Upcoming robotic RP - Dr. Vipul Patel - need post op ideas on supplies

kmaly1

On May 5th I have an RP scheduled w Dr. Vipul Patel. Been watching it for 4 years after it hit 5 ng/ml.

Hovered around 7, then rose to 15. 4KPSA 50.1

MRI guided biopsy 6/10 cores positive.

I worked in a hospital lab for 25 years and used to batch run PSAs years ago and would get that result and think "that poor SOB" - and now its me! And the last line is very telling - needed another path review.

How much will this affect my career as a sales rep who flies every other week?

MRI guided biopsy:

Specimens: A) - Prostate	LEFT LATERAL BASE
B) - Prostate	LEFT LATERAL MID
C) - Prostate	LEFT LATERAL APEX
D) - Prostate	LEFT BASE
E) - Prostate	LEFT MID
F) - Prostate	LEFT APEX
G) - Prostate	RIGHT BASE
H) - Prostate	RIGHT MID
I) - Prostate	RIGHT APEX
J) - Prostate	RIGHT LATERAL BASE
K) - Prostate	RIGHT LATERAL MID
L) - Prostate	RIGHT LATERAL APEX
M) - Prostate	MRI FUSION LEFT MIDGLAND TRANSITION ZONE TO APEX

A. PROSTATE, LEFT LATERAL BASE, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 20% OF THE BIOPSY.
PATTERN 4 IS 60% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.
B. PROSTATE, LEFT LATERAL MID, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA INVOLVES LESS THAN 1 MM OF THE BIOPSY.
TUMOR IS TOO SMALL TO GRADE.
C. PROSTATE, LEFT LATERAL APEX, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
D. PROSTATE, LEFT BASE, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 10% OF THE BIOPSY.
PATTERN 4 IS APPROXIMATELY 70% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.
E. PROSTATE, LEFT MID, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 60% OF THE BIOPSY.
PATTERN 4 IS APPROXIMATELY 80% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.
F. PROSTATE, LEFT APEX, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 5% OF THE BIOPSY.
PATTERN 4 IS APPROXIMATELY 55% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.
G. PROSTATE, RIGHT BASE, BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 2% OF THE BIOPSY.
PATTERN 4 IS APPROXIMATELY 70% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.
H. PROSTATE, RIGHT MID, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
I. PROSTATE, RIGHT APEX, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
J. PROSTATE, RIGHT LATERAL BASE, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
K. PROSTATE, RIGHT LATERAL MID, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
L. PROSTATE, RIGHT LATERAL APEX, BIOPSY:
NO INVASIVE ADENOCARCINOMA IDENTIFIED.
M. PROSTATE, LEFT MID GLAND TRANSITION ZONE TO APEX MRI FUSION BIOPSY:
PROSTATIC ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4 + 3 = 7), INVOLVES 40% OF THE BIOPSY TISSUE.
PATTERN 4 IS APPROXIMATELY 50-60% OF TUMOR.
NO CRIBRIFORM MORPHOLOGY IDENTIFIED.

COMMENT:
The case was reviewed by another pathologist for diagnostic concurrence.

jc5549

I am now 3 months out from my prostatectomy done by Dr. Patel. There is no question having the procedure will forever change your life. I am back to a very active work life again and am coping fine. I think we both will need to remember to be patient and expect continued improvement even up to two years after the surgery (still leaking more than I would like and waiting for return of erections). Another thing that helps me cope is, like you, I had significant disease that needed to be handled by some form of intervention. My preference was to deal with the side effects of surgery and save radiation as my salvage procedure if necessary. When I say this out loud it reminds me that something needed to be done to manage this disease and there was going to be a price to pay regardless (such as impacting our very busy lives we lead).

If he needs to resect one or both of your nerves for cure this may change your recovery of function as well. I had this discussion with him and encourage you to do the same.

He is technically excellent and was up to 18,000 prostates when he did mine in February. May be up to 19,000 by your procedure in May 😁

Good luck to you

jc

Clevelandguy

Hi,

To answer your question on downtime, based on my robotic removal I would imagine at least 3-4 weeks minimum. Probably 10 days initially with an external catheter and possibly a week or two after that on light activity duty with male diapers. You might have some lifting limitations also. We all heal at different rates and I hope your Urologist will guide you. From what I can remember I was into light pee pads about 2-3 months out. Good luck

Dave 3+4

kmaly1

Thank you both for your counsel. Is there a resource for the incontinence supplies? External catheter is supposed to be in for a week.

Steve1961

https://csn.cancer.org/discussion/comment/1714759#Comment_1714759

lol i would make sure he is the one doing it lol come on up to 19000 from 18000 in 3 months thats like 80 a week lol this isn’t oil changers most great surgeons do about 4 a week even if they do 2 a day thats 10 a week i would be careful

jc5549

https://csn.cancer.org/discussion/comment/1714770#Comment_1714770

everyone has their preference, I rapidly figured out that pull up type of incontinence pads were very restrictive and had seams that were uncomfortable. I eventually migrated to pads that you insert in underwear, I’m attaching ones that worked for me. I’m sure there’s many more out there that work well. The Amazon brand was maximal absorption earlier in the process when I was more incontinent. The Tena product was a suggestion from one of the spouses from this site and I really do like them as lighter pads that seem more functional.

hope this helps,

jc

https://a.co/d/3tIy9Va

https://a.co/d/1ySeIgp

jc5549

https://csn.cancer.org/discussion/comment/1714773#Comment_1714773

I was just being funny in my comment, although he does perform >30 per week.

csjchas

https://csn.cancer.org/discussion/327920/upcoming-robotic-rp-dr-vipul-patel-need-post-op-ideas-on-supplies

Interesting that your biopsy proactively mentions no crib present. Most oncologists I talked to over the last few years poopood cribriform as anything other than a grade 4 type of cancer. It seems that crib has become more of a concern recently… even with my urologist/surgeon. I had my rp a year ago. The catheter was horrible and I wasn't shy about taking pain pills. They tell you to drink a lot of water after surgery but it made me keep the big bag attached and not use the leg one at all. Once the catheter is out you should improve quickly. There are some good videos on you tube that helped me prepare for the recovery. Good luck!

Clevelandguy

https://csn.cancer.org/discussion/comment/1714770#Comment_1714770

Hi,

I get my pads at the local supermarket or drug store. Can also do it online at Amazon.

Dave 3+4

kmaly1

thank you for all of the help. So is the catheter painful for everybody?

Rob.Ski

Catheter was more discomfort than painful. After 10 days though, everyone would be happy to get it out. I did mine myself in the shower. Certainly plan for worse but, you may get lucky. I was on a plane 3 weeks later. Only really had incontinence when drinking initially. Now I'm fine. Mild ED, overcome by Vitamin V if I need it.

Best of luck.

Steve1961

https://csn.cancer.org/discussion/comment/1714775#Comment_1714775

thats 5 a day its not oil changers

Steve1961

catheter they make such a big deal about it guy gave me three day bags three night bags told me just to clean it in the morning and at night with Baby white start at the tip and just work down the little 3 inch rubber hose no need to clean the bag no ointment no nothing it went by fast. Yeah it was a drag, but it was really nothing, with the bag on my thigh, emptied it a few times a day the night bagger threw it on the floor

kmaly1

Thank you to everyone - I have been spending a few days in my "denial" phase of cancer riding my horses on the trails around my house, which I understand I will be unable to do for 6 months. Sadly, that is my therapy