Surgery Date Set and.. a little humor for us with PCa

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RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 1/23/2010 10:26 PM (GMT -6)   
Well, 6 weeks after diagnosis and I have reviewed all the options.  Talked with 1 radiation oncologist and 4 surgeons.  My decision is to have Robot Assisted Laparoscopic Prostatectomy with Dr. Joseph Smith at Vanderbilty University Medical Center.   He has over 3000 RALPs and the entire Urologic Surgery Center seems first rate and extremely compotent.  With 3000 RALPs (plus another 2000 RRPs before switching to Robotic) I believe Dr. Smith has seen just about every variation imaginable and I feel confident he can handle my surgery.  He has very good numbers for his outcomes as I stated in another post.  The only drawback is that he is in high demand thus my surgery has been set for April 7.  He was very confident that with my low volume, low risk cancer that whether I had surgery in February or in April I would have the same outcome.  I feel good about this decision. 
 
Now on to the humor:
 
I called the incontinence hotlline.........They asked?  "Can you HOLD please?"
 
Impotence... nature's way of saying "No HARD feelings."
 
Rick
Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc


Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 665
   Posted 1/23/2010 10:38 PM (GMT -6)   
Ricky, I believe the better the surgeon the better the outcome... it looks like yours is VERY experienced. Did your homework, did your deliberation, gone through the hard part of deciding. Now relax. My experience was I found a lot of peace after I made the decision. The hard part is over (no pun intended!). You are going into it with the right attitude. Rest well.
God bless.
Gleason, 3+4; PSA, 7
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
cancer contained, no penetration, lymph nodes clear
PSA consistently <0.1 since surgery


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 1/24/2010 6:12 AM (GMT -6)   

Ricky D - Good decision.  You looked at everything thoroughly, then made your decision.

I did that too.  With about the same stats as you (I was told my cancer was slow growing), I did not rush and decided I could live with a four month wait time to get the surgeon I wanted.  I attribute my good outcomes post surgery in large part to him.

I used the four months to engage in what for me was a vigorous walking program of 5k a day.  I also used portion control when eating.  I lost 15 lb in the time between being told I had PCa and the surgery which my GP had wanted me to lose for several years.  This exercise and weight control also contributed hugely I believe to my good outcomes after surgery.

Of course the downside is that you are waiting longer than normal for the surgery which, if you are like me, will give you more time to fret and be stressed.  I found that in order to really understand PCa, you have to be in the PCa club which is why I was so happy to find this forum.  It was really helpful to read about guys who were going through the same thing.

3 months post op and I am very happy with the decisions I made. Hang in there Ricky.  You have made the right decision!!

Skeener 


Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 07/10.      


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 1/24/2010 3:17 PM (GMT -6)   
Rick, I had Dr. Smith do my surgery back in August 2009. I was very pleased. I do have a positive margin post surgery but believe that Dr. Smith did a great job for me. I've been dry since getting cath out and excellent results at 5 months post surgery with erections using Levitra.

Do you live in Tn? Or travelling to Dr. Smith? I live near Chattanooga.

Larry
Age 55 / age at diagnosis 54, PSA 5.1
Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/24/2010 3:41 PM (GMT -6)   
Sounds like a good choice and decision for you. With your numbers, the extra wait for the surgeon of your choice shouldn't impact the results at all. Now's a good time to breathe and relax.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


In This Together Wife
Regular Member


Date Joined Dec 2009
Total Posts : 135
   Posted 1/24/2010 6:46 PM (GMT -6)   
Speaking of humor--isn't it time for a link to the Ray Steven's PCa song again?
CareBear
(Bear's stats)
Age 49
 healthy-had bronchitis once :)
 8-4-09    Family Practioner for back pain  PSA 4.9
8-20-09  Consult with urologist                PSA 4.89
9-2-09    Biopsy          3 cores positive 7% 3+3 (6) gleason
9-22-09  Birthday turned 49
10-12-09 2nd opinion
11-13-09 DaVinci
11-23-09 Cath removed  Path report cancer contained neg. margins
Feb 2010 wil be followup PSA


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/24/2010 7:09 PM (GMT -6)   
Probably so, Carebear, would be good timing
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 1/24/2010 7:56 PM (GMT -6)   
I live 2 hours from Nashville in Huntsville AL.
Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 1/24/2010 8:25 PM (GMT -6)   
Ricky,
We wish the best for you and thanks for a little bit of humor. It's a rainy day in Georgia so any brevity helps. You are going to a great place for surgery so that helps with any anxiety that surgery might bring. Keep us posted.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/24/2010 10:26 PM (GMT -6)   
A bit longer to give that old walnut a real workout GFMPH
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 1/25/2010 1:56 AM (GMT -6)   
Making a decision as to how you're going to battle your PCa is very difficult. Certainly you are feeling a sense of relief for having reached a decision. Looking at your low numbers, I was curious if you considered Active Surveillance. I can understand if that was not an option for you, however.

Best of luck.
Age: 53 6' 0" Weight: 170 Caucasian

Rising PSA over the last six years (from when I started being tested) from 3.9 to 5.2 to 4.6 to 4.5 to 4.9.

DX with PC in January 2009 after biopsy. Bone scan--negative

Consulted Cedars-Sinai Beverly Hills urologist--recommended surgery
Consulted Cedars-Sinai Beverly Hills radiologist--recommended IMRT
Consulted San Diego Cyber-Blade doctor--recommended treatments
Consulted Long Beach radiologist--recommended IGRT
Consulted Loma Linda radiologist--recommended Hypo-fractionated Proton treatments

Insurance approved any treatment I wanted.

Consulted Marnia del Rey urologist Dr. Scholz.
Dr. Scholz referred me to Dr. Bahn for a Color Doppler test.
Scholz and Bahn recommended Active Surveillance, some diet changes, and steady exercise.

I am currently on Active Surveillance.


RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 1/25/2010 11:00 PM (GMT -6)   
Franchot
I did consider AS. I even brought it up in consults with the various doctors. Dr Smith actually said that was "not a crazy consideration".
However it came down to these factors:
1) Biopsies every 6 months or every 12 months would wear on me. Could I keep myself sane with all the imaginary symptoms I would "feel".
2) Between examinations and testing this thing could grow to the point it was "outside" the prostate and a completely different problem. Much more difficult to cure.
3) At a realtively young age (55) and reasonably healthy it seems nearly certain that I would eventually be needing treatment. If that was 5 years or 10 years down the road would I be able to recover as well as I would at 55. What if my health was not good at that point?
4) Surgery allows a complete examination of the removed prostate with definitive pathology results. As well as the PSA monitoring would give an early indication of success of surgical cure and any follow up needed (radiation, HT, etc)

1,2, and 3 above ruled out AS in my mind. 4 helped me make my mind up for surgery over other treatments.
Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 1/26/2010 1:56 PM (GMT -6)   
Ricky,

Thanks for posting back your thoughts. Those are very good reasons to seek out surgery as a treatment. (And some of the same things that I have thought about myself.) As I monitor my PCa and continue through AS, your Number 3 reason really hits home with me. I watch myself age and notice how I more slowly recover from the everyday bumps and bruises of life. Imagine what surgery does to the body of an older person.

You've sought out a top surgeon so that's the most important step. Good luck with the rest of the journey.
Age: 53 6' 0" Weight: 170 Caucasian

Rising PSA over the last six years (from when I started being tested) from 3.9 to 5.2 to 4.6 to 4.5 to 4.9.

DX with PC in January 2009 after biopsy. Bone scan--negative

Consulted Cedars-Sinai Beverly Hills urologist--recommended surgery
Consulted Cedars-Sinai Beverly Hills radiologist--recommended IMRT
Consulted San Diego Cyber-Blade doctor--recommended treatments
Consulted Long Beach radiologist--recommended IGRT
Consulted Loma Linda radiologist--recommended Hypo-fractionated Proton treatments

Insurance approved any treatment I wanted.

Consulted Marnia del Rey urologist Dr. Scholz.
Dr. Scholz referred me to Dr. Bahn for a Color Doppler test.
Scholz and Bahn recommended Active Surveillance, some diet changes, and steady exercise.

I am currently on Active Surveillance.


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 1/27/2010 6:48 AM (GMT -6)   
Greetings, Franchot and RickyD.  Just to amplify on the last couple of posts - my doc continues to say I'm his star patient and have done better than almost any of his other thousands of patients.  He attributes that to the fact that I am 15 to 20 years younger than most of his other patients.  All things considered, I'd just as soon have not had cancer but since I did, I am very happy with the treatment I received and the timing of that treatment.  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

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