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Prostate Cancer
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Posted 4/22/2007 4:35 PM (GMT -6)

Hi Everyone,

 

I have some follow-up questions regarding my husband who was diagnosed with PC, gleason (3+4):

 

1.  He scheduled for an open surgery but we keep hearing that the Robotic is the better option.  What is your opinion?  What are the pros and cons of both of these procedures?

 

2.  What was the post surgery like for you, mentally, emotionally and spiritually?  How long did it take you to get back to yourself?  I'm trying to prepare myself for what’s to come.

 

3.  I heard that it takes a while for the sexual functions to return (if they do at all) and even if they do, a lot of men shy away from sex because the orgasms are painful.  Please shed some light on this topic.

 

4.  The doctor recommended a trans-rectal MRI.  Does this test reveal if the cancer spread outside the prostate?  What is considered a normal (or acceptable) result of the MRI?

 

Thank you in advance.

 

Hugs,

 

AEG 

 

Posted 4/22/2007 4:57 PM (GMT -6)
Hi AEG,

I had "open" surgery (RRP) and you can read my experience on Biker90's RRP Journey if you wish. If I had to do cancer again, I would do the exact same surgery with the same surgeon.

Good luck and stay with us for support...

Jim
Posted 4/22/2007 5:17 PM (GMT -6)

AEG,

1. Better option is the best doctor you can find, regardless of method used.  An advantage of robotic can be short term recovery time, however an expert surgeon can also provide good short term and long term advantages with open surgery.

Sexual function varies a lot, an important aspect is whether nerve sparing surgery is applicable, and again this comes back to having a top surgeon. Many men mention a 6 week recovery time, but sexual function can take anything from a couple of weeks to years.

Somestimes an MRI can give a clearer picture, but very often they are not exact.

John

Posted 4/22/2007 5:20 PM (GMT -6)
Hi AEG - We opted for laproscopic and understand it to be less invasive and a bit quicker in the healing process. We are 7 months post surgery and although total sexual function hasn't returned are finding good results with the Trimix injections to obtain erections. Bob has not had any pain with his orgasms at all.

Good luck!
;o) Linda & Bob
Posted 4/22/2007 9:23 PM (GMT -6)
AEG,

It is difficult to answer your question about what is best, open or robotic as none of us have had both. I had the robotic because I felt that the minimal invasive approach would improve my recovery and provide less pain. As already mentioned the most important thing is a skilled surgeon that promotes nerve sparing. The pros and cons are again difficult to provide. The robotic as I already mentioned generally provides for faster recovery. less blood loss and less pain. The open allows the surgeon to be able to feel the prostate gland which can be important if the tumor is on the margins.

Post surgery the first few weeks were good because my post op path report was good. Of course dealing with the catheter is no fun but it lasts for only a short time. The leakge after the catheter came out was the most depressing point immediately as I wanted it to be none. I became fully continent about three months post surgery. Physically I felt good and did everything I wanted except picking up something heavier then a gallon of milk. Once the restrictions were lifted at six weeks I went back to doing all of the things that I did before surgery.

The sexual part is very variable between men. You have to accept that the nerves may take months to get over the trauma. There are interventions while this waiting period occurs such as Viagra, Cialis or Levitra; vacuum pumps in combination with the pills; penile injections. I am now using Bimix injections which give me an erection as good or better then I had before the surgery. I have not had any pain with orgasms and they are just as good if not better then they were before surgery. Of course they are dry orgasms with no ejaculate. You can have an orgasm without an erection.

I do not know anything about the MRI but it sounds like it could tell more about the progression of the cancer.

Hope this helps.

Tamu
Posted 4/23/2007 5:27 PM (GMT -6)
AEG,

Let me tell you our experience and try to shed some light on why we went the Da Vinci route. To answer # 1, we too were told by our local doctors that open was better. But when we started to research the differences, and after talking to doctors who would not have had anypart in either surgery, we liked the da vinci. For Kurt it meant getting back to work sooner, but more importantly, getting back into the kids active lives quicker. (we have two sons, 14 and 10) He also liked the shorte cath time, 7 days. What scared us was the lose of feel. I watched 2 da vinci surgeries in which they talked about the inhanced view from the magnification. That ended that worry for the most part. We had to travel out of state for the da vinci, but would not trade our experience for anything other than this not happening.

#2. I am assuming you are wanting to know what it is like for the wife, in the aftermath. It is HARD. I have had to deal with Kurt being short with me for nothing, to decreased help with the kids and household, to just being upset and asking me constantly if I still love him. Half the time, I can't go 10 minutes without him trying to touch me all over, and the other half, he will not come near me. We are still new to this side, only 5 weeks out, but this is what our life is now like. So, spiritually, we are fine. Emotionally and mentally, it is day to day. I love my husband and want to do everything possible to help him back, but honestly, sometimes I am mentally and emotionally exhausted. But, it is getting better. Communication is the key.

#3. He has had, or says he thinks he has had an orgasm. "not painful" he says, "just different". As for sexual function, see #2. Frustration!!! But, our doctor had to cut some nerves and said he expected only 50% at 8 weeks. With full recovery expected overall. I KNOW we will get there, just takes time. Not to scare you, and maybe this response should be on our journey page and not here, but I didn't expect this side to be this hard. BUT, we are Cancer FREE!!!!!!!

#4. I have no idea. Kurt had bone scan and CT scan here. Doc in texas did ultrasound before surgery and it was invasive, but can't help on MRI.

Please tell us where you are located, PSA level, and stage if you know it. This will help in others giving you info. Also good to know husbands age and general health. And sorry you are joining our group. Courtney
Posted 4/23/2007 6:14 PM (GMT -6)
Hi AEG,

Good for you in looking into your prostate cancer options throughly and doing all the research you can.

1. He scheduled for an open surgery but we keep hearing that the Robotic is the better option. What is your opinion? What are the pros and cons of both of these procedures?

We did da vinci. I think most will defend their choice of open or robotic surgery, radiation, etc. unless something went really wrong. So you can predict that Ken and I think that da vinci is better :). We found a good da vacini doc around here who had completed over 400 and who had also done over 1,000 opens (and still does on occasion opens). Of course we also consulted with an open guy and a double-certified oncologist/radiologist.

Our original urologist (who does open) was actually very honest with us. When we asked if there would be any better "Feel" with the open. He basically right out told us, with your stats, not likely. And when we consulted with our robotic surgeon (recommended by original urologist) he also said that after doing tons of opens and lots of robotic, he feels that he "feels" the margins just through sight (from the experience in opens).

With this said, i wonder if the best choice might be someone with BOTH lots of open and robotic experience.

We actually had three consults and although it took time, i am glad we did, instead of just jumping in with first instinct (get it out NOW!).


2. What was the post surgery like for you, mentally, emotionally and spiritually? How long did it take you to get back to yourself? I'm trying to prepare myself for what’s to come.

well we are less than two weeks out. We were very happy with the initial recovery from surgery. I seriously have to give away adominal pads, surgery tape, etc. that we thought we might need for wound dressing! (I think some things i read were for open surgery and totally didn't apply in our case). That is the physical part.

Mentally, it was almost the same ... we were amazed that the recovery was so easy. (so far). Emotionally, ecstatic especially over path results and seeming promise with incontinence. (dribbles, but definitely progressing rapidly).

Spiritually, thank GOD that surgery went ok, no major complications. That is the primary thing we prayed for. As long as he got through it ok and looked like cancer was out, that is all we can ask for with all the others who have much worse.

3. I heard that it takes a while for the sexual functions to return (if they do at all) and even if they do, a lot of men shy away from sex because the orgasms are painful. Please shed some light on this topic.

we aren't there yet! BUT definitely looking forward. We are doing cialis therapy and have had some "stirrings" and it has definitely come out from his little shell :)

4. The doctor recommended a trans-rectal MRI. Does this test reveal if the cancer spread outside the prostate? What is considered a normal (or acceptable) result of the MRI?

sorry didn't have one.

Tanya and Ken

Posted 4/23/2007 8:40 PM (GMT -6)

I agree with the previous comments. It is very much a personal decision and you must be comfortable. I have no idea what a standard minimal number of surgeries to be proficient is but I suspect it is at least 100-200.

I would make one other point - BOTH of you should get in the best physical shape possible. I worked out at least two hours every day to get upper body strength, strong abs and cardio. My wife needed upper body strength to help pull me up and help on many occasions. The exercise has payed off after surgery. Ed

Posted 4/23/2007 8:49 PM (GMT -6)
I really appreciate all of your respones. You guys (& gals of course) are the best!

AEG
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