The week of Da Vinci.

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Kmac
Regular Member


Date Joined Mar 2010
Total Posts : 58
   Posted 5/22/2010 5:21 AM (GMT -6)   
Well a week has nearly passed since dad had his date with the robot. It has been a frustrating one for him (and mum) as I don't think he expected to be that uncomfortable and in pain. This forum has been a great help for me to pass on your post surgery experiences and help him feel like it is a normal part of recovery.

The surgeon phoned yesterday with the pathology results already. I was out so couldn't harrass him myself with questions about the margins etc. He is still Gleason 7, down from the pre surgery 7.6 and it has remained localised. So I guess that is good news? Mum will get the path report next wk when he gets the catheter out.

He has to come back in 5 wks... Will they measure his PSA then?

I'm at the airport now about to fly back to Perth and feel emotionally tired, but glad that I was there for my folks.

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/22/2010 5:42 AM (GMT -6)   
Kmac, sorry your dad is experiencing so much discomfort - some men have virtually no problems and so have more than their share. Hopefully dad will feel better real soon - having the catheter removed should be a big morale booster for him.

If I may point out something: I think you are confusing the Gleason score with a PSA score. Your post states that his pathology says Gleason 7, which is down from the 7.6 he had before surgery. The 7.6 is likely his PSA reading before surgery - this was done through a blood test. The Gleason score comes from the biopsy and surgical pathology report. Gleason scores are comprised of two numbers: is your dad a Gleason 3+4 or a Gleason 4+3? The difference is in that first number: were most of the cancer cells a Gleason 3 or a Gleason 4 (it's confusing, I know).

Overall, the report sounds pretty good but do make sure you and your parents have a copy of the pathology report and that it is explained to you by the surgeon.

Some doctors like to wait about 8 weeks after surgery to check PSA, and some will do a test around 1 month after surgery. I expect that your dad will have his PSA checked when he sees the doctor in 5 weeks.

Please let us know how things go.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 5/22/2010 6:30 AM (GMT -6)   
Kmac,
The discomfort happens to many of us and hopefully your fathers will pass soon. Some have little and some, like me, have a lot but it does pass. Good that you Mom is going to get the path report as that will help you get a good idea of the cancer staging and if it was localized. Also glad that you were able to be there for your parents as there is nothing like family to bring comfort. Please keep us posted.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 5/22/2010 7:37 AM (GMT -6)   
Kmac,
I'm sorry that your Dad is having so much discomfort, We all go through it. Surgery and its effects don't end all it once. Tell your Dad that he will feel a lot better once the catheter is removed. If he is lucky he will have no incontinence problems, most of us do for a while but that eventually will clear up. ED is another story. Sephie is correct in telling you that you may have confused the PSA number with the Gleason score. Please let us know what the pathology report comes out. By the way, my doctor did a PSA test after 8 weeks, it allows for all the PSA already in your blood to go away.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/22/2010 9:46 AM (GMT -6)   
Kmac, thanks for the report. I bet your mom and dad were thrilled you were with them.

Sheldon aka Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02
PSA on April 9 less than 0.02 
 
  


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/22/2010 9:53 AM (GMT -6)   
Kylie,

The pain and grumpiness that go along with recovery are expected - I was not a good patient at that point - just remember, remind both of them - NEVER put off calling the Doc if anything strange is going on, regardless. "Being strong" is not a plus at this point in the process.

I know your dad appreciated you being there, but he will say it was for your mom, and perhaps even if you don't realize it, she probably got more strength from you being there than he did. Being grumpy and in pain makes him oblivious to a lot in those weeks after surgery.

My best for travel and recovery.

Kmac
Regular Member


Date Joined Mar 2010
Total Posts : 58
   Posted 5/25/2010 9:29 AM (GMT -6)   
Thanks everyone. Dad got his catheter out today and the dye test/ xray indicated no leaks so he should be able to go home tomorrow. He said it wasn't as bad as he thought which is good. I guess only time will tell for any incontinence and ED issues.

He is not scheduled for a post surgery PSA test for another 3 mths... Coincidentally the same time I am due to pop out his grandson. I will be praying that he can begin a long run in the zero club then :)

Thanks for the clarification Sephie.. Yes psa of 7.6 and Gleason 7 3+4. will find out more from the post surgery path report when I see it.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 5/26/2010 12:31 PM (GMT -6)   
Hi Kylie

You may not feel like it has been the case, but I'd say that your dad has basically had an average experience so far.

Discomfort is not the same as pain. That catheter just feels unpleasant and gets in the way and stops you being able to lie comfortably to sleep properly etc, and once it goes it is a big difference, even if uyou then leak like crazy to start with the discomfort factor odf that is ojn the outside of your body wheras the catheter was so uncomfortable on the inside too.

May I make a bold suggestion for the benefit of you, dad, mum etc. In the interests of managing the number of different things that a family can worry about at one time. Have a word with the surgeon/docs re the timing of the follow-up PSA test to see if it can be shifted a bit so as not to clash with your event.

(Saw fair bit of WA on Dutch TV last night as they were showing one of those house-moving programmes from Britsih telly about Brits moving to OZ. I suppose I'd say that I'd love the space, but hate the heat. When my wife's family emigrated to OZ in 1970 by boat they stopped in Perth, it's changed a bit since then)

Take care. And enjoy the bump

Alf
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


Kmac
Regular Member


Date Joined Mar 2010
Total Posts : 58
   Posted 5/27/2010 9:23 AM (GMT -6)   
Thanks Alf, that is a good idea regarding the follow up test timing. The only problem is that the folks live 7 hrs away from Melbourne and try and coordinate their visits. I am moving there in two weeks so at least now they will have a place to stay other than a hotel. So it is farewell to the big red state of WA. I love the space of Oz but miss the history of Europe.

I hope your radiation sessions are going smoothly.
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