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jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 4/25/2009 12:40 PM (GMT -6)   
Just a little to introduce myself. Married, two grown sons.
My prostate issues began in February of 08 after I had an inguinal and naval hernia repair that left me with a catheter for 7 weeks due to an inability to urinate. For 4 weeks after having the Foley catheter removed I was required to self catheterize until I thankfully was able to pass urine with no problem. Following that experience, I had a regular DRE and PSA tests. The DRE was negative but the PSA was going up in a worrying trend. The urologist gave me numerous options including an ultrasound/biopsy which when completed indicated a Gleason of 3+3=6.

I was referred to a very good surgeon who has years of experience with both open and robotic; because of the previous mesh hernia repair he recommended open which is scheduled for May 5th.

I am very fortunate to have a loving and understanding wife who is fully supporting me in this adventure. I am also lucky to have many family and friends who are praying for me and offering encouragement. I also feel blessed that I have found this cyber family to provide much needed information.
Age 62 Sex Male
PSA - 3-20-08 2.7; 4-17-08 3.1; 9-18-08 3.6; 1-22-09 3.8
DRE negative
Ultrasound/biopsy 2-12-09 50
4 of 12 samples positive 3+3=6, Right mid-medial <5%, Right mid-lateral 10-20%, Right base medial 10%, Right base lateral 10% adenocarcinoma
RRP scheduled for 5-5-09

Post Edited (jacketch) : 4/25/2009 11:44:27 AM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/25/2009 12:53 PM (GMT -6)   
Hi Jack,
Welcome to HealingWell. I believe it is the best site on the web for compassionate and caring support. If it wasn't for the number of cores positive, I'd say I'd keep monitoring it. But you are on top of things. Your surgeon is probably right on track with recommending an open procedure as it is quite commont for mesh hernia repair to hinder efforts for robotice surgery. I hope you stay with us through your experience. You are right, this is a great family no matter what your treatment selection is.

PS: I changed your post to include a subject line. We get to have too many "no subject" posts it get's hard to navigate the site. (LOL, never mind)

Peace,

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 4/25/2009 3:17:39 PM (GMT-6)


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 4/25/2009 1:29 PM (GMT -6)   
Tony, Thanks for the encouraging words.
As to your comment on just monitoring: This was the most difficult part of my decision, wait or act. Due to my age, DX, current health, financial status and the possibility of deteriorating employment conditions which could affect health insurance, my wife and I have decided go ahead with the surgery. In addition, the surgeon, while not guaranteeing anything, has said that my present health and DX would indicate a quick recovery with fewer complications and side effects. He isn't pushing to get it done but I do agree that the outcome would likely be better than if I waited for a more serious DX down the road.
Age 62 Sex Male
PSA - 3-20-08 2.7; 4-17-08 3.1; 9-18-08 3.6; 1-22-09 3.8
DRE negative
Ultrasound/biopsy 2-12-09 50
4 of 12 samples positive 3+3=6, Right mid-medial <5%, Right mid-lateral 10-20%, Right base medial 10%, Right base lateral 10% adenocarcinoma
RRP scheduled for 5-5-09


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/25/2009 2:13 PM (GMT -6)   
Welcome to the Forum. I hope you have found a place to share your Journey here with us. Keep us updated and ask all the questions you wish. :-)
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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/25/2009 4:22 PM (GMT -6)   
Hey Jack,
I certainly can understand that reasoning to move now. Good job on the research. Since you have made the call, perhaps it's time to talk to and monitor others here who are fresh on their journey's with the surgery experience.

LOL, I went above and cleaned up my typo's. I'm not sure if I wore out this keyboard or my fingers.

Peace,

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 4/25/2009 4:58 PM (GMT -6)   
This coming Tuesday morning the wife and I will be attending a pre-op class at the urology clinic. My wife jokingly refers to it as the "sex class." They will be talking about post op care and rehabilitation so it should be interesting. Afterward we will head over to the hospital for the pre-op preparation. The time is rapidly approaching and my anxiety level is slowly rising. My usual method of handling stress like this is through humor but I find most people I talk to about it seem to think that is a bit odd. Fortunately my wife still retains her excellent sense of humor and consequently we laugh frequently over many trivial things.
Age 62 Sex Male
PSA - 3-20-08 2.7; 4-17-08 3.1; 9-18-08 3.6; 1-22-09 3.8
DRE negative
Ultrasound/biopsy 2-12-09 50
4 of 12 samples positive 3+3=6, Right mid-medial <5%, Right mid-lateral 10-20%, Right base medial 10%, Right base lateral 10% adenocarcinoma
RRP scheduled for 5-5-09


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 4/25/2009 5:35 PM (GMT -6)   
good luck to you. My doctor started me on kegel exercises before surgery. He said that helps lead to continence earlier. i had surgery last May. It is major surgery but I am happy I made the decision for surgery.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 4/25/2009 6:01 PM (GMT -6)   
Jack,
The highest anxiety for me was the first chapter, that is figuring out what to do and who do do it with. It sounds like you passed that part and have now given it to the experts. Trust your judgement and study what you can about the process and recovery stages.
Best wishes,
TeddyG

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 4/25/2009 6:42 PM (GMT -6)   
I had a mesh hernia repair about 4 years ago and I knew that it would complicate a prostatectomy. The literature for open retropubic prostatectomy suggests that surgeons find the mesh makes the operation more difficult but that the outcomes are just as good.

When I discussed this with my surgeon he first looked at my CT scans and showed me the clips used to attach the mesh which also showed him exactly where it was. He told me that the presence of the mesh meant that he would have to carefully peal my bladder off of the mesh but this was not a problem except that it might add about 20 minutes to the surgery. He did not suggest that this ruled out robotic surgery. After my robotic surgery I asked the doctor if the mesh had presented any problem and he said that it had not.

None of this should be taken to imply that your situation and mine are alike or that one doctor is right and the other is wrong, but it does show that a prior hernia repair is not an absolute bar to robotic surgery
Age at diagnosis 67, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7


dsmc
Regular Member


Date Joined Jul 2008
Total Posts : 149
   Posted 4/25/2009 8:18 PM (GMT -6)   
Hi jacketch,
I am sorry for you having to be here but this is a pretty good place to land when you are in need of advice and experiences. You are past the first hurdle with having a surgery date. As the other guys said it is a major surgery but with patience it will be fine. I wish you the very best and will be following your progress.

David
Age 53
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/25/2009 10:08 PM (GMT -6)   
Hello and welcome here Jack, sorry you are here but glad you are at the same time. I know about the catheter thing, due to complications with my open surgery, I was on one for 63 days straight. A second corrective mini-surgery gave me the ability to pee on my own. I don't know how you handled the self cath stuff, I was close to having to do that myself, but fortunately never had to.

open surgery makes best sense for your situation. I will be glad when you are on the other side of that, the recovery side. My best to you.

Yes, having a great wife by your side and family, makes a big recovery difference. My wife of 35 years is also a nurse and that helped to. Please keep us posted.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9
 
 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 4/26/2009 7:46 AM (GMT -6)   
Greetings, Jack.  Sorry you have to be here but you are among friends. Reading your post brought back so many memories.  We too had the presurgery class followed by preop work at the hospital.  My wife who is a nurse and been with me 36 years has been right by my side and a great help.  I trust your results will be just like mine and you'll be well on your way to full healing and recovery very soon.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4110
   Posted 4/26/2009 8:35 PM (GMT -6)   
Jack: Welcome to the board. This place has given me more info and hope than you could possibly think of. Thanks to all the guys for the info.
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 ED- 5 mg Cialis daily, pump daily,

Post Edited (corvetteman3) : 4/26/2009 8:13:10 PM (GMT-6)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4184
   Posted 4/27/2009 11:48 AM (GMT -6)   
Dear Jack:
 
It sounds like you already have your mind made up re a treatment option so I hope you don't take this the wrong way and I don't mean to add to your anxiety.  But...with your stats, surgery is only one of the many options you have.  From your posts it sounds like you only spoke with people with expertise in surgery.  Most men on this site, including those who choose surgery, suggest that every patient speak with multiple doctors with specialties in surgery, radiation oncology and a prostate oncologist...I agree with that advice.  Plus, I usually remind early stage folks like yourself to examine all of the other options like proton beam, HIFU and TFT (see realziggy's posts).
 
I guess the bottom line for me is to make sure you are FULLY INFORMED before making a final decision.  It may very well be that surgery is still the choice.  But, this is a big deal and I think all men owe it to themselves and their loved ones to make an informed choice. 
 
Finally, even though your surgeon has "years" of experience...how many procedures has he/she done?  The studies are clear that he/she needs to have done 300+ to get the best results.
 
Best of success in whatever you choose,
 
Tudpock
Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 5/1/09.

jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 4/27/2009 5:05 PM (GMT -6)   
Tudpock,

No, I don't take it the wrong way. I am here because of the wealth of info.

Regarding the surgeon: He is Clinical Instructor of Surgery (Urology), Medical College of Virginia, Richmond, VA and has done well over 700 RRP procedures and many DaVinci procedures. Additionally, he was recommended by the owner of the company I work for. He has 34 years of experience.

Re:"From your posts it sounds like you only spoke with people with expertise in surgery." I originally had several consultations with my urologist and discussed wait and see, traditional and robotic surgery, HIFU, cryo, brachy and proton radiation and chems. I also spoke with several men with experience with some of the aforementioned procedures.

Finally, after doing the research, I spoke at length with the surgeon, taking into consideration my outcome desires, family history and my physical profile.

Finally, with the recommendation of the physicians and after much discussion and prayer with my wife, I decided on the RRP.

Now that I am a week away from surgery, I am having a rising level of anxiety both about my decision and about the actual surgery.
Age 62, Sex Male
PSA - 3-20-08 2.7; 4-17-08 3.1; 9-18-08 3.6; 1-22-09 3.8
DRE negative
Ultrasound/biopsy 2-12-09, 50cc
4 of 12 samples positive 3+3=6, Right mid-medial <5%, Right mid-lateral 10-20%, Right base medial 10%, Right base lateral 10% adenocarcinoma
RRP scheduled for 5-5-09

Remember, don't drop the bag!!!


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4184
   Posted 4/27/2009 7:11 PM (GMT -6)   

Jack, sounds like you researched this well.  Anxiety is normal as you'll hear from most of the guys here.  For me, most of the anxiety took place before I made a decision.  Once we made a choice, we were pretty calm...just wanted to get it over with and get on with our lives.  I think this was because I chose a relatively non-invasive treatment with few short term side effects.  I think those who choose surgery have some more natural anxiety because of the short term issues they will face...and I think this is normal.

Since you have done your homework, I'm sure all will work out well and I'll say a prayer for your success.

Best wishes,

Tudpock


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 5/1/09.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/27/2009 9:12 PM (GMT -6)   
Jack, already sounds like you made the right informed choice for you, and it's important to trust that decision and go with it. We will all be anxiously waiting for you to come out on the other side after your surgery in a few days, don't know if you have ever had a major surgery before or not. Once they put you under, you will be oblivious to the rest and will simply blink yours eyes and wake up in recovery. The best part for me, was when they wheeled me to my room , and my entire immediate family was outside the room waving at me, it made it all worth it. My wife took off for 10 days from her job, spent 3 of the 4 nights I was in the hospital, I begged her to go home but she wouldn't hear of it. Can't wait to you are on the recovery side, and hope this skilled surgery gets all the nasty cancer out of you. My best to you and your family.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9
 
 

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