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Surgery

zakpaga
Posts: 66
Joined: Jan 2010

I just had my surgery on Monday 3/15 (birthday of my son who turned 20) with Dr. Samadi. I could have changed the date but my son told me that it was the best birthday gift he could receive(the life of his father, I almost cried).
The surgery went well and I was released from the hospital the next day. I still have to get the pathology report. I have an appointment on Monday 3/22 to have the cathether removed.

Thank you all for your support

Zakpaga

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

Welcome to the other side of our disease....post treatment side.... Please keep us updated on how you do with things and best wishes for a quick recovery. One you get rid of the cath you will feel like a new person.

Larry

jminnj's picture
jminnj
Posts: 129
Joined: Nov 2009

As Larry stated, welcome to the other side. Wishing you all the best for a speedy recovery.

joe

luckyman2's picture
luckyman2
Posts: 54
Joined: Sep 2009

It get's better from here on... and now you're a survivor!

I've always been the kind of fellow who looks at his glass as being half full instead of half empty. You now have the opportunity to discover your body again and it will be a very interesting journey. You will most likely have some set-backs along the way, but give it time and have patience.

zakpaga
Posts: 66
Joined: Jan 2010

Thank you Larry, Joe and Luckyman2. It is good to know that I can always count on the experiences of those you started this journey before me. More importantly,it is good to know that there will most likely be set-backs along the way.

Zakpaga

winsom
Posts: 1
Joined: Feb 2010

I am not sure what to decide on, surgery or radiation, both of them have some not so nice side effects. any suggestions anyone. I am concern about lognterm quality of life, if that is possible also.

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

I'm no Doctor Winsom only a cancer surviver (7 months) A gleason 9 is a rough one as I'm sure you know. How old are you? Read Dr. Patrick Walsh's book on Surviving Prostate Cancer. You can order online at a good price. There are also other excellent books.

Have you had other tests yet to see if the cancer has spread? Not to discourage you but with Surgery on the Gleason 9 you may still be facing radiation afterwards. Read, research, Ask your Doctor questions and get many opinions from experts.

Good luck and keep us posted.

Larry (Age 55 Gleason 7) 7 months post Davinci Surgery.

Evagirl's picture
Evagirl
Posts: 60
Joined: Mar 2010

Larry our urologist offered us surgery or radiation with a gleason of 7

do you think radiation in itself could be the total treatment?

Not holding you to any statment..just wanting your thoughts~~

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

Evagirl,
There are so many things to consider! I've been sharing with you in several threads. Can radiation in itself be the total treatment? That is so hard to know. The thing is that a Gleason 7 is borderline aggressive. I had 12 core biopsy and 5 of the cores found cancer. Three were graded at 4+3 (7) and 2 at 3+4 (7). The 4+3 are worse grade then the 3+4 even though they both equal 7. At any rate what played into my mind was my age at diagnosis of being 54. Being frank....Sex was important to me and my wife....With a borderline aggresive cancer and much ressearh...I opted for the Davinci Robotic surgery.
reasons as:
1. With Surgery they take out the CANCER and can determine spread, margins etc. After surgery they sent the prostate and removed items off to pathology. They downgraded mine to an overall Gleason 7 at 3+4. During surgery they found some spread into the nerve bundles. Men have two nerve bundles that run along the edge of the prostate. During surgery the Doc has to seperate these nerve bundles from the prostate and try and save them for return of sexual function. That is one reason why EXPERIENCE Counts in Davinci. They say seperating these nerves is like pulling a piece of wet tissue paper off an apple with out it tearing it! Doc spared 100% of the one nerve bundle and about 60% of the second nerve bundle. Also during pathology they found That I have a positive margin in the prostate bed. This means that cancer went to the very edge of the surgery site. Now they monitor my PSA Very frequently and if the cancer comes back then I have option #2
2. Radiation - Proton or Other ....This is my backup plan...If my cancer comes back I can then have radiation and Hopefully kill off the remainder. I visited one Doctor before making my final decision that does radiation with Seed implants....He only gave me a 60% chance of being cancer free in 10 years. To low of a chance for me...so that also helped me think of radiation as a backup plan.

Again there are so many choices to make and this is the one cancer where they let you PICK YOUR attack plan! You talk to a Surgeon and they will suggest surgery, Talk to radiation and they say radiate,,,talk proton and they say Proton...Just remember the goal is to GET Rid of the Cancer.

Being frank here again consider how important is sex to you? Following surgery you will have problems with sexual function and urinary since they have to cut the urethra in two places and sew it back together. I've been lucky with the surgeons skill and have been 99.9% dry with no need of protective pads and can get an erection using Levitra.

Also after removal there is no ejaculate but the male can still orgasm and it feels the same. Just no mess to clean up. Some people do not realize this until later.

Keep asking those questions! That's why many of us our on these forums to try and help others as we have been helped and also Keep praying!

Larry

Evagirl's picture
Evagirl
Posts: 60
Joined: Mar 2010

Larry ,,

having the surgery and keeping the radiation possibility in the back pocket to me seems like a wise plan.
You talk about the Davinci...as our urologist did...he talked about sparing the nerves
on the right side/w him doing the open surgery...He said the robotic surgery was not
smart enought to let go of a piece of tissue at the exact second of delicate surgery
What is your oponion of this statement?
But you said that your dr spared the nerves with the Davinci...that is impressive
I am sure that you found a dr that had done many many of these surgery's.

I am glad that you are being frank...as to me these are all things that need to be talked about...being sexually capable is still important to my DH. and of course no man wants to experience incontinence...
after the Turp surgery , you do no longer have the ejaculate either...
you can just pee a lot better~ :-)

I am studying all on what you have said and relating to DH ...and praying~~ :-)

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

Evagirl, I'll try and answer a couple questions here from a few other threads we have been talking on. My dad had Proton in 1997 at Loma Linda and is doing great. Since then though being frank he still has a need to urinate frequently and when he has to go he has to find a bathroom NOW!! At times he still gets some minor mucus discharge with the bowel movement. He did great sexually for about 3-4 years following Proton and then gradually lost the ability to maintain an erection. He is in about 77 now so how much is from proton or how much from getting older no one will now. He has tried the pills with no luck and refuses to try anything else though my mother would like him to. He is afraid to try the shot to the penis. I've not needed that since the pills are working for me but they say it is similiar to a diabetic giving themselves a shot. It just is hard for some to put a needle in their penis.

The doctor I picked has performed around 2,500 Davinci surgeries and also performs the traditional surgery He chooses which he things is best for the case. He told me there was a chance they might have to switch from robotic to traditional depending on some previous surgery I had but all went well and they did robotic 100%. The skill counts as I have said. I actually found several online videos of the Davinci Surgery and watched them after watching 2 other doctors I found one with My Doctor perfoming the surgery. I watched it 3 times and then it clicked with me...The doctor I picked movements were so graceful with the robotic tools compared to some of the others I watched! So I tend to slightly disagree with the statement about it being smart enough. One thing that really impressed me on my robotic research was that the urethra passes through the prostate. So the Doctor has to cut this section out and then stitch back together. This is very deep inside the male anatomy and I read that when stiching the urethra back together that one part is actually done 'blind' since the surgeon can not see that area because of other things in the way. With the Robot they move the camera and the surgeon has a 360% View of what he is sewing back together. Also think of the surgeons large hands in side of you versus the robotic insturments. The robotic is 100% controlled by the Doctor and they also have built in where the robotic movements will not jerk or slip if the doctors hand would.

It is a gamble though on the sexual return and urinary contol return. Some men do not get the sexual return back and others do. Some men get quick 100% control of the urinary function back and others have to use pads. Each individual is so different.

One thing on the Proton is that there is no pain per say during the treatments but the patient does get tired as each treatment progresses.

Also in case you did not know I believe that you can ask for your husbands biopsy to be sent off to John Hopkins in Baltimore for a second opinion. Not sure on how to do that but I know of others that have done it.

Ask the Doc those hard questions...I did! My local urologist does traditional surgery and he told me the truth on every question i asked. I verified his answers! he also told me that he had several patients that went with Proton and several that went with Robotic. He would support me and give me local follow up care regardless of my choice.

I just spoke with another man this morning that had traditional surgery with the local urologist and is doing great 2 years post surgery. My wife works at the local hospital and got the 'scoop' on the local Doctor. If I had gone with traditional surgery I would have let him operate but felt that robotic was the best plan of attack for me.

Larry

Swingshiftworker
Posts: 634
Joined: Mar 2010

Larry:

For me, surgery is the treatment of last resort, BUT if I have to get surgery done I want one of the BEST doing it. What's the name of your surgeon, where is he located & what is his phone number?

lewvino's picture
lewvino
Posts: 1006
Joined: May 2009

My Surgeon was Dr. Joe Smith At vanderbilt Hospital in Nashville, Tn. You can google to get the number. He has a backlog of patients. Even with my local urologists help it was about a 2-3 month wait to get in to see Dr. Smith then waited about two more months for my Davinci Surgery. Overall I'm very pleased with my results at 7 months post surgery.

Larry (Age 55)

mavoh50
Posts: 5
Joined: Mar 2010

hi Zakpaga well 2 day you got your cath out do you feel better lol i'm 3 weeks post op i'm feeling and moving around good--- i had the Davinci and everything went good and the limphnodes came back negative and now i need to go back in a couple of weeks for blood test to ck psa---- welcome to the group take it easy DO NOT OVER DO IT AND REST you will be fine---good luck--- mark

zakpaga
Posts: 66
Joined: Jan 2010

Thanks Mark,

I had the cathether removed yesterday. I am moving around well but I still have some pains for which I take Tylenol. My pathology report was a good one so to speak. The Gleason was downgraded from 4+3 to 3+4. The limph nodes are negative. I am glad you talked about the PSA since I was suprised that it was not in the pathology report. So if I understand, it is after 5 weeks that the PSA is checked.

I have an appointment with teh surgeon in five weeks but there was no mention of PSA test. I will ckeck with them to see if I need to have the PSA test before the appointment.

Victor

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

My surgeon does not want a PSA test prior to 6 weeks from surgery because they have found that too many times there is still some residual PSA hanging around in the blood at 4 weeks from surgery and have caused unnecessary frustration for everyone. I had mine checked 43 days following my surgery day and was a lucky dog with non-detectable reading of >0.1. Very good news your gleason was down graded..that is usually NOT the case and most often it's Upgraded from the biopsy results...I believe the stats are more than half increase and less than 1/3 decrease and the rest stay the same. Mine increased...well from one biopsy and stayed the same from a second opinion/reading of the biopsy.

Also good that you are only on Tylenol...I was told to take the pain medicine if I felt the slightest pain..and boy I liked my pain meds as they made me sleep good and really gave me a peaceful feeling while on them then the next day actually made me feel very happy for some weird reason...I totally understand how people get hooked on pain meds... I went out and refilled to the max and are saving for those very hard days of work around the compound on projects...or an injury that will happen in the future at some point.

Best of luck for your recovery!

randy in indy

zakpaga
Posts: 66
Joined: Jan 2010

Thanks Randy

Very good explanation for the reason for not testing PSA before 6 weeks. I am still learning and even more after the surgery as I am confronted with the post operative side effects.

As for the post op. grading of my cancer, I should say that the first reading was Gleason (3+4) but the second opinion had it at 4+3, which is what I tend to use as pre surgery Gleason score.

Yes, I am taking only Tylenol because the doctor told me that other pain medication will make me constipated. I wish I had a stronger one.

Victor

bdhilton
Posts: 758
Joined: Jan 2010

Walsh recommends that your first PSA should be 8-12 weeks out from surgery. My urologist wants one at 6 weeks and Catalona wants one from me next Wednesday 4 weeks out for his research….

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I don't want to sound like a drug pusher but Tramadol-APAP 37.5-325 MG TPAR was a Godsend for me. Some people do not want to take pain meds just because they are against it...I rarely ever take any drug...have not had many asprin or tylenol, Ibuprofin's in my life time..I just don't take pills...but the Tramadol was FANTASTIC! My surgeon team said it will not make you constipated and wow..talk about totally wiping out the pain it completely made it non-existant but without feeling drowsy or sleepy in any way....I had to be careful because it made me feel too good and I could easily over do it. I have never ever had any ki8nd of antidepressant in my life but I would wake up in the morning each day and have such a good outlook and feel so positive that I really felt like it was the pain meds doing that....very strange...I would recomend trying to get them to write a script for that...I was using 100mg stool softners twice per day(morning and night) and never had any problem being constipated...but then again I have been accused a time or two of being full of it! lol

Hope this helps.

bdhilton
Posts: 758
Joined: Jan 2010

Just read up on it and it sound like a powerful medicine. My doc gave me oxycodone and never took one because the iron was making me constipated….

zakpaga
Posts: 66
Joined: Jan 2010

I will try to see my primary care physican today to go over my health status. I will ask him for this Tramadol. I remember having taken it after I have had abdominal pain last year but the GI doctor gave me only 10 pills because he did not want me to get hooked to it.

The pain from peeing is getting better now. I am also using Colace as stool softener and having more tha frequent BM. At least now they are soft.

Thank so much Randy

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

Glad I could be of assistance! That is really what I am doing here now that my surgery is complete as I recieved so much help from others prior to and during my recovery I feel it is my duty to try and be a help to others going through the same unfortunate process with this beast. Besides, I have met some really nice people here and hope I have established perhaps some lifelong friends along the way. You know.... it's really what makes life so worth living helping others and having help from others!

Randy in Indy

hopeful and opt...
Posts: 1316
Joined: Apr 2009

great job

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