Follow-up Quesions

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 

 

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

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

---

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

Began injections in April '07

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

---

Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (up from 3.4 previous year)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins. Gleason 3+4=7.

Post Edited (Izzyblizzy) : 4/23/2007 6:20:27 PM (GMT-6)

I really appreciate all of your respones. You guys (& gals of course) are the best!

AEG