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robotic surgery with heart disease

Annelis
Posts: 7
Joined: Mar 2012

Has anyone had robotic prostatectomy with heart issuees. I was scheduled for this week. New Family Dr. wouldn't clear due to abnormal ekg. I will have a stress test early in the week,

I'm just wondering if it is still possible to have the surgery. I surely don't want to wait on this any longer than necessary.  Thanks in advance. Gordy

hopeful and opt...
Posts: 2226
Joined: Apr 2009

You are not cleared for surgery since the medical profession intent is to do no harm.

Since prostate cancer is very slow growing, generally there is no rush for treatment.

There are alternate treatments that effectively treat prostate cancer with  less side effects than surgery.

If you provide the details of your diagnosis, the survivors at this forum may be able to provide input for your review.

 

Annelis
Posts: 7
Joined: Mar 2012

Biopsy showed Gleason sore of 7 Dr. said intermediate risk and suggested robotic prostatectomy. Second opinion Surgeon also recommended the same. Already had bone scan and Endorectal MRI. I am hoping to still be cleared for surgery as both Dr.s felt the surgery to be my best option. I am also a long time Diabetic with some lower extremity PAD. I have had no past history of heart disease. Thanks again for any input. G

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Thanks for the response:

So we can understand more what is happening with you, please provide answers to these questions.

First is that a Gleason 3+4=7 or a 4+3=7. How many cores were taken; how many were postive---what was the involvement, that is the percent cancer of each core that was positive. Did the pathologist make any other comments in the analysis. Since all treatment is based on the outcome of the pathology, and determining results of the pathology is subjective, did you have a second opinion by a world class pathologist who specializes in prostate cancer.

What did the MRI indicate? (Was this a multiparmetric T3 MRI)

What did the bone scan indicate?

What did the digital rectal exam indicate?

Any other diagnostic tests?

What is your PSA, and history?

What is your age?

......................

As I understand you visited with two urologists (surgeons) who recommended surgery. Did you visit with a radiation oncologist?...basically surgeons are biased toward surgery as radiaiton oncologists are biased toward radiation..

 

Drahmed
Posts: 3
Joined: Jan 2013

once your cardiac work  is completed and if any issues are addressed you can proceed with your robotic surgery 

VascodaGama's picture
VascodaGama
Posts: 3045
Joined: Nov 2010

Gordy (annelis)

Surgery is not a walk in the park. It usually takes 3 to 5 hours to have it done. During that period many things can happen. The robotic procedure may be accomplished in shorter time (3.5 hours) with lesser blood lost but still nobody could assure you a procedure without troubles or with the need of a transfusion.

I do not know details of your cancer status, type of cardiac problem and age which could make the reason for an earlier intervention but I image you having a non aggressive case because of your both doctors recommendation for surgery. If such is the fact, then you may wait till solving the heart issues in case these are mild. I wonder about the opinion of both urologists in regards to the situation.

My recommendation is for you to consult a cardiologist on the facts and request him to contact one of your urologists to discuss the issue.

Best wishes and luck in your journey,

VG

Annelis
Posts: 7
Joined: Mar 2012

Hi

Results I have are Gleason 4=3 =7 40% on one core at left lateral base. At right mid is 1.3 rare atypical small acinar

Right lateral mid 1.8 Focal HGPIN I do not have the results of the Bone scan or MRI yet. The Drs. felt that the pattern was one which precluded radiation so

felt that surgery was the best option. I am 59 years old with a 55 year history of type1 Diabetes. Other than a stent behind my right knee, I've had no history of major blood vessel issues. Cholesterol, triglygerides,etc always good. BP has been elevated but controlled with Cozaar. I'm also on a statin for the Diabetes as a vasodialator for early kidney issues. I had an episode of chest pain in October while at the gym. Dr. just recommended to slow down on exercise regimen-no tests run. During preop test the ekg was "abnormal". Now I need a stress test.

Again, thanks for any input. Gordon (using wife's account-she is a survivor)

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Vasco gave good advise to consult with a cardialogist.

Also , of course you want to see the results of the MRI and bone scan. the results of these test will influence your decision as well.

I have a friend who was diagnosed with extensive 3+4=7. He was 70 at the time. He has a history of cardio disease; had bipass surgery about 20 years ago. This is not scientific, but when he was making a decision for treatment, he was afraid to have robotic surgery because of his heart problems, so he opted for Novalis, a form of SBRT (Cyberknife is a different manufacturer  that does SBRT) at UCLA.

Now he spoke with a surgeon, who recommended that surgery would be the best choice........he also spoke with the radiation oncologist who thought that the radiation was best, and managed the SBRT. This was about three years ago....he is doing fine.

....

I wonder why the surgeons recommended that the pattern of your cancer precluded radiation........other posters may wish to comment.

At any rate, keep on doing research, as you are. Good luck with the cardialogist and I hope that you will have favorable results from the diagnostic tests. Please keep us posted.

 

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3328
Joined: May 2012

Gordon,

I had DaVinci surgical removal exactly one year ago this week, at the age of 58.

I would recommend that you go directly to a good radiation oncologist to discuss radiation instead of surgery.  It was borderline irresponsible for your urologist to not mention this option to you.

An abnormal EKG strongly suggest caution in choosing major surgery, and some doctors will not operate on a patient with significant heart issues.  I suppose it may depend on the specifics of the EKG.  Diabetes is also a negative when considering surgery.

As the guys have mentioned, DaVinci removal is no walk in the park. The proceedure normally takes 2 to three hours. Recovery, even for a guy without diabetes or heart issues, can be slow and painful. You will be on pain narcotics for at least a week.

I would go see a radiation oncologist before deciding. Actually, most writers here recommend considering all options for ANY PCa patient. But I think your medical history demands, in fairness and thoroughness, that you discuss radiation. 

Although your bone scan is not back yet, be aware that, very generally, the more advanced a man's prostate cancer is, the more radiation rather than surgery becomes a more reasonable choice.

max

Beau2
Posts: 261
Joined: Sep 2010

Hey Gordy,

To answer your question, I had a heart condition and a pulmonary embolism before robotic PCa Surgery. I went off of blood thinners (warfarin) and statins a week or so before surgery. I had no problems.

My surgery lasted three hours, there was less pain than with my inguinal hernia repairs. I was walking the next day and went home from the hospital. Stuck close to home for a week. Pain in the chest from the injection nitrogen used to inflate your belly was worse than the incisional pain, it took a couple of days for that to go away. No heavy lifting for six weeks. The catheter was in for a week and it was a pain in the but to carry around.

i was in my early 60s when I was operated on.

Checking all of your options, as advised by the other posters, is good advice If you go with robotic surgery check up on how he was trained to do the procedure and how many procedures ha has done (at least 200).

Best wishes and good luck.

Annelis
Posts: 7
Joined: Mar 2012

Thanks you to everyone. My stress test was positive so off to Cardio I go tomorrow. I'll deal with the heart issues, then see about treatment. If its not one thing, its another.

Im a glass half full kind of guy. I'll stay positive!

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