Before my surgery I asked similar questions. My doctor felt the MRI would give him a bit more information about
the tumor. However, the ultimate decision about
nerve sparing would be made when he was cutting the prostate out from the neurovascular bundle. Robotic surgery takes away the surgeon's ability to feel the tissues, which was the way an
open surgeon could determine what was cancer and what wasn't. The robotic surgeon relies on the better field of vision to see the bundle covering the prostate. He explained that healthy tissues separate easily, and cancerous tissue wants to stick to the healthy stuff. So as the tissue is peeled away, if it looks like is sticking, then it is probably cancer and he will remove it.
My surgeon said when he is doing that dissection it is the "loneliest moment". It is up to him, what he can see, and "feel" in his instruments. There's no one else to ask.
Bottom line is choose a surgeon with a great deal of experience and a low rate of positive margins. You want to get the best result of cancer control. You should recover continence if you follow the exercises, are in good shape, and have normal urologic function going in. The sexual side effects are more problematic. There may be no guarantees in that area.
You're asking the right questions.
Age at diagnosis-66 Diagnosed 6/16
RALP 10/16 at U of Chicago, Dr. Shalhav. Experienced internal bleeding post op requiring transfusion of 2 units.
Pathology Gleason 3+4=7, tumor volume 15% Margins negative except for one focal margin, .1mm
PSA @ 6 wks <0.02;16 wks <0.02; 5/17 <0.02; 10/17 <0.02