group's success. Paddy also attributes the groups success to the recruitment process. “Dr Moolman's receptionist invites new members to sign up as they are scheduled for the procedure. This constant ow of new members joining the group encourages existing members to reect again on their own emotions and at least offer experiential advice or reection.” The group started with a handful of members and has since grown to over 260. For many men the support group is useful before and after surgery, and particularly for seeking support with post RALP side effects. Sometimes it's as simple as seeking advice on what incontinence pads to buy or asking other men how they have managed their erectile dysfunction. Once they have recovered, they often move on. Fortunately, there is a small group of men who remain active, and they are essential to the group's success as they encourage new patients who are about to undergo treatment and support them during the recovery phase. We asked some of the group members how they have benetted by belonging to the group: “As a RALP patient, with post op Radiation and 18 months of ADT treatment, I feel that the group has provided me with an invaluable source of support. Reading the members shared perspectives and views is often extremely thought provoking. The feelings shared typically range from shock, bewilderment, anger, frustration, determination, empathy, and sometimes good humour. These emotions and the online views expressed are moderated with condentiality and tact. It is reassuring to realise that I am not alone in this battle. It has been important for me to understand that although this feels like an extremely private health challenge, there are so many of us on a similar journey. All of us are wrestling with our own physical and psychological challenges resulting from our unique prostate cancer treatments. All in all, the honest sharing of views is constructive as it provides us with a deeper ongoing understanding of prostate cancer. It certainly helps me feel supported and less isolated as I continue this roller coaster path to recovery. “ “For me the support group shows me that I am not alone with the Big C and others care when asked for advice. On the other hand, I see the many different paths which our members go through. Everybody has a (slightly) different story to tell.” “It helped me so much when I joined the group and received advice and thoughts of the members regarding the route for me to take. During those difcult times it made such a difference to me making a decision between surgery or radiation.” “Having recently been diagnosed with Stage 2 Prostrate Cancer, I heard about a group of fellow survivors of the same condition and their journeys. So I asked to be added to the group. After explaining my short journey, it has been very informative to hear everyone else's story. I have found it very helpful to understand what challenges each person has gone through in their recovery.” In 2019 the Prostate Cancer Foundation approached Paddy and Conray with the idea of expanding the support group to include patients who had approached the Foundation to join a support group, irrespective of what treatment they had undergone or who their treating doctor was. Although this worked initially, there was a loss of focus. One of the major reasons for the success of the RALP group has been the common bond that men feel due to having the same treatment. Support groups are not without their challenges, every patient has a different experience, and they are not all good. One patient's negative experience (often given without providing the full context) or misinformation can put off other patients. This is where the importance of a well-informed moderator becomes critical. In one particular instance, a patient on Dr Moolman's RALP support group, who had undergone a salvage RALP after failed brachytherapy, attempted to warn all men on the group of the horric incontinence rates caused by a RALP and to avoid the procedure at all costs. It is well known that incontinence rates for men undergoing a salvage RALP after brachytherapy are considerably higher than for men who are undergoing a RALP without any other previous treatment, but the patient failed to provide this background information. When this occurs a group moderator is UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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