One year update since robotic surgery

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Regular Member

Date Joined Aug 2007
Total Posts : 118
   Posted 11/6/2008 12:20 AM (GMT -6)   
It's been one year since my robotic radical prostatectomy. I couldn't have asked for better results, and I hope that my experience will give hope to those going through the same procedure, especially the younger guys.
My PSA was again 0.01 ng/ml which I am very thankful for. Some of you might remember my posts about possibly switching to the "standard" sensitivity PSA test so that I could avoid seeing the background "noise" and resulting anxiety of (hopefully) transient blips in PSA level. This turned out to be harder than anticipated. I first contacted my primary physician. He said that he thought the sensitivity level was "0.4, I think" at his lab. Sure. I called the lab directly, but they would not speak to patients. I also asked my uro's office, and the nurse said "sure, we can do the standard test if you wish." What I got was the same old ultrasensitive test. When I went in to see the uro for an office visit, I planned to ask him if he could just tell me if the latest blood result was <0.1. When I got to the patient room, lo and behold, there was my latest result smack in front of me on the door in plain sight along with the rest of my file. I just couldn't help looking and was relieved it was again 0.01. Wouldn't you know it, my uro then misquoted the result verbally to me as "0.1" in the office. I have been shocked at the lack of basic math skills and misunderstanding around the PSA tests and hope your experience is better than mine in this regard. Sorry to rant, though I really do focus on the good result as opposed my experiences with PSA reporting vagaries.
I have also been very blessed with my outcome in regards to continence and ED. For this, I thank God, my surgeon (Dr. Patel) and luck.  Continence has been perfect. The only time I have leaked at all was after a couple glasses of wine AND being hit in the stomach by my four-year old, and that only resulted in maybe a drop of urine. On the potency front, erections have been great, maybe too great, while I am still on Cialis. I honestly have more and better sex now than before the surgery, so I am frankly not in any hurry to ween myself off of the little yellow pill.
I know that surgery is not for everyone, but great outcomes are indeed possible. I hope this does not come across as boastful in any way. My hope is that those facing surgery will take comfort in a possible positive outcome while also weighing the inherent risks. Thanks to everyone who has read and answered my questions in the past. This forum is a tremendous resource, and the collective knowledge here is truly amazing.
Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.

Veteran Member

Date Joined Nov 2006
Total Posts : 1464
   Posted 11/6/2008 12:35 AM (GMT -6)   
Hey CaPCA,

Great news and congrats for being a one year survivor! Every zero PSA puts another bullet in the beast. Also your recovery from incontinence and ED is encouraging to all who have had or are contemplating surgery.

I had similar results with continence but still use Trimix for ED. With it sex is lots better than before surgery as you have said. It stays up for about an hour and outlasts my energy level. Dry orgasms last longer and are more intense than before surgery.

Recovery takes patience and experimentation. Each of us is different and docs prescribe a "one size fits all" solution. To make it work we have to try different doses and routines. All in all, the outcome has been well worth the work.

Lets get well together...

Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Started chemo in September 08
"Patience is essential, attitude is everything."

M. Kat
Veteran Member

Date Joined Jul 2006
Total Posts : 715
   Posted 11/6/2008 7:42 AM (GMT -6)   
that is wonderful news! no, you are not boasting. I think we should all share our experiences, good and bad, because we all deal with different issues. you are living proof that the results can be great and the side affects minimal. best wishes on zeroes forever....kat
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump
8/07 - 1 yr PSA <0.1
9/1/07 - achieved erection with Viagra - no pump!
3/08 - 18 mo PSA <0.1
switched to Levitra - works much better than Viagra & Cialis - fewer side affects
summer of 2008 - have had a few erections with no drugs! yeah!!
8/08 - 2 yr PSA <0.1

Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 11/6/2008 7:52 AM (GMT -6)   
Great News, something I am praying and looking forward to!

Age Dx 37, 7/2008
First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008
Biopsy : 6 out 12 Postive all on right side, Gleason 7 (3+4).
Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008
Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008
PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
First PostOp PSA 9/2008: <0.01
2nd PSA 12/2008: Praying for <0.01

Regular Member

Date Joined Jan 2007
Total Posts : 376
   Posted 11/6/2008 9:26 AM (GMT -6)   

Great news on the one year test, the big "0". May you continue this sucess and experience a lifetime of 0 test results.

Current age 50, Age at Dx-48 PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Surgery Pathology report 4+3=7 a couple agressive Grade 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
1st & 2nd Post PSA Blood Test .1 and less - Undetectable
3nd Post PSA Blood Test 01-17-07 .3
March 27th PSA .422 Begin Salvage Radiation April, 14 2008
Radiation Complete June 4, 2008 36 treatments
August 5, 2008 PSA .09 or < .1 again
October 9, 2008 PSA <.06 or as low as my clinic can read.
Incontenence-Pad free since end of May 07 4 1/2 months post surgery 
ED back to 95% prior to surgery - no medication required.

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 11/6/2008 10:33 AM (GMT -6)   
Great news! Thanks for sharing and spreading encouragment! Look forward to a lifetime of posts like this one! All the best to you!
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

Regular Member

Date Joined Oct 2008
Total Posts : 23
   Posted 11/6/2008 7:32 PM (GMT -6)   
I will make my husband read your post! He's scheduled for the Da Vinci surgery on November 24th. I think your post will help him to see what lies ahead or at least allow him to see what's possible!
Husband's biopsy: 10/3/08
Husband's diagnosis: 10/10/08
Husband's age at time of diagnosis: 54
PSA: 5.0
Gleason: 3+4
Clinical stage at time of diagnosis: T1c
DRE: No nodules
CT and bone scans: Negative

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 11/6/2008 8:52 PM (GMT -6)   
That's a great result and here's to it continuing indefinitely. No, that's not boasting but rather telling it like it is. If a newbie or information seeker comes here and only reads the stories of guys like me who have ongoing problems with post-op ED they may well base their treatment decision on wrong assumptions. Although I am jealous tongueit is great to read of such a success story. yeah
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 11/7/2008 3:49 PM (GMT -6)   
Thanks for the update.  And, Congratulations!

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (getting better, though)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0


Regular Member

Date Joined Jan 2008
Total Posts : 276
   Posted 11/7/2008 11:18 PM (GMT -6)   
Great news, welcome to the 1 year club. For me, the 12 month mark was a milestone. I wish you many more "1 Year Anniversaries"
46 you when diagnosed, now 47
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, 9 Month PSA 0.01
One Year PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement.
Cialis 5 mg every night.
Success with BiMix

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