Report: Very positive surgical experience

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hm austin
New Member


Date Joined Apr 2010
Total Posts : 6
   Posted 6/11/2010 8:19 PM (GMT -6)   
Greetings, Folks
 
I post this mainly as a perspective to those newly diagnosed, or nearing surgery. My heart breaks for those who have had difficulties with their surgeries, and I pray for your rapid recovery, no matter how long its been. I had read and re-read many of these threads pre-op, and was well informed and prepared for what may come. It never crossed my mind that my procedure would be, as of now, so positive. My attitude was 'why worry about what will be - just do it". 
 
Some of these surgeries just turn out OK for the fortunate.
 
I chose robotic lapriscopy surgery by Dr. Michael Fagin in Austin, TX.; an internationally recognized surgeon (luckily for me, I live in Austin). When I first met with him my blood pressure was 150/som'n. The surgery was 3 weeks later, on May 31st (Memorial Day?!!)  at 1:30 PM. I was walking the halls of the hospital by 6PM. I checked out of the hospital at 9AM the next day, and my BP was 98/som'n.  (Boy, was I a cool cat during that interview.)
 
I wore the cath for 8 days, just removed June 8th. No probs with the cath at all. Discomfort in abdomen, bloating and pain was easily tolerable and mostly gone by day 3 after surgery. Blood in urine only one time - during my 1st BM three days later (prompted by Milk of Magnesia, per instructions).  No cath leakage. No irritation at cath removal. Blood in first urination after cath removal; none since.  No swelling of legs/ankles. No bruising of abdomen except one small area on my left side. No scrotum pain, negligeable perineum discomfort.
 
Patholology report, June 8: I have not seen the report yet, Doc was kinda in a hurry, which was OK by me as soon as he said no margin involvement. Nerves spared. Upgrade Gleason to 3+4=7. Report is being mailed to me. He said he expects a complete recovery, with nothing but zeros in future PSA's. I choose to hang onto his optomism.
 
Now here's the wierd part. I have had NO leakage. Very minimal with the cath in, and none since it was removed. I wore pads for 3 days after removal, none soiled. Today (day 4) I did not use one. No drips or flows. Made a 30 mile drive in my truck with no problem or discomfort. I was concerned something was wrong, because I was expecting leakage, so I called the nurse and she said 'Good for you'... huh? I never heard of a report of no leakage, and I am still not sure whats going on.
 
So this experience, in a way has been surreal. I was prepared for the worst, and hoping it would be better than that. I simply was not prepared for it to go as well as it has - I didn't know it could go so well. I am not counting my chickens before they hatch, I am simply counting the ones that have hatched. I know this will be a long road, and there will likely be some detours.
 
So, if you are approaching your surgery, recognize that all surgeries and recoverys are different. So, just do it. Prepare yourself as best you can with the abundance of knowledge and compassion available here and elsewhere. And, hope for the best!
 
God bless all of you.
Hal
[I never ask 'Why me' questions]
 
 
 
 

Age 55
 
Biopsy 4/18/10
PSA 6.2
6 of 12 samples positive
Both lobes 3 and 3
Gleason 3+3=6 (all)
Perineural invasion identified right apex


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/11/2010 8:43 PM (GMT -6)   
Hal,

Its nice to read of someone that is on the good side of a surgical procedure. Very happy yours has gone text book perfect so far. I hope your recovery continues to do so well.

Please keep us posted. Other's contemplating surgery as their primary treatment, will love to read of one going so very well.

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, 4/8 .04, next one:  July
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, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/11/2010 11:56 PM (GMT -6)   

We take heart in your report as Mac's surgery is on Monday.  So glad to hear about your positive experience.

 

Paella


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 6/12/2010 12:37 AM (GMT -6)   
Good to hear of your positive surgical experience. I think they are much more common than we might suppose -- the positives often never post here.

I also had a good surgical experience, much the same as yours but the pathology was not so good -- Gleason 8 and no nerves spared. Two years out, I still have the expected ED, which I can live with, and now a rising PSA which I can't live with :-)
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
25-month: 0.2 (yes, bummer)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.


April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 6/12/2010 8:01 AM (GMT -6)   
hm austin,

Congratulations on your positive experience and outcome!

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/12/2010 9:54 AM (GMT -6)   

It is so good to hear of your positive experience.  I pray my husband will be so lucky!  Take care!

Aimzee


Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
one core left base (5% ` 0.5 mm)  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm)
Gleason 6 (3+3)
Surgery to be scheduled: THE DA VINCI ROBOTIC method
 
(I do the posting for both of us.)


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 6/12/2010 11:07 AM (GMT -6)   
It really is great to hear somebody who goes through this ordeal with little or no problems. Congrats!. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream. Unfortunately, incontinence back to post surgery level.
*04/14 - Six month PSA - .21.
*05/15 - Incontinence basically under control.  99% dry.  Wear pad daily at work "just in case".
*06/10 - Started IGRT.   39 treatments scheduled.
 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 6/13/2010 10:59 AM (GMT -6)   
Hal,

It is great to hear that there really is someone representing that 98% the doctor bragged about. The nurse who pulled my catheter really expected me to be dry.

It was suggested somewhere along the way that I had not done enough to prepare for surgery (exercise and kegels). I did not know about this board until after the fact, and also took surgery dates based on when I could get one. Hindsight is 20/20, as always.

My best wishes that things only get better.

Keep us informed -

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3742
   Posted 6/13/2010 7:16 PM (GMT -6)   
Hal,
I guess someone has to be on the other side of the bell curve. I guess it's you. Congratulations!

Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23.
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 12.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05, 4/14 9 months - 0.04 and <0.01 with ECLIA.


IDguy55
Regular Member


Date Joined Mar 2010
Total Posts : 27
   Posted 6/13/2010 11:13 PM (GMT -6)   
Good For You! My father had the same experience. He had his surgery 16 years ago at age 70 (A young, very active 70). He never had a problem, never had to wear a pad, and most important the cancer has never came back.
Current Age 55, DX October 2005 PSA 50
Biopsy 11/15/2005 Gleason 4 + 3, High Grade PIN, Perineural Invasion, T2 NX MX Stage 2
Bone Scan Clear, CT Scan Negative
open RRP on 12/19/2005 Gleason changed to 3 + 4, Tumor estimated at 25% of prostate volume, Negative Margins,
Extensive Perineural Invasion, Lymph Nodes Clear, Catheter removed 1/3/2006 (holidays) Dry at night. moderate incontinence during the day.
1/25/2006 PSA .046, Moderate Incontinence
2/28/2006 PSA .027
6/22/2006 PSA .043 Just a little stress incontinence
9/08/2006 PSA .065
IMRT Start 10/12/2006 45 treatments 80 gy
1/4/2007 Almost Total Urinary Blockage, Cystoscopy performed, The next few days I had the Urinary tract of a teenager.
1/8/2007 Clogged up again, Catheter put back in. Removed myself (highly recommended) 7 days later No problems since with only occasional very mild stess incontinence since.
1/11/2007 PSA .03
7/26/2007 PSA .011
1/24/2008 PSA .027
5/22/2008 PSA .104
9/25/2008 PSA .383
2/17/2009 PSA 1.06
5/12/2009 PSA 1.5
8/25/2009 PSA 3.8 LHRH agonist (3 month Zoladex) started
11/24/2009 PSA .021
2/23/2010 PSA 0.99 another 3 month Zoladex
5/25/2010 PSA .016, T level 17


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 6/14/2010 3:58 PM (GMT -6)   
The good report is  great. I'm happy for you. Let us know how everything else progresses. Hopefully, more good news.
Age 52 at diagnosis, father died of PCa
 
PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary) via phone by the nurse! (dropped this Uro!)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
 
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian
Pathology report on 10 Jun 2010: Gleason 6; gland involvement by carcinoma < 2%; tumor in peripheral zone on BOTH sides; no capsular, extracapsular extension, lymph node, or seminal vesical involvement; and no positive margins.
 
Incontinence: first four days after catheter removal - only1-3 pads/day (but urethra was inflammed); 2d week (after inflammation) - 8-10 pads/day (sometimes more!); 3d week - 4-6 pads; 4th week - 3-4 pads.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 6/14/2010 4:52 PM (GMT -6)   
Hal,
I had my surgery on 2/9/09 with doctor Randy Fagin in Austin. He is really amazing. My pathology report is not as good as yours but that is due to my high Gleason. I tless than 24 hours in the hospital and started walking 2 miles after days.
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


hm austin
New Member


Date Joined Apr 2010
Total Posts : 6
   Posted 6/14/2010 6:45 PM (GMT -6)   
Thanks for the thoughts, y'all.
 
I find this a bit interesting:  2 days ago I had lunch with a friend who is a retired physical therapist, familialiar with prostate issues. [Background - I am not a marathoner, and I dont work out regularly - I am in decent shape but nowhere near where I should be].  We discussed the absence of leakage. 
 
25 years ago, I had major hemeroidectamy(sp) surgery. Since then, when the urge for BM occurs, I had, and still have literally minutes to resolve it. Longer than that is a real physical and mental challenge. I dont go anywhere without TP being accessible.  My friend says that for the last 25 years, I have been doing 'Superman' kegels on a daily basis, without knowing what I was doing.
 
Pre-surgery, Dr. Fagin said to begin kegels, trying to build up to 10 seconds (etc), 'I doubt you will be able to, right away'. I told him the first time I tried, I held for 30 seconds, and then 60 seconds and more, and got bored with it.  His eyebrow raised, and he said, 'Just keep doing them'.  I dont think he believed me.
 
Remembering that h-roid surgery is like re-living it; it was awful (and I was in linebacker shape then).  I'm not quite as mad at that memory now as I have been.
 
Positive thoughts and prayers to all of you.
 
Hal
 
 

Age 55
 
Biopsy 4/18/10
PSA 6.2
6 of 12 samples positive
Both lobes 3 and 3
Gleason 3+3=6 (all)
Perineural invasion identified right apex


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 6/15/2010 8:30 AM (GMT -6)   

HM, like you I have had nothing but positives regarding my surgery last year. I hate to sound like I am bragging but I want others to know that a good outcome is not an impossibility.

Best to you on your continued recovery.


63 yo
V10.46 Dx Feb-09

RRP 5-5-09

No adverse SE

PSA 6-19-09  -0-

PSA 9-21-09  -0-

1 year PSA 5-3-10  -0-



Thriving, not just surviving!


sciacca50
New Member


Date Joined Jun 2010
Total Posts : 2
   Posted 6/22/2010 12:59 AM (GMT -6)   
I am a new member and I also had a positive experience with the Davinci robot surgery. I am so happy with the results and, if you are a candidate for this type of surgery, go with an experienced surgeon. I am now 11 days post-op and I feel I made the right move. The worst part of this ordeal was the anxiety, the waiting and the element of the unknown these past 6 months. Once the procedure is done and then the pathology report results are made known, all there is to do is get those follow-up PSA tests done. Keep positive, get educated about this disease, and do all you can to make life better for yourself.
PSA test: 8/2007-2.8, 8/2008-3.2, 12/09-4.2, 2/10-4.72
DRE's all normal.
Free PSA test: 3/10 4.6 w/10% free PSA
Biopsy: 4/2010  4 of 12 cores positive for Pca
             Core #1 5% of Gleason 3+3=6
             Core #2 25% of Gleason 3+3=6
             Core #3 80% of Gleason 3+4=7
             Core #4 100% of Gleason 3+4=7
Davinci Robotic surgery at Queen of the Valley MC in Napa, CA on 6/10/2010 performed by Dr. James Hendricks.
Surgery went without any problems, from 7:30 am to 11:00am.
Released from hospital next morning 11am.
Catheter removed 6/16/2010.
Biopsy report: Adenocarcinoma, Gleason score 3+4=7 involving <half left lobe only. Margins free of tumor. No evidence of extraprostatic extension of tumor. No neoplasm identified in bilateral seminal vesicles/ vas deferens. No lymph node involvement.
Perineural invasion: Yes (positive).
Tumor site: Left apex, Left mid <5% involvement.
pt2a, pNX, pMX. Tumor size 1.8 cm.
High grade prostatic intraepithelial neoplasia (PIN).
Prostate weight 41 grams.
Continence: 1 pad per day-(mostly for just in case). Just about completely dry! Every day gets better.
ED: Yes, but I have hopes since both nerves were spared.
Pain level is just about nil 11 days after surgery.


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/22/2010 4:49 AM (GMT -6)   
VIEW IMAGE
sciacca50, thank you for posting your positive report.  I am printing it up as I did with Hal's posting.  My husband needs to read this for positive thoughts!
 
I wish you the very best!
 
Aimzee
Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
4/1/10 PSA 5.5  Prostate size = 50 cc.
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... Adenocarcinoma:  3 positive on right side,
one core left base (5% ` 0.5 mm) -  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm) - No Perineural Invasion
Gleason 6 (3+3)
Surgery to be scheduled: da Vinci Prostatectomy
 
(I do the posting for both of us.)


RobnTexas
Regular Member


Date Joined Apr 2010
Total Posts : 24
   Posted 6/22/2010 3:00 PM (GMT -6)   
Hal,

I have been thinking the same thing about "superman" kegels on a daily basis. I too was completely dry 2 days after my catheter removal. The more I thought about it the more I contributed it to the fact that I have had urgency and frequency for the past 2 years. When I am in a meeting or driving to work it is hard to go immediately so I had become accustomed to "holding it" for long periods. I think that my eyes were sometimes pouring tears before I got relief. That was my own personal theory, so it is nice to hear someone else contribute their consistency to having built up the muscles over a long period.

I was on the phone a couple of weeks ago for over 2 hours. After I had finished my wife informed me that I had not gone to the bathroom 1 time. That is when it really struck me.
Age: 49, Height 5'11, Weight 190
Problem with urgency and frequency
No family history of C
Biopsy: 4/10 - 4 of 12 Positive 2@ 30% 2 @ 60%, Gleason 3+3=6, T2A
RRP: 5/18
PostOp: Gleason 3+4=7, 45g, 2cm tumor
6/1 - Catheter out YES!!!!

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