Husbands quick surgery decision

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VaFan
Regular Member


Date Joined Mar 2008
Total Posts : 203
   Posted 4/8/2008 5:07 AM (GMT -6)   
I don't know if I should be posting in new topic or replying. (Not very good at this). But several members asked why the surgery was scheduled so quickly and honestly I don't know.
The surgeon is Dr Sam Graham here in Richmond Va. He came highly recommended having done over 2000 surgeries, written books on the subject. Found alot of info when we googled him because we thought about going for a second opinion. Then we talked with local people who had surgery with him and there were no complaints.
He told us he would do it whenever we were ready but he didn't recommend waiting any longer than a month to make a decision. We had told him my husbands mother died at 50 with lymphatic cancer, we think started with Hodgkins. Not real sure of the exact details with this but it had concerned my husband because he finally passed that 50 mark.
I have started doubting our decision to go on with this so quickly and now the surgery is just 2 days away. I woke up at 3 this morning panicking that we should wait.
Maybe its just like 2nd guessing anything..as it gets closer.
 
Thank you again for ALL of your concern. There couldn't be a better place to come to for help.
 
Cindy
Age 51 Kent
January 08 PSA 5.2 round of antibiotics went to 4.3
February 08 anpther round of antibiotics went to 4.2
March 17,08 had biopsy, 2 days later told cancer was on
one entire side of prostate.
Gleason 3+3
Doctor thinks its best to get the whole prostate with Perineal Retropubic Prostatectomy.
Surgery scheduled for this Thursday April 10th.
Cindy (I'm the one that does all the posting)
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/8/2008 8:22 AM (GMT -6)   
I think most people second guess their decision just before surgery.  The thing you need to remember is that lots of decisions are made on recommendations and trust.  I can't tell if you are worried about the Dr. or the need for surgery, or that you have overlooked other options.   I see the biopsy indicated "one entire side of prostate" was cancerous.  This is probably why the doc recommends not waiting long, 'cause if the entire side or lobe of the thing is cancerous, then the likelihood of margin involvement and spread beyond is greater.  If you trust the Dr. and agree with his recommendation and you trust his skill as a competent surgeon, then it's probably just pre-surgery jitters that we all have had.  If you are unsure of the need for surgery, or feel you haven't considered all the options available besides surgery for treatment, then you are left with a dilemma. That I can't tell you how to proceed.  That's just my thinking, no recommendation or suggestion being made.   

James C. 
 
Help support the forums so they can support you:  http://www.healingwell.com/donate 
 
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   (Open) Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08  Caverject started/stopped, aching.  2/24/08 .5ml Bimix started-success
3/24/08   ED- 6 mts.-Viagra, pump, no response- Bimix continues
Post-surgery PSA's:  3 mt:0, 6 mt:0,


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 677
   Posted 4/8/2008 10:26 AM (GMT -6)   

Hello

Sorry to hear about your husbands problem.  I think most of us were very worried just before surgery. 

The Gleason rating that your doctor reported (3 + 3) is not usually considered highly agressive.  For that reason, I am surprised that your husband's doctor apparently urged you to act so quickly. In my case, we waited over eight months and consultations from two different surgeons before surgery was finally performed.

If I remember correctly Perineal Retropubic surgery is an older style and is not the first choice of younger, more active surgeons. I had the DaVinci guided surgery that is becoming the new favorite because it is less invasive. What ever you decide to do, be sure you trust your doctor and have had all of your questions answered.


biopsy 10/16/06
T2A,  PSA 4.7
Gleason  4+4=8  right side
DaVinci Surgery  1/16/07
Post op confirms gleason 4+4=8
no extension or invasion found
no continence problems
PSA 90 day -.01  , 6 month -.01 , 9 month +.02 , 1 year +.02
Ed problems continue
Caverject/viagra /discomfort
02/28/08  start Bi-Mix Rx
 


Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 4/8/2008 10:42 AM (GMT -6)   
My surgeon wanted to wait 45-60 days post biopsy to do the procedure, and he was not the same MD who did the biopsy, he wanted to do it ASAP. We sought a second opinion and am glad we did. The prostate and all surrounding tissue is swollen following something as invasive as a needle biopsy. Take care, you are young, make a good decision based on facts and knowledge.
Randy
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.01, 6 Month PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement, more notable over last month
with Viagra 100 mg.


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2301
   Posted 4/8/2008 12:15 PM (GMT -6)   
From what you write, perhaps what is driving the decision for surgery as soon as possible is the finding that an entire lobe of the prostate is cancerous.
 
I agree with several other posters about
(1) waiting until the prostate heals from the post-biopsy inflammation--at least 6 weeks--before surgery. 
 
(2) The perineal retropubic surgery is not done as commonly anymore, being replaced by the open retropubic surgery and the DaVinci robotic prostatectomy. 
 
(3) It may be a good idea to let this diagnosis settle in and researching different options and getting 2nd opinions before deciding on which is the best for you in your situation. 
 
In my own situation, I waited several months before deciding to go forward with surgery, but fully considered brachytherapy (a good treatment with excellent outcomes for many) and did some research on proton therapy (which was not practical for me).
 
You'll find a wealth of information, opinions, experience and help from folks who are at various stages of prostate cancer.  I'm almost two years post-prostatectomy.
 
Take care and hang in there....Tim
 
 
 


Age 59  PSA velocity quadrupled in 1 yr (0.6 to 2.6) 
1 of 12 biopsies positive (5%) 
Open surgery June 2006 
Cancer confined to one small area Gleason 5 
PSA's undetectable
 


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 4/8/2008 1:05 PM (GMT -6)   

:-)    Hey ~ Cindy & Kent,

You are doing fine with your postings…  The main thing is to keep posting and stay close.   yeah   

Once things settle down ~ you can start a personal thread to share your updates if this is someting you'd like to do.  I'm glad you added Kent's name... it brings a closer bond for me when there is a personal name to connect with. 

 

There are reasons doctors make certain request about a specific procedure.  It may be the procedure they are more familiar with, it may have something to do with other issues concerning health status, and I’m sure there are other variables that come into play.  As you will read within the forum… there are many options.  And each “Journey” you read about varies a little here and there.  It all boils down to what’s right for your husband.  The surgeon is so important in your decision making if this is the treatment you choose.  And moving closer to surgery day always gets the mind and heart working overtime.

 

Stop ~ and take a nice deep breath…. Okay………….  Now Stop ~ and take another one. 

Now... continue moving forward....

 

I will share with you what we went through.  Each person has their own feelings about the treatment they choose.  And 2nd opinions are there for you to move on if this is something you both need.  Our urologist suggested that we look at all options and we told him we were ready for open surgery.  I told him if we could I’d be willing to have Buddy lay down right now on the top of his desk and I’d help him get that sucker out!!!  We called it the bad walnut!  He had a good laugh and said we needed to wait for the area from the biopsy to heal.  6 weeks was the time frame he wanted.  Again ~ each doctor has their own specific requirements so don’t be too alarmed.  There have been a few members here that have had surgery within a 4 week period after biopsy and did well.  I don’t recall who ~ but they did fine!! 

 

If you and your husband still have concerns ~ talk with your doctor today!!! You must go into this with a good clear, positive frame of mind.  Both of you!!

 

Cindy ~ continue reaching out… and pull the strength that we share.

 

KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear

 

YOU MAKE THE DECISIONS… YOU HAVE OPTIONS…

~ and ~

Your decision will be the right decision for you!!!

 

Before you know it ~ you’ll be signing on to let us know that you are on the other side and we will all be waiting to hear from you!

Pull from all of us ~ the information that we share … to help make your path a little smoother.  It is a scary time and we have been where you are.  And can truly say ~ We know how you’re feeling. 

 

Gentle Hugs and Warm Thoughts

Surround you at this time….

In Friendship ~ Lee & Buddy

 

http://i206.photobucket.com/albums/bb179/mamabluebird1955/Stepping-StonestoHealingWell.jpg


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

4th PSA 2-13-2008 (23 months) Less than 0.1 Non-Detectable :)


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 4/8/2008 2:38 PM (GMT -6)   
Hi and welcome to a great place.
 
I am no expert and my situation is different from your husbands so I can only tell you about what we are going through.
 
It has been 3 months since my diagnosis and we are still waiting to go to Florida for Proton treatment.
 
I would discuss my fears with the doctor and ask for a short postponment.  There are so many different ways one can go; different surgery techniques and various radiation techniques as well.  We all have an idea of what is going through you minds and I can only say "DONT PANIC"
 
Do as much research as you possibly can, keep your faith and stay positive.
 
Richard
 
 
Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Neg Bios 1997 & 2000 PSA within considered normal range
11/06 PSA 1.9 PSA 11/07 was 4.9 PSA 12/07 was 7.7 MDA 2/12/08 3.3 On Proscar so shud be doubled
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Bone scan 1/17/08 hot spot on ribs, CT shows rib enjury CT CHest 1/30/08 Clear
M.D. Anderson 2/12/08 Gleason 9 - CT Abdomin & Pelvis Clear Recommended Hormone&Radiation
2/19/08 Dr Fagin, Austin, TX did not recommend surgery based on medical history
2/22/08 Contacted U of Florida Proton Therapy Institute - Appt 3/13/08 
3/24/08 PET Scan await results - 4/1/08 Prostascint Scan await results
Preliminary appt UFPTI for 3 day workup 4/14/08 or 4/21/08 depending on when last Scan available
Turn Stumbling Blocks into Steping Stones and Keep Smiling


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 4/8/2008 2:50 PM (GMT -6)   

VaFan,

No harm in being worried or having second thoughts.  Ultimately, however, your husband has to do what he is comfortable doing.

I agree with others that having surgery less than 6 weeks after biopsy is very unusual.  Typically, surgeons wait 6 weeks to allow the prostate to heal up, so the removal can be done easier and the extracted tissues examined more easily.

I hope that whatever decision is ultimately made, you and your husband develop a peace within yourselves that you did what you feel is best for you.

Good luck in your decision-making process and with whatever treatment is decided upon.


Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 4/8/2008 3:04 PM (GMT -6)   
Question for VaFan or anyone else....does that older style of surgery allow for sparing of nerve bundles....i.e. is that an option?
Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008


VaFan
Regular Member


Date Joined Mar 2008
Total Posts : 203
   Posted 4/8/2008 3:27 PM (GMT -6)   
The doctor told my husband he always tries to spare the nerves and the reason he prefers this kind of surgery is because he can see better than with the robotic. This way he opens it up and isn't playing any guessing games. Thats why we chose to do it that way.

Age 51 Kent
January 08 PSA 5.2 round of antibiotics went to 4.3
February 08 anpther round of antibiotics went to 4.2
March 17,08 had biopsy, 2 days later told cancer was on
one entire side of prostate.
Gleason 3+3
Doctor thinks its best to get the whole prostate with Perineal Retropubic Prostatectomy.
Surgery scheduled for this Thursday April 10th.
Cindy (I'm the one that does all the posting)
 
 

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