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Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/5/2009 7:05 PM (GMT -6)   
I am still trying to figure out what to do about my prostrate cancer. I have researched brachytherapy, IMRT, HDr and conventional (nerve sparring) surgery, daVinci surgery. I am looking closer at daVinci surgery. But am not sure how to find excellent surgeons in my area of Daytona, FL. Any one have any insight or worked with any DRs here?

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/5/2009 7:14 PM (GMT -6)   
Hello and welcome here, Confusion. It is a difficult process learning all the treatment options and what might be best for you. Have you posted more of your story here before, perhaps some stats on your diagnosis and current condition? It would help us understand what is going on with you. We have men here experienced with the full spectrum of treatments that you listed, and would be more than happy to help you sort through it.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/6/2009 8:28 AM (GMT -6)   
I thought my signature would have posted.

Age 61
PSA 7.8
Gleason 6 (3+3)
Physical condition - ex
4 of 12 biopsys = cancer
Father had prostrate cancer

Yes; deciding is difficult especially when you read all the stories to try to get a handle on which procedure is the best. Some stories are good and some not so good. So I try to make a balance. No balance yet; but it will happen.

Dr Patel. Found this:
"Florida Hospital is proud to have Dr. Vipul Patel, MD on staff. An internationally respected leader in the field of minimally invasive robotic prostatectomy, here is a list of his recent achievements."
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


Godfather
Regular Member


Date Joined Jan 2009
Total Posts : 64
   Posted 2/6/2009 9:00 AM (GMT -6)   
Confusion:

I'm in Venice, FL. Going to see Dr. Patel in Orlando (Florida Hospital) next week. He's done thousands of robotic RPs. Also going to Moffitt/Tampa to see Dr Pow-Sang, also well known and respected in this field.

My appointment with Patel is 2/12 - I'll try to remember to fill you in on this thread after that. If you don't hear from me by 2/13 PM, shoot me an email (my email address is in my profile) and remind me. In the interim, here's Dr. Patel's website.

http://www.globalroboticsinstitute.com/en/urology-robotic-prostatectomy

Sorry you have to be here but you found the right place to learn about this crappy problem we have. Your stats look good so you'll be fine no matter which treatment you choose. Just keep doing your research and keep coming back here to ask questions.

Tony
Age at diagnosis 61
Resides in SW Florida
12/07 PSA 2.6  12/08 PSA 4.0
Biopsy 1/09 - 6 of 8 nodes positive 
Left - 2 of 4 positive, 15% involved, 3+4=7 Gleason
Right - 4 of 4 positive, 40% involved, 4+3=7 Gleason
DRE small nodule on right - Prostate 22.6 cc's
Planning da Vinci - searching for surgeon


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 2/6/2009 11:23 AM (GMT -6)   

 

I was operated on by Dr Patel in October at Flordia Hospital in Orlando.  He has done thousands of these surgeries and has taught the procedure all over the world.  His staff and the hospital are great everyone is in a private room and my wife was able to spend the night at the hospital in my room.  I quickly recovered and feel great and was completly dry by 6 weeks.  Prior to that only had slight leakage one pad a day.  I also live in Fl but was willing to go where I could get the best treatment and Dr. Patel was recommended highly. 

Jerry  


Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample, Second option of biopsy from Methodist Hospital Houston same DX
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 
 


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/7/2009 2:06 AM (GMT -6)   
Dr. Pow-Sang at Moffitt Cancer Center here in Tampa. You can't do better. See my sig for links.
cheers & beers,
Chris


Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/7/2009 9:29 AM (GMT -6)   
Chris, on y computer your sig. is now a light blue and virtually unreadable?
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/7/2009 10:56 AM (GMT -6)   
James C. said...
Chris, on y computer your sig. is now a light blue and virtually unreadable?


The body of my sig is in HTML gray. I can change it, but I suspect your contrast setting is amiss if you can't see my sig now...
cheers & beers,
Chris


Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.


spisam
Regular Member


Date Joined Jan 2009
Total Posts : 47
   Posted 2/7/2009 12:27 PM (GMT -6)   

I had the robotic surgery with Dr. Patel in Orlando, FL on January 6, 2009. He, his staff and hospital are wondeful. I felt like a guest at a 5 star resort. Dr. Patel is also known and respected internationally with many patients from outside the USA. I stayed at the Mona Lisa Hotel right on the hospital grounds and had a 1 bedroom appartment until the catheter came out. Its now 4.5 weeks since surgery and I feel great. I still leak, especially in the afternoon. I take the doctor prescribed viagra 3 times a week and for the past two weeks have had strong erections and orgasms. You will be very happy with Dr. Patel and his team. I'm 60 yo. 6'00", 176# and in excellent physical shape for my age. However, this message is not about me, its about the great Dr. Patel.

Sam

  


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/7/2009 4:47 PM (GMT -6)   
Chris, I see the same light blue/gray on 3 different computers. Ok, I'll give you the html gray, but its still a very light gray and still very hard to read......lol smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


ups4
Regular Member


Date Joined Nov 2008
Total Posts : 20
   Posted 2/7/2009 8:18 PM (GMT -6)   
James C. said...
Chris, I see the same light blue/gray on 3 different computers. Ok, I'll give you the html gray, but its still a very light gray and still very hard to read......lol smilewinkgrin

Yes, I can read it also, but it is very light and hard to read. shocked   
Paul

Paul in Sunrise, FL
Diagnosed 7/07 age 52, 53 now.
PSA 2.5-3.5 at diagnosis.
Biopsy proved positive.
Davinci surgery 10/07.
All nerve bundles/lymph nodes spared.
Continence returned by 12/07.
ED getting better everyday w/Viagra.
PSA's post surgery all <.01.
Dr. Daniel Ead, Urologist in Plantation FL
Latest PSA results from 1/12/09=.01


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/11/2009 9:26 AM (GMT -6)   
I have an appointment with Dr Patel in March. I sent an email with questions and when I called for an appointment they answered the questions directly from the email. I thought that showed a concern on their part for the patient. Will keep everyone posted.

spisam...what is the Mona Lisa Hotel and how do they charge you for the stay? Did they say when the leaking might stop?
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


spisam
Regular Member


Date Joined Jan 2009
Total Posts : 47
   Posted 2/11/2009 5:12 PM (GMT -6)   

The Mona Lisa Hotel is located on the Hospital grounds about a two minute drive away. The hotel also runs a shuttle to the hospital. I have a post op exam on 2/20/09. The Patel rate is $129/day for February. The rooms are 1 or 2 bedroom appartments. We took the 1 bedroom. It includes a kitchen, living room, dining table, bedroom and nice bathroom. Two TV's, WiFi, outside patio overlooking a pool. Real luxurious.  (401-964-7000).

With respect to leakage, I'm leaking. Here in the forum it seems that the concensus is 2 to 3 months. I'd rather hear from actual peoples experiences rather than the Doctors statistics.

Sam

 

 


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/16/2009 10:05 AM (GMT -6)   
Was reafing about the pre and post-surg procedures. Lots to do. The catheter concerns me. Can anyone explain what the catheter is like? Silly question I suppose; but curious to know. I am asking about how it feels and ??? Can you easily get around? Concerned about having something suck up there.
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/16/2009 10:41 AM (GMT -6)   
the catheter is a tube with a bulb on the end. It is inserted in the penis and the bulb end goes up inside the bladder. Once in place, the bulb is inflated with sterile water by filling the bulb, using a syringe. This line to the bulb is very small and seperate from the catheter itself. Once the bulb is inflated, it swells up and seals the bottom or neck of the bladder, keeping the catheter tube inside and preventing urine leakage outside. The bulb and end is inside the bladder maybe 3/4 to 1 inch and the bulb does an excellent job of keeping the catheter inside. Pulling, tugging and such will not dislodge an inflated catheter bulb. The danger of injury from the bulb is the act of pulling on the catheter and bulb to the extent that it breaks the stitches that are holding the bladder neck together for healing. I couldn't feel my catheter, except at the head of the penis. The line there did irritate and the penis would actually slide up and down on the tubing, which is why the tube there is kept lubricated with an antibiotic salve such as neosporin and such. There is no danger of anything being sucked up inside, the device is gravity driven and has no internal suction capability. Mobility can be a pain until you figure how to move with it. The act itself isn't a problem, hundreds of thousands of people live their daily life with them, it's just the newness to us the first time. Most of us will use the big bag especially the firsdt few days and while at home. This bag is carried around and causes little problems itself. The tubing and positioning is the problem with it, it seems. The smaller leg bag is attached to the leg, either the thigh or the calf, and allows for hidden use when outside and moving around. This bag holds 1/4 the urine the big bag does, but allows for much more mobility. Removal of the catheter is usually a non-event. The nurse or doctor will remove the sterile water in the bulb with a syringe and the catheter will usually just slide out on its own, with a 'funny' feeling", as described here many times. The whole thing slides out and is discarded, you pull up your pants, with a pad or diaper the first time, just to be safe and you are on your way. Here's a link to a diagram of the Foley Catheter system.

findlaw.doereport.com/generateexhibit.php?id=9259&ExhibitKeywordsRaw=&TL=4294967295&A=42409
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/16/2009 11:15 AM (GMT -6)   
james just gave you a good description of the operation of the foley catheter. if you want more details on a day to day basis, be happy to answer any questions. due to complications, i ended up staying on a total of 5 catheters over 66 days after my operation. so free to ask away.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/16/2009 4:03 PM (GMT -6)   
I was written off as incurable by 3 fancy research urologists, 2 from Duke and one from MUSC. Dr Lotenfoe in Celebration FL instead looked at my chart and films and suggested a saturation biopsy. We now have good reason to believe that although my robotic surgery was a failure that I have been cured of the cancer.

Dr. Lotenfoe was the only Dr. out of many I saw who looked out of the box.

You can find a reference to him by searching online.

I recommend him without reservation.

Very best to you, Scott
Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07 robotic
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 PCA3 negative
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/17/2009 11:59 AM (GMT -6)   
James, great description of what I may have to look forward to if I have the surgery. Sill not sure if it will be rad or surg.

Purgatory, why so many catheters?
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/17/2009 12:16 PM (GMT -6)   
Give you the short version, lol. First 31 days, by surgeons choice due to surgical complications. Cath came out, next day, blockage, new cath in. 2 weeks later, cath out, back in ER that night, blockage, cath 3 in place. Cath came out, cyclscope checked me out, noted "flap" blockage at bladder neck, scope out, cath 4 in place. Week later, surgery to correct flap blockage, cath 5 in place. On day 66, cath 5 out, been on my own since, that was January 19th.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/17/2009 12:41 PM (GMT -6)   
Hope you are ok and stay that way. Thanks for the information
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/17/2009 1:04 PM (GMT -6)   
It was my unique ordeal, confusion. The rest of my surgery and post surgery care and recovery was pretty well by the book, nothing unusual to report about. Staples out in 10 days, the incision healed very fast. Some classic "rear end" pain went away after about 6 weeks out.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 2/17/2009 1:45 PM (GMT -6)   
hanks for he insight. Sill not sure which direction to go. Have an appointment for daVinci consultation. Already did the radiation consultation. Trying to learn as much as possible.
Age 61
PSA 7.8
Gleason 6 (3+3)
Cancer in 4 of 12 biopsys


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/17/2009 6:25 PM (GMT -6)   
OK, better? :-) I sure wish the old posts would reflect updated sig's....

ups4 said...
James C. said...

Chris, I see the same light blue/gray on 3 different computers. Ok, I'll give you the html gray, but its still a very light gray and still very hard to read......lol [img]/community/emoticons/smilewinkgrin.gif[/img]


Yes, I can read it also, but it is very light and hard to read. [img]/community/emoticons/shocked.gif[/img]
Paul

cheers & beers,
Chris


Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/17/2009 6:31 PM (GMT -6)   
Others have offered eloquent descriptions of the catheter.... My own experience, and far less eloquent: it was a effing nightmare. I hated it. Hurt like hell the whole time it was in. It's been out about two weeks now, and I'm *still* sore from it. The recovery from the surgery stuff wasn't that bad - that catheter kicked my butt though!

Confusion said...
Was reafing about the pre and post-surg procedures. Lots to do. The catheter concerns me. Can anyone explain what the catheter is like? Silly question I suppose; but curious to know. I am asking about how it feels and ??? Can you easily get around? Concerned about having something suck up there.

cheers & beers,
Chris


Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/17/2009 6:34 PM (GMT -6)   
and to think chris, you only had your's in for 2 weeks! that would have been paradise to me, lol. you will heal soon from the post catheter pain.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 

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