Robotic vs Open

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Bob116
New Member


Date Joined Dec 2006
Total Posts : 15
   Posted 1/2/2007 5:10 PM (GMT -7)   

Bob from CT

I have questions about robotic surgery. At the time that my Dr. informed us of my PC, he told me that robotics was an option available. He explained about the reduced recovery time and lessened amount of pain but also said that there was a higher risk of something being left behind mostly due to the surgeons inability to feel cancerous tissue as in open surgery.

Any thoughts on this?


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 1/2/2007 5:25 PM (GMT -7)   
hi bob,

Sorry to welcome you to the forum.

There is another thread recent thread on here.

http://www.healingwell.com/community/default.aspx?f=35&m=659125


We haven't had surgery yet and are still debating the open vs. robotic, but are leaning toward the robotic, but will wait until we consult with the robotic guy on the 5th. But hopefully the other thread will help with some of your questions.

We had the same question of the guy we are considering if going for the open surgery, and he said with the small nature of our cancer on biopsy (5% in one core out of 12, there really wouldn't be that advantage of "feeling cancer". or being able to tell any different from robotic.

What are your stats? (PSA, biopsy, etc?)

Again welcome to the forum. Hope you keep us updated on your decision!

Tanya and Ken (from CO)
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided


Bob116
New Member


Date Joined Dec 2006
Total Posts : 15
   Posted 1/2/2007 5:45 PM (GMT -7)   
Thanks for the reply.
I've read alot about the robotic method and watched part of it online. Everything is a little scary right now.
I'm leaning toward open but am meeting a seed guy on the 10th.
Rescheduled with my Dr on the 16th.
they foung cancer in 3 of 12 biopsies.
Grandfather died from it at age 60 and father had implants 10 years ago.
 
 
Diagnosed 12/14/06
Age: 53
Gleason 6
PSA 5.3


bluebird
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Date Joined May 2006
Total Posts : 2542
   Posted 1/2/2007 6:19 PM (GMT -7)   

Hi Bob,

 

                Sending a special   “Warm Welcome”   to You!   yeah   

This will be the hardest time for you….. but once you make your decision… the mind settles down and things start to happen in a positive way.  You are on the next stepping-stone that will take you closer to being cancer free.

 

Your grandfather and father have had their own personal journey with prostate cancer.  Now it’s your journey and we are happy you joined us.  Thank you for allowing us to walk with you!!!  Each journey is different, Each journey is the same….  Having friends to walk it with you will truly make it smoother.  You will have had a little more insight possibly ~ with having it in the family prior to your diagnosis…. But it is still a New Journey!

 

Buddy and I invite you to read our personal Thread:  Our Journey ~ Sharing is Caring

We chose Radical Retropubic Prostatectomy

We also watched Dr. Walsh’s 45 minute DVD on RRP.  Our urologist was able to order it free by using his letterhead with the request for one.  …It was awesome….. 

 

Excerpt from: Our Journey

(C) We had already made our decision before the Consultation

Radical Retropubic Prostatectomy…..Lift the Hood …We wanted Dr. Staley to visually see and feel the tissue and take out all surrounding tissue that may be hiding… cancer cells. 

 

Excerpt from: Our Journey

KNOWLEDGE IS POWER... and POWER conquers FEAR!!!!!

We decided to share "Our Journey” in hopes of helping at least 1 person! 

If it helps more….  If it helps you!!!! That will truly be a blessing 

At no time are we writing to tell you what you must do, or what you should do….

                               Your decision is Your Decision!!

Just giving you a view of what decisions we made, what the process was for us, and the outcome as of this date. 

 

Hope to hear from you soon…  Keep posting.... OKAY!! 

Take care and know our thoughts and prayers are with you.

 

In Friendship ~ Lee & Buddy

 

                    “God Bless You”

 

It's a little prayer  ~  "God BlessYou"

...but it means so much each day,

It means may angels guard you

 and guide you on your way.

 

 

 

Sharing ~ Our Personal Threads with You!!  updated  11-17

If you or your loved ones ~  pull “1” thing from our journey that helps you on your journey……

it will truly make our hearts happy!!!

 

Helpful Hint: 

Click on Thread name that is underlined and it will take you directly to the Thread!

Once it opens up …you may see weird symbols in the body of the post.

Hit the REFRESH button to clear them… 

 

Our Journey ~ Sharing is Caring

Murphy ~ Our Special Helper

A Special Note for Loved Ones (Wives, Partners, and Caregivers)

Give Yourself a Second Opinion... Read this book...

The hardest thing for me....

Helpful Hints for New Members... Hope this helps you! :)


mama bluebird - Lee & Buddy… from North Carolina

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a  

Confined to Prostate   June 29th ~ PSA Less than 0.1 Non-detectable

Post Edited (bluebird) : 1/4/2007 9:00:57 PM (GMT-7)


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 1/2/2007 6:21 PM (GMT -7)   
Hello Bob,

Sorry to have to welcome you to this Group, but you will find that everyone here will be supporting you every step of the way. So let me give a preliminary response to your initial query. All the major therapy strategies yield excellent results, and you will find that PCa is the most cureable of all cancers. How to decide which is best for you is going to be a personal preference. Which ever one you choose however should be done by the best qualitified most experianced urologist you can find. That is the single most important factor in the selection process.

I wish you the very best of luck, and hope you will continue to ask questions. We will be here to help you all we can.

Glen
Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. boundaries
DaVinci surgery on 02/23/06
 


Tamu
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Date Joined Oct 2006
Total Posts : 626
   Posted 1/2/2007 6:54 PM (GMT -7)   
Hi Bob,

I chose to have a second opinion on treatment at a university urology clinic. The advantage on going to a clinic like this is that they have several highly qualified suregons that do both the open and robotic. The first urologist I saw at this clinic did only the open and when I asked him about the advantages and disadvantages he told me that if the bipsy had shown more cancer and a higher Gleason then open would have an advanatge because of the ability to feel. In my case he felt that the robotic would be a better choice. The surgeon that did the robotic told me the same thing but he felt after having done over 2,000 of the open procedures and 800 of the robotic that the field of view and preciseness that the robotic provides gives a slightly better result for impotence and incontinence and the recovery time is much less and it is almost painless. I cam attest to the painless as I never took any pain medication following surgery other then regular Tylenol.

Hope this helps.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06


parson
Regular Member


Date Joined Dec 2006
Total Posts : 55
   Posted 1/2/2007 8:30 PM (GMT -7)   
Dear Bob from Ct. I am two weeks ahead of you and need to make the same decision on open v robotic. I have several appointments this month and I plan to ask them. Age 64, PSA 3.4, 3 of 12 positive , gleason 3+3=6. I don't have the answer but looking for the procedure that will remove as much as possible. Barrister from NJ

hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 1/2/2007 8:54 PM (GMT -7)   

Two thouhts:

I'm having the Da vinci procedure January 19, and am satisfyed with my chioce.  A friend of mine who I officiate high school basketball with had the same procedure November 1, and he is working games today.  Admittedly, he is probably on the very plus side, but had a good experience.

Second, it was good to see the response from Izzyblizzy, since he is very close to my diagnosis:  I have 1 of 10 positive at 5%, two others the infamous "atypical small gland proliferation".  At 57, my only intrepredation surrounds the fact that I'm feeling great with no symptoms, but hitting my cancer aggresively with surgery.  From a ton of reading, I am confident with my decision to rid myself of this cancer.  Even with my "small" amount discovered, I have a solid understanding that there may be more, or just what the biopsy found.  (It's like trying to hit every number on a dart board with only 10 throws!)  I don't want to take the chance and gamble with the next 30+ years of my life.  Get it out, done, and I won't have to think about it every day like I've been doing since my diagnosis. 

NBC had a recent news clip about this machine, and that solidified my choice.  While your hand can only turn about 180 degrees when you sew, the robot can go a full 360 and keep going.  I have to think I should have bought my son a video game when he wanted it so badly.  He may have been a surgeon now!!

Good luck!

 

 

 

 

 

 

 

 

 

 

 

 

 


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 1/2/2007 11:08 PM (GMT -7)   
I had the robotic surgery on July 25, 2006 at UCLA Medical Center. They say you are generally out of the hospital in 1 to 2 days. I was out in 5 due to some bleeding during surgery (probably would have happened with open surgery, maybe worse).

I work as a consultant and do training, and I was giving classes in 3 weeks, though I had to manage my breaks and deal with pads, etc. I am very satisfied with the procedure I had. My number one concern was getting through the surgery with negative margins, which was accomplished.
____________________
 
Prostate cancer diagnosed:  May 15, 2006 (age 40)
Gleason score:  3+3=6
daVinci radical prostatectomy:  July 25, 2006
size of tumor:  approx 1.1 inches
post-surgery Gleason score:  3+4=7
negative margins from surgery
number of pads/day at 3 months after surgery:  3 to 5
number of pads/day at 4 months after surgery:  1 to 2
first post-surgery PSA:  0
ongoing post-surgery treatment:  Cialis every other day, Viagra "on-demand", ErecAid pump daily
 


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 1/2/2007 11:15 PM (GMT -7)   
I will note that I chose the UCLA robotic surgeon over a very experienced open surgeon at USC (not that the UCLA guy was not very experienced with open, and he said if he ran into problems during robotic, he'd make the switch during surgery).

The open surgery guy at USC seemed cocky about his skills, while the UCLA guy was more analytic and emphasized the need to have negative margins (while the USC guy emphasized being able to have erections and lack of blood loss). My wife disagreed with my choice, but I had to do what made sense to me. Everyone has to make the choice that makes sense to them. It didn't hurt that I went to UCLA and was very comfortable at the UCLA hospital.

Get multiple opinions (surgeons, radiologists, etc) and go with makes you feel most comfortable and don't second guess! At least as much as you can help it.
____________________
 
Prostate cancer diagnosed:  May 15, 2006 (age 40)
Gleason score:  3+3=6
daVinci radical prostatectomy:  July 25, 2006
size of tumor:  approx 1.1 inches
post-surgery Gleason score:  3+4=7
negative margins from surgery
number of pads/day at 3 months after surgery:  3 to 5
number of pads/day at 4 months after surgery:  1 to 2
first post-surgery PSA:  0
ongoing post-surgery treatment:  Cialis every other day, Viagra "on-demand", ErecAid pump daily
 


Bob116
New Member


Date Joined Dec 2006
Total Posts : 15
   Posted 1/3/2007 1:39 AM (GMT -7)   
Thanks to all
Will keep you informed
Diagnosed 12/14/06
Age: 53
Gleason 6
PSA 5.3
Biopsy 3 of 12 positive


Pete trips again!
Veteran Member


Date Joined Nov 2006
Total Posts : 1899
   Posted 1/3/2007 7:34 AM (GMT -7)   
Hey Bob, Well as you can see by the responces you got this is a great place to meet people who are in your shoes as well as guys like me who have already been down the road for a while and everyone in between. I know you will make the right decision. They didn't offer robotic back when I was done so I didn't have to make that choice but must admit, I'm very happy w/ the way things turned out. I never had any problems w/ leaking at all and I started having sex 6 weeks after w/ about 60 - 70% usable erection w/ out any pills. I was never told about the penis rehab the guys are doing now, but I have to say I'm back in the game now running at about 90% w/ out any help. I don't know if it's possible to get back to 100% but I'm trying!! Good luck Brother! I'm sorry you have to be here but since you are please stay with us!
Your friend, Pete
53 years old, Surgury, Radical Prostatectomy 8/20/03, PSA 6.6, Gleason 3 + 3 = 6, Adenocarcinoma extent (moderate) Stage & Margin:T2NOMX, No Metastases, Organ Confined, bone scan: Neg.  


Rybak
New Member


Date Joined Nov 2006
Total Posts : 2
   Posted 1/3/2007 11:03 AM (GMT -7)   
Good day to everyone! I'm 51, was diagnosed w/PC in April 2006, at age 50, 3+3=6 Gleason, cancer found via DRE, PSA was not elevated. Two biopsies performed, 8-12 samples each time, cancer showed up on second biopsy. Following biopsy of prostate after surgery, cancer found in another lobe, but still within prostate. Prognosis is that I am cancer free. First PSA after surgery 2nd week of Jan 2007. I did all of the research once I found out I had PC and decided on DaVinci Robotic surgery which I had on 28 Nov 2006 at Swedish Medical Center in Seattle, Wa. I live in Alaska and was not able to have the procedure done here at this time. I was concerned about nerve sparing, less invasive surgery, quicker recovery time, etc. and, hence, why I chose DaVinci. I am in week 5 following the surgery, feel pretty good, and managing incontinence, using about 5-7 super absorbency depends underwear per day. Thanks for all who have made posts. They've been helpful to me during this time. Mikhail1956

shepla
Regular Member


Date Joined Sep 2006
Total Posts : 102
   Posted 1/4/2007 3:00 PM (GMT -7)   
HI BOB,       I had open Surgery at Sloan Kettering in NYC. DR Eastham said that he did 2000 of them and liked to Feel. He said that th 5 or 6  inch cut was about like the 5 or6 1 inch cuts the robotic surgery does so there wasn,t that much healing difference. I trusted Him totally and the Hospital. I would do it again tommorrow if I had to.  The cathater was in fo 11 days and the week it came out I got an erection 25mgs of Viagra and my wife just kissing.  Continence iscoming along   1 or 2 pads a day but I think it will be less very soon. I am 59  3 = 3=6   7 at Surgery T1C   2 out of 12.  Cancer Undetectable at 2 months contained in the Prostate. I like to have sex 2 a week with Viagra . M wife says I am cured.   Shepla

biged
New Member


Date Joined Jan 2007
Total Posts : 2
   Posted 1/7/2007 2:33 PM (GMT -7)   
I was diagnosed with prostate cancer the first part of Dec. 06. I am contemplating the robotic surgery at St. Louis. I will be talking to the surgeon tomorrow. My main concern is that I twisted my ankle about four years ago and got a blood clot in my left leg. Took coumadin for a year, about two years later I developed a double pulmonary embolism. Five days in the hospital. The night after I got out of the hospital I sat in a car for a short drive of just over an hour and developed another clot in my left leg. They wouldn't let me get out of bed while I was in the hospital for at least 3-4 days. I remain on coumadin. How will all of this affect my having a robitic prostatectomy?

__________________________________________________________________________________________________________________
I will soon be 67 and my PSA two years ago was about 2.4. I Forgot to have it tested, and the doctor who was prescribing testosteron and DHEA didn't mention having it done. In Nov. 06, it was 12, put me on antibiotics, tested again one month later, was 16. Had biopsy showed 12% cancer in the samples taken. Gleason was 7. I have been on IP6, a natural cancer killer for about a month. I had another PSA done and it was 13 after 1 month on the IP6. I continue to take the IP6 and will retest in several months.

Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 1/7/2007 2:53 PM (GMT -7)   
welcome biged,
 
I am sure that is something you will have to discuss with your surgeon.  Although, I would think robotic would be better indicated than open in your case, due to less blood loss.  I am guessing they will have to take you off the coumadin for any surgery though??  (it is a blood thinner right?). But I don't know. 
 
Were you taking coumadin when you had your biopsy?  I know they didn't even want us to take aspirin.  And Ken had just sprained his ankle two days before his scheduled biopsy and basically could only give him extra-strength tylenol cause of the bleeding risk of most of the other pain killers.
 
Might also want to discuss banking blood with your surgeon too.  (I think we are going to do that, just cause Ken has a kinda rare blood type).
 
Here is one thing i found about coumadin and surgery:
 

Coumadin : Elective Surgery


Coumadin® patients may occasionally face additional surgery or invasive procedures at some point in their future life. However, it is potentially dangerous to undergo some elective operations while anticoagulated. For instance, brain or eye surgery can be dangerous while on blood thinners. Even less serious operations, such as prostate or joint replacement surgery, can be associated with serious bleeding in a fully anticoagulated patient.

It is good advice to always inform your physician or surgeon that you are taking Coumadin®. Before any planned procedure, a Pro-Time should be checked to see what level of anticoagulation exists in your blood at that time. You should conference with your surgeon and ask whether Coumadin® should be temporarily stopped around the time of the upcoming operation. In most situations, a temporary stoppage of Coumadin® is all that will be needed.

http://www.hsforum.com/stories/storyReader$1515


Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 1/7/2007 8:14 PM (GMT -7)   
An addition word of advice when telling your surgeon about the coumadin is to be sure the surgeon is fully aware of your past blood clotting episodes so as to avoid a re-occurance after this surgery. Good luck to you! Please keep us posted.
:o) Linda & Bob
Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more agressive, previously undetected cancer)      PSA UNDETECTABLE.   Next PSA check Feb 27, 2007.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


biged
New Member


Date Joined Jan 2007
Total Posts : 2
   Posted 1/8/2007 9:59 AM (GMT -7)   
Izzybusy,
Thanks for the info. Yes, I realize that I must go off the blood thinner for surgery. Just concerned about a clot forming before I get thinned out again.
biged

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 2/11/2007 5:05 PM (GMT -7)   
The differences in how some surgeons do their work is indicated by mistake's post. The five incisions he had were closed with staples. The five I had were closed with internal stitches and then glued. I wonder sometimes how well the medical community really standardizes practices. I spent 30 years in mnaufacturing and it took about 20 of those years before we realized the value of standardization. I was always a believer that the medical community would be a leader in valued practices. I guess they are just like any field. I just find this interesting.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/15/2007 2:02 PM (GMT -7)   

Hi ~ Bob,

 

Are you still with us??  Wondering how your appointments went?  How is your research coming…..

Touch base when you have time.  Okay…  yeah  

 

Keeping you close in thoughts and prayers as you search for answers. 

In Friendship ~ Lee & Buddy

 


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

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