another new member-unfortunately!

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Regular Member

Date Joined Mar 2010
Total Posts : 208
   Posted 3/23/2010 2:09 PM (GMT -6)   
Greetings from the sunshine state
I've been cruising the forum for a few weeks since my husband's lastest psa-4.7, free 8.  He's 56, very active, doesn't smoke ect. ect. Last Wed. we got the biopsy report-pc, gleeson 6.  Fortunately, I had been reading posts here so I knew what to expect from the talk with the doctor and what questions to ask.  My husband urologist is 2 years younger than my husband and when I asked him what he would do in my husband's shoes, he said he may be someday and if he were my husband's age he would have DaVinci surgery.  From the research I've been doing I agree, as does my husband but I have to admit it's scary for both of us.  Not so much the surgery as the after effects and being tied to having psa tests every few months looking for more cancer-seems a cruel sentence.  We hope to go cruising next year on our sailboat-have no intention of letting this stop us, but are we being realistic? Also, our doctor recommended 3 doctors , but particularly Dr. Vipul Patil; global Robatic Inst. Orlando-does anyone out there have any experience with him?
Thanks for listening

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4818
   Posted 3/23/2010 2:18 PM (GMT -6)   
Welcome to the site...
Once you reach a certain age - looking for cancer becomes part of lifecool
I'd imagine at this point going sailing next year would be fine....Heck - odds are you could do surgery after that.
Age 55   - 5'11"   215lbs
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
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Regular Member

Date Joined Aug 2009
Total Posts : 372
   Posted 3/23/2010 2:24 PM (GMT -6)   
Hi 47........sorry you have to be here, but glad you found us
I believe there are several guys on this forum who have had surgery by Dr. Patel, and they will chime in over time. Your husband is my age, and the stats and similarities are in line. I'm up here in the mid-atlantic region, but as others will tell you, the experience of the surgeon, or brachytherapist, or whatever mode of treatment you decide on will be the most important factor. You shouldn't think that your life will be put on hold after treatment necessarily. Immediately after, perhaps, but depending on when you have treatment, next year's sailing should stay on your calendar. Others will also tell you that you have time to make an informed and well researched decision about how to treat this. The good news is, there are many ways to treat this---the bad news is, there are many ways to treat this. And you have to make that choice--------but we'll help guide you, so stick around, ask any/all questions, and hopefully you will be guided on the right path for you.
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, NO MX, 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......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 3/23/2010 2:31 PM (GMT -6)   
Welcome to HW, glad you decided to join us. When you get a chance, make a signature of your husbands stats at the bottom of your posts, makes it easier for us to follow what is going on.

We have several here from Florida, including Sonny who is in the Orlando area.

Please keep us posted, and keep hope, as you find more answers, and learn more ,as you are doing, some of that initial fear will go away, and you will be able to think clearer about the situation.

I love sailing too, what do you have for a boat?

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, no problem post SRT
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, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days

Regular Member

Date Joined Mar 2010
Total Posts : 34
   Posted 3/23/2010 2:32 PM (GMT -6)   
I don't know anything about him, but I did a search (Google "Dr. Vipul Patil orlando") and found these:

This is what we did when my wife was looking for a gynecologic oncologist after her ovarian cancer diagnosis last year. You should be able to find some patient reviews.

Regular Member

Date Joined Oct 2009
Total Posts : 24
   Posted 3/23/2010 2:38 PM (GMT -6)   
Welcome...unfortunately you are here....I felt the same way 6 months ago with similar #'s that you have. Since then I have had a Biopsy seen
my surgeon in Dec had open surgery Feb 24th and received the news just yesterday that I am Cancer free...I feel great with very little incontinence and ready to start the next chapter of my life and feeling better physically and mentally than I did before this all happened.
This is not a death sentence by any means just a little blip of life....Educate yourself with your options and the most important thing I believe no matter which type of surgery you have is the experience of the surgeon. I am from Canada and had Dr. Chin in London Ont. and I owe everything to him....good luck....Healing well will help you with a lot the information you need.....good luck.....
Diagnosed Oct 2009 during annual routine physical at age 58
PSA 4.37
10 biopsies - 3 positive all on one side
2 samples at 1%
1 sample at 3%
Gleason 3+3
Scheduled for Pre-op London Ont Feb 2nd St. Joseph's London
Decided for open RRP surgery Feb 24th St. Joseph's Hospital London Ont.
with Dr. Chin.......
Surgery Feb 24th home on 26th returned for post-op and catheter removal
March 08th Received the news March 22nd that everything contained and am Cancer free

Veteran Member

Date Joined Nov 2009
Total Posts : 1095
   Posted 3/23/2010 2:40 PM (GMT -6)   
Dr. Patel is well regarded and has done MANY of these surgeries.

Don't cancel the sailing!

My dad died of this disease (the overwhelming majority don't die, but he had an agressive case and it was caught too late). But one thing he did really well was not waste a single day. Indeed, after he was diagnosed, he was even more focused on using every day well. Don't put life on hold. Get the surgery (or whatever), and then get out there on the boat.
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 3/23/2010 2:43 PM (GMT -6)   
Welcome to the Forum. Sorry you're here but glad you came.. smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

Veteran Member

Date Joined May 2009
Total Posts : 2691
   Posted 3/23/2010 3:08 PM (GMT -6)   
I think most of remember the feelings that run through your mind when the doctor tells you these things. I am glad you had some exposure to HW before the biopsy came back.

You guys have lots of options. Surgery is a very commonly used option, but for a Gleason 6, you may be able to pick a less invasive option such as Brachytherapy that will make your sailing date even more certain. The side effects of surgery can be very annoying.

As advised by others, take your time and learn all you can. There is no hurry, and once you take an option, it is kind of permanent.

Second opinions are advisable too, even another reading of the biopsy slides.

Welcome to HW. No question is considered unaskable on this site.

Good luck on your PC voyage, and your nautical one as well.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01

Forum Moderator

Date Joined Sep 2008
Total Posts : 4045
   Posted 3/23/2010 3:23 PM (GMT -6)   
Dear rhb:
Welcome to our forum, but I'm sorry you have to be here.  You will find that this is an excellent place for both information and support.  As David (Purgatory) said, it would be helpful if you would post a more complete set of hubby's stats so that we have a better picture of what you are facing.
Having said that, with a G6 you likely have some time to make an informed decision.  And, 1 week post diagnosis is WAY too soon to be settling on an option.  And, as goodlife said, you very likely have multiple options and you should research them all.  Surgery is a BIG DEAL with life changing side effects.  My advice is that you talk with a radiation oncologist, a prostate oncologist and maybe a urology practice that has experience with AS (depending on your husbands stats).  As long as you are in Florida, I would recommend a trip to the Dattoli Cancer center.
They specialize in less invasive treatment and have high success rates.
If brachytherapy is of interest, please feel free to read my "journey" via the link in my signature and I, along with a few others here who are "seeded" will be glad to give you our biased opinions based on our personal successes with that treatment.
Best of luck,
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 12/09.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Regular Member

Date Joined Mar 2010
Total Posts : 208
   Posted 3/24/2010 6:30 AM (GMT -6)   
Thanks so much to all of you who responded to my post-your words of encouragement and advice are really going to be helpful to me and my husband going thru this adventure. We go back to the doctor next wed(31st). He wanted us to take a couple of weeks to digest the news and read Dr. Sheldon Marks book and study up on our options. We are doing surprisingly well mainly because we are very happy and optimistic people. I will post his stats next week when I get a copy from the doctor. Once again, thanks all. And to Dave in SC, we have a 34' steel boat built in Europe in 2003 -we love it but it's true-'Rust never sleeps!"

New Member

Date Joined Mar 2010
Total Posts : 7
   Posted 3/24/2010 9:34 AM (GMT -6)   
TO rhb47:
I wanted to let you know that my 57 yr old husband had divinci done by Dr. Vipul Patel 90 days ago, and it was a very positive experience. He was Gleason 7 with a 100 gm prostate. He is completely leakfree and pad free. The surgeon was not able to spare one side of a nerve due to perineural invasion, but his ED was due to 2 years of Finasteride and Uroxital. He had a very easy recovery. The Robotic Institute is very specialized and adapted to Dr. Patel. They are a very professional office, but very personal. Your initial visit may take 3-4 hours for them to evaluate and educate you to help you make the right decision for you. The wait time after deciding on surgery is usually 90 days. Prostate cancer is usually slow growing, and this gives you time to heal from your biopsy and to get your general health in order. They are an Adventist Hospital in Celebration, but there is no religious agenda or pressure. The best place to stay post-op is Mona Lisa Suites because it is next to the hospital and they provide 24 hour shuttle to the hospital and have ample of walking space. You will be discharged the morning after your surgery, but will want to stay in town for a few days in case you have catheter problems. My husband had a fever the first night in the hotel, and the response from Dr. Patel's office was immediate, and I was able to reach the actual doctor within minutes. Read past posts, especially "Things I did not know before having PCa" This site helped me immensely in all the details to help my husband recover. He post-op PSA is <.01 - nondetectable!!! We had Avmed insurance and all we had to pay of the $50,000 bill was our tiny deductible - all pre-op visits and second opinions, post-op visits, all hospital costs and medications sent home, and all cystograms were all covered. We have been very pleased. Our local urologist only did open surgery and said he would recommend the divinci to anyone due to the ease of recovery - he is too old to learn all the skills of the robot. If you decide surgery, be SURE to DRINK and WALK as you KEGEL.

You have been so helpful to us over the last 5 months - you probably will not ever know the extent of your influence on so many people just by your information and encouragement. I will be praying for you as to your decisions with the new PSA numbers. Keep up the fight!!

I do not know how to add the signature at the bottom!

Regular Member

Date Joined Mar 2010
Total Posts : 208
   Posted 3/24/2010 1:45 PM (GMT -6)   
Thanks so much for your info about Dr. Patel-my husband's urologist suggested him and we have checked out the website for Global Robotics.  Having to have surgery or threatment is very hard for my husband because he is very healthy, not overweight , exercises every day ect. We have a great diet-lots of fruits veggies ect.  Anyway, your message and advice has already made me feel better and I will have my husband read it and all the other messages.  Glad to hear that your husbans's numbers are un-detectable and that he is doing so well.  Thanks again for taking the time to help. 

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 3/24/2010 2:59 PM (GMT -6)   
Don't rush just yet for surgery. Go up to the links at the top of the topics list, find some good books and read. Your husband's low PSA and Gleason of 6 would generally indicate that you had lots of treatment choices and lots of time to choose. Seeds might be especially attractive. If you could post more detail of your husband's biopsy report -- number of cores, number of positive cores, %cancer, if would help in comparing his situation with that of others

I am afraid that whatever your choice of treatment, your husband is going to spend the rest of his life with regular PSA tests and the opportunity to worry about them.
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
9 mo. PSA 0.00 -- 1 light pad/day ED remains

Regular Member

Date Joined Mar 2010
Total Posts : 46
   Posted 3/24/2010 6:58 PM (GMT -6)   
Hi Rhb47,
It sounds like you're at the stage that my husband (age 65 at diagnosis) and I were in this time last year.  Hubby had a gleason 6 with 2 positive cores and a small palpable nodule.  In addition to our local urologist, we consulted with the head of GU oncology at Moffitt Cancer Center in Tampa and with a nearby radiation oncology group that could provide seeds or CyberKnife procedures. 
All along the way we were told that his cancer was small and slow growing, and that we could take our time (up to 5 years) to decide upon a course of treatment.  After seeds and the CyberKnife treatment were ruled out due to his "unique" anatomy (born with only 1 kidney and a large bladder diverticulum), he decided to have surgery.  His local urologist recommended Dr. Patel at the Global Robotics Institute.  Hubby had his robotic radical prostatectomy in November of last year.  The good news was that he did very well and regained his continence almost as soon as his catheter was removed.  The bad news is that his cancer turned out to be much worse than everyone had believed - Gleason 5+3=8, positive margins, extraprostatic extension, perineural invasion. 
Dr. Patel and his staff have been absolutely wonderful.  The care at both his office and the hospital has been outstanding.  I'm a retired nurse and kept an eagle eye on everything that was said and done to him throughout our journey up to this point, and I can only echo the remarks made by a previous poster about her and her husband's experience.
Dr. Patel spends time with us, talks to us in terms we can understand, is honest and up front about the possibility of a recurrance due to the aggressive nature of hubby's cancer.  We've had two followup visits so far at 6 weeks and 3 months post-op, and so far his PSA's have been undetectable!  We go back again in June for another check.  Dr. Patel told us that if the PSA goes up at all, hubby will need to have radiation therapy, and also that there is a good chance that it will.  We're learning to live from PSA test to PSA test, and it will be that way for years to come. 
Best wishes to you both as you begin this journey!

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 3/24/2010 7:05 PM (GMT -6)   
Welcome to the Forum, 47. Lots of good info here and lots of caring guys who have been down the road your about to travel. I couldn't have made the journey sanely without this bunch. Take your time. Check out the options, and don't look back. I didn't. good luck
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Gleason 7 (3+4)
1 positive margin (.3cm)
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)
11/23/09 Post IMRT PSA .18
2/12/10   Post IMRT PSA 0.00

Regular Member

Date Joined Aug 2007
Total Posts : 118
   Posted 3/26/2010 12:11 AM (GMT -6)   

Dr. Patel was my robotic surgeon back when he was at OSUMC. Although I can't comment about the Global Robotics Institute, I can say that I was extremely pleased with the staff and the surgical outcome. In fact, I do not see how it could have possibly been any better. I was only 44 at the time and in excellent health, so this certainly helped with my recovery. Dr. Patel is one of a handful of surgeons that consistently come up as being at the very top of their profession.

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)

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