Two year update from a "young" RRP guy

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CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 10/20/2009 11:31 PM (GMT -6)   
It's been two years since I was wheeled into the O.R. on a gurney for robotic surgery. I was 44 at the time but had been fighting a rising PSA for five years prior. My father was diagnosed (and cured) of prostate cancer at age 52, I decided to start the PSA testing early. At only 39, my PSA was already at 2.23.
 
Fortunately, the pathology revealed that the cancer was caught at a very early stage. Was I "overtreated"? I think not, but sometimes wish I was so that I wouldn't have so much PSA test anxiety. I have posted before about the "ultrasensitive" test, and I ultimately decided that switching to the "standard" variety would be reduce my anxiety without risking my future health, given that I am in a "low risk" group. My latest PSA came back as "<0.1".
 
I have been truly blessed with my fast and complete recovery of urinary and erectile functions. Other than an obvious lack of semen and a few small scars, I have no evidence of my new "plumbing". It's as if my prostate was abducted by aliens. I do still take a 5mg Cialis every 3-4 days, but I am better than I was before surgery and sometimes feel like a teenager again. I am considering stopping the Cialis since I probably don't need it, however it sure is nice to have this "treat", considering what I have been through.
 
Although my experience with robotic surgery is a personal journey, I can say that it sure seems like it was the right choice for me. I am also a firm believer in getting the PSA test, at least a baseline, at an early age, say 40.
 
Regards,
 
CaPCa
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.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02
10/19/09 PSA: < 0.1 (switched to "standard" assay)
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 10/21/2009 7:08 AM (GMT -6)   
What a great and positive follow up story to read first thing this morning. I am sincerely glad that things have gone so well for you. In your case, early detection was truly your friend. I hope you stay this well for many years to come.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 374
   Posted 10/21/2009 7:15 AM (GMT -6)   
Hey CaPCA----------ditto Purgatory on the early AM news! Congrats-----I run into "younger" friends of mine all the time who question whether they should start testing earlier than the "standard" age of 50. I point to stories such as yours as to why they need not rush to the lab, but should begin to question their doctor about earlier testing, especially when there's a history of the disease in the family tree.
 
                           Arnie in DE
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point.
3 month PSA--<0.1
6 month PSA--<0.1


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/21/2009 7:50 AM (GMT -6)   
CaPCa, great post - thank you! So happy that your outcome was good, and that your recovery is moving along nicely.

Sadly, it seems that prostate and breast cancer are being diagnosed in more and more of our younger men and women. My niece was 34 when diagnosed with stage III breast cancer - and there's no family history!

We are all responsible for getting the word out to get screened for these diseases which are so much more manageable (dare I say "curable") when caught early.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


Modelshipwright
Regular Member


Date Joined May 2009
Total Posts : 215
   Posted 10/21/2009 7:55 AM (GMT -6)   
Great news on your progress. It is inspiring to hear from people who are beating this thing with dignity.

Keep well,
Regards,
Bill
Pre-Op:
 
Age 64. Diagnosed with Pca January 2009.
PSA 5.6, Gleason 3+3=6, T1c
 
Biopsy:
 
TRUS biopsies of prostate left adenocarcinoma of prostate involving part of 1/4 biopsy fragments, less than 10% of the surface area involved, CT scan clear.
 
Treatment choice:
 
Robotic Assisted Laparoscopic Prostatectomy - September 29/09. 
Pre-op PSA down to 5.28 which I attribute to visualization techniques and a new vegetarian diet.
 
Post-Op:
 
Robotic Prostatectomy - 09/29/09, back home 10/02/09.
 
Pathology - 10/14/09  Gleason Score remained at 3+3 = 6 as it was when originally diagnosed. There were no positive margins. Tumors were found in both lobes and involved 3-5% of the prostate. There was no Seminal Vesicle, Perineural, Lymphovascular or Lymph node involvement, and the bladder neck was also cancer free. 
 
Continence
 
10/16/09 - 3-4 pads a day and working on pelvic floor exercises as prescribed.
 
Potency:
 
10/16/09 - Zip, nada
 
State of mind:
 
Excellent - always positive.
 
 


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 10/21/2009 8:25 AM (GMT -6)   
CaPCA,
What good news.  Certainly a great update.  I, like you, have those uncomfortable feelings with the ultra sensitive tests.  I went from .008 to .01 a couple of times in my 18 months.   Too much information.  I would like the less sensitive test but the Lab I need is quite a drive.  There is one locally but I don't have confidence in any tests they do.
 
Live the good life. You deserve it.
 
Frank
 
 
Currently 55, surgery at 54
Normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008, University of Chicago.
Catheter out in 7 days normaly expected leakage
Post Pathology T2C, Gleason 7, (3+4) 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear, single positve margin at apex measuring less than 1/2mm. 
PSA Six week < 0.1 4 month PSA <.05 6 month PSA<0.01,9 month<0.01,12 month <.008, 18 month .010
Watching PSA @ 6 months for 2 years,  will do salvage radiation if necessary.
Fair to Good results with Viagra,  side effects are bothersome at times. Tried Levetra about the same as Viagra.  Tried Cialis, think I will stay with the Viagra at 50 mg.  Side effects worse at 100 mg.  


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 10/21/2009 9:18 AM (GMT -6)   
I love good news, the longer after treatment the better. Congratulations........ cool
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 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN


CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 10/21/2009 10:56 PM (GMT -6)   
Thank you everyone for the kind and encouraging words. This forum has been a tremendous benefit to me, and hopefully my occasional posts have helped others in some small way, too. In addition to having the wealth of knowledge and experience of everyone here, it means so much just to be able to talk and vent with folks who have been touched by this disease.
 
CaPCa
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.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02
10/19/09 PSA: < 0.1 (switched to "standard" assay)
 


MIZRAV
New Member


Date Joined Oct 2009
Total Posts : 6
   Posted 10/22/2009 2:05 AM (GMT -6)   
Indeed a great post with great news i will have nothing to add to the guys above but YAYYYYY for you !!!

Keep it UP in many ways !!!

wink

GB
Age 58
DX September 2009 by Dr Antonio Reyes
Biopsy @ Memorial Hospital Pembroke
Gleason 6 (3+3)

2 out of 10 with 10%

no treatment decision yet ....


SHU93
Regular Member


Date Joined Aug 2008
Total Posts : 328
   Posted 10/22/2009 9:35 AM (GMT -6)   
Great News! I am a fellow young person diagnosed when I turned just turned 37. If you look at my stats at biopsy there were alot of positives!!! I am a strong advocate of EARLY testing especially if you have a family history! We are the evidence that PSA testing early Hopefully Saves Lives!!
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).
4 Post OP PSA's from 9/2008 to 6/2009: <0.1
 
 
 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 10/22/2009 10:43 AM (GMT -6)   

Greetings, CaPCa.  Thanks for a good, encouraging post.  I was diagnosed at 55 after my Dad was diagnosed at about 70.  My uro says my son should be tested at 35 and my son agrees.  I have also wondered if I could stop taking the Levitra I take a couple of times a week.  There are times when I don't take it all week and seem to do fine.  Just something about taking the pill that gives me that little boost - don't know if it is confidence or what it may be but it just seems to help and I continue to take them. 

I am glad my doc doesn't use the ultra sensitive test - no need to go through the anxiety.  My next test will be at the two year mark and I trust I will get just as good a result as you did.  Congratulations and keep those zeros coming in.  David


Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 10/22/2009 2:27 PM (GMT -6)   
Thanks for sharing. It is always great to read the good news also. I'm encouraging my two sons to get tested when they reach age 40. They have two grandfathers who have had prostate cancer and now me their dad.

Wishing you many more cancer free years.

Larry
Age 55 / age at diagnosis 54, PSA 5.1
Biopsy 04/08/09 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0

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