A Failed Operation?

Yank31

I had a radical prostatectomy with the Da Vinci robot in early February of this year. So far I have taken three PSA tests at 4, 8, and 12 weeks which scored: 0.1, 0.1, 0.2. From what I have seen on this site, this is not encouraging and is far wide of the zero "cure" that I was seeking with the operation. My prostate was extremely large, about 120 g which is about three times normal size. (The record at the hospital was 200 g.)

My doctor says that some "benign tissue" may have been left behind due to the difficulty in removal of such a large prostate and he wants to see if my PSA will stabilize. I will take another PSA test in September, but I am not hopeful that the PSA will go down. If it goes up, I am fairly certain that I will be facing SRT early in the fall.

I do not regret the surgery. In fact, the doctors would not recommend radiation for initial treatment due to the size of the gland. Now, I hope, the radiation may stomp the bandit for good. 

Has anyone else out there experienced the "giant prostate" phenomenon and its complications?

My stats are: Negative DRE, 7 postive cores (out of 21 samples taken with a transurethal biopsy), initial Gleason 7 was upgraded to Gleason 8 on second opinion. Path report revealed an array of hot spots with one Gleason 7 and one Gleason 8. Seminal vesicles and lymph nodes were clear. Vascular bundle on the right was removed, but bundle on the left was spared. One surgical margin "was too close to call".

 

 

VascodaGama

Too early for conclusions

My lay opinion is that you should give time a chance for better resoning of your status. The laboratory doing the PSA test uses a single decimal place (0.X ng/m) which result in a sensitive assay could mean 0.0X or a lower value. Remission after surgery is classified in results lower than 0.06 ng/ml.

PSA=0.2 is not good if it comes from a 0.1 but in your case you got benign tissue producing the serum so that any increase cannot be judged to be a cause of cancer alone.This is still early to make any decision. I would recommend you to start getting sensitive PSA and control from there.

Best wishes for full recovery.

VG

Yank31

VascodaGama said:

Too early for conclusions

My lay opinion is that you should give time a chance for better resoning of your status. The laboratory doing the PSA test uses a single decimal place (0.X ng/m) which result in a sensitive assay could mean 0.0X or a lower value. Remission after surgery is classified in results lower than 0.06 ng/ml.

PSA=0.2 is not good if it comes from a 0.1 but in your case you got benign tissue producing the serum so that any increase cannot be judged to be a cause of cancer alone.This is still early to make any decision. I would recommend you to start getting sensitive PSA and control from there.

Best wishes for full recovery.

VG

Thank You

VG

Thank you. I apprecieate your reply and support.

The most difficult part of this whole adventure is wanting answers and solutions as soon as possible so we can get on with our lives without worry. Learning to have patience over the long run is most difficult, but necessary.

Stay well.

VascodaGama

Yank31 said:

Thank You

VG

Thank you. I apprecieate your reply and support.

The most difficult part of this whole adventure is wanting answers and solutions as soon as possible so we can get on with our lives without worry. Learning to have patience over the long run is most difficult, but necessary.

Stay well.

Hang in there

You are right. The best friend of our enemy is anxiety. PSA results cause that. We need them for peace of mind and they will be there in time. You have chosen an avatar that should help you in creating patience. I think it to be the Buddhist protector Fūjin (wind god). How about doing some Buddhism meditation?

Our comrade Rakendra may help you (http://csn.cancer.org/node/263139). Here are some good reading materials;

http://www.shambhalasun.com/index.php?option=content&task=view&id=2418
http://www.wildmind.org/applied/stress/meditation-for-the-very-very-busy

VGama

tarhoosier

Path report

Yank:

Have you the full pathology report post surgery? Is there a comment about prostate tissue at the margin of the sample removed? Or something to that effect? This would confirm the intra-surgical comments from the surgeon about some prostate tissue still remaining inside you. It would be unusual for the surgeon to excise exactly on the very limit of the gland over the course of his excision leaving only prostate on one side and zero prostate on the other. If you wish for a second opinion from another pathologist about this issue it is possible to achieve and might help make decisions concerning treatment, if any.

If you do not have the full report or only a synopsis, then obtaining the report and fully understanding the report is the first step. For someone such as yourself this can be critical.

Yank31

tarhoosier said:

Path report

Yank:

Have you the full pathology report post surgery? Is there a comment about prostate tissue at the margin of the sample removed? Or something to that effect? This would confirm the intra-surgical comments from the surgeon about some prostate tissue still remaining inside you. It would be unusual for the surgeon to excise exactly on the very limit of the gland over the course of his excision leaving only prostate on one side and zero prostate on the other. If you wish for a second opinion from another pathologist about this issue it is possible to achieve and might help make decisions concerning treatment, if any.

If you do not have the full report or only a synopsis, then obtaining the report and fully understanding the report is the first step. For someone such as yourself this can be critical.

Thank You

Tarhoosier,

Thank you for your comments. I am going to see my URO tomorrow, and I will bring up more details about my path report. All I can say now, is that he told me it was very difficult to remove the gland due to its size. The robotic surgery took over four hours (it normally requires about 1.5 to 2 hours,  I believe). My next PSA test is scheduled for 1 Sep. Your comments and those of fellow members above are a great help for me in preparation of questions for my next session with my surgeon.

Thank you again.

Yank31

VascodaGama said:

Hang in there

You are right. The best friend of our enemy is anxiety. PSA results cause that. We need them for peace of mind and they will be there in time. You have chosen an avatar that should help you in creating patience. I think it to be the Buddhist protector Fūjin (wind god). How about doing some Buddhism meditation?

Our comrade Rakendra may help you (http://csn.cancer.org/node/263139). Here are some good reading materials;

http://www.shambhalasun.com/index.php?option=content&task=view&id=2418
http://www.wildmind.org/applied/stress/meditation-for-the-very-very-busy

VGama

Thanks, VGama

Thank you for the links.