Size of the Prostate

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New Member

Date Joined Oct 2009
Total Posts : 6
   Posted 10/21/2009 3:20 AM (GMT -6)   
Hi everyone and thank you for all your advise and posts , i truly educating myself greatly on this site.

I have an enlarged prostate in addition to being cancerous (Gleason 6 (3+3)

i have heard on a health program by a prostate surgeon that the size of the gland also determine at times the treatment route recommended , and once the prostate is enlarged an open procedure is recommended oppose to a robotic one.

I was wondering if any of you have had such experiences or heard the same theory , and if so , how much of an enlargement will deter a robotic surgery ... again

thanks for your helpful advise
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 ....

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4818
   Posted 10/21/2009 5:16 AM (GMT -6)   
Pretty some of the guys here have been down this road. Pretty sure they took fairly standard "shrink it" meds for enlarged prostate prior to doing anything else.

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 10/21/2009 6:51 AM (GMT -6)   
There are several factors that determine whether the surgical route will be open or robotic. But size of prostate is one of them. Like Steve said above, often times the prostate volume is reduced with meds to prior to treatment...primarily for the brachy therapy procedure however. Don't know what the upper limit in size of the prostate is for the robotic procedure, but obviously it needs to be small enough to fit through the keyhole incision.

Sorry you had to be here and welcome. Making the decision of what to do will be very difficult, but you will find lots of folks here to provide their take on their treatment plans to guide you.

Good luck and let us know what your final decision will be.
You are beating back cancer, so hold your head up with dignity
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 10/21/2009 8:17 AM (GMT -6)   
When I had the original ultrasound with the biopsy, the doctor confirmed that I had an enlarged prostate, he said in the 75cc range. Nothing new to me or my GP, as we knew it had been enlarged for years. I had struggled with urinary function due to BPE for at least 10 years. The "normal" sized prostate is around 25cc, I think. Mine being 3 times that size on the ultrasound, he said I was not a candidate for robotic, as it was much too large to go thru the openings, and there was a risk of losing cancer cells off the gland during the process of forcing the issue. In addition, I was told that I wasn't eligible for seeding for the same reason- size of the gland. I don't remember now what the parameter was, but I wasn't eligible. The idea of hitting it with external radiation to shrink it, then trying seeding was floated, but the odds of success wasn't very much. That left the standards of open surgery or external radiation with hormone therepy. I chose open surgery. My prostate weighed 110 grams upon removal, not counting the seminal vessels, lymph nodes and such.
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

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