Robotic surgery problems arising from internal abdominal scar tissue

JDS73

I have a recent diagnosis of prostate cancer, psa 5.74, Gleason 4+3=7, 2.2 cm in size, located in lower right half of prostate. Cribriform glands present, nerves not involved. I am 73 years old, active and otherwise healthy. Doctors have ruled out HIFU treatment, due to no safe margins near rectum. Options are proton beam or surgery. PET scan is scheduled for end of June, and still awaiting results of other tests. I'm presently leaning toward surgery, but had abdominal surgery in the past that left scar tissue, which is a concern to my surgeon. So I'm thinking of trying the robotic surgery first, and if the scar tissue presents a problem, then finishing the procedure with traditional open surgery. Is there anyone out there who has any knowledge/experience with this problem?

Steve1961

first of all inthonk you’re doing the right thing I was in the same boat as you you almost exactly Cribi form. I did external beam radiation with breakytherapy and now I’m now being told they’re finding out that cribiform is radiation resistant unfortunately it didn’t kill all the cancer so I had major scar tissue from the radiation and I just had salvage robotic surgery and went extremely well except that I am in a leaking quite a bit during the day which is to be expected other than that surgery went without a hitch I was up and walking in a few hours it was a little bit rough. Thought it was going be worse than that. I had some scar tissue built up inside my penis which I’m going have dealt with, but I would definitely go that route surgery for sure. I would find a surgeon that has done over 3000 of them by with you.

Stewartc

In 2020 I had a pas of 1.2 and before that 1. And .4 but about 2021 I always had to pee like right away. I figure abot 4 oz I'm 70 now my doctor said you have a swollen prostate In November of 2023 complained about peeing all the time and had to go not much warning I told him I should get a psa. It was 3.4 I then new I had a problem. Only because of the jump. It was time to see a specialist. Called pen first appointment February 24th. I was going to Florida for the part of the winter so I called Cleveland Clinic in Florida 30 minutes away gave me an appointment for December 14 grate when I saw the urologist he said you have a PSA of 3.4 that's in range for your age so why are you here I said the jump. He checked the prostate and felt something an said I need a biopsy ok can you give me another PSA he said yes. January did biopsy PSA now 4.3 report I'm now a Gleason 7 cancer in half my prostate long story short talk to different doctors ended up going to Cleveland Clinic in Ohio Dr Stein who did thousands of robotic surgeries I didn't do radiation because I was already having problems with urinary and radiation most likely would have made it worse pet scan is showing a spot on my sternum and they could be a spot on outer wall of prostate after surgery I have another pet scan scheduled so here I go. If anybody has any questions about any of it I'm more than willing to share my experiences

Clevelandguy

Hi,

You might want to look into Proton therapy as to it’s effectiveness on Cribiform. Proton therapy is proton based, others like Cyberknife are xray based.

Dave 3+4

jc5549

Hello JDS73,

The degree of scarring varies by the extent of prior abdominal surgery. You should discuss your case in depth with your Urologist and gauge their comfort with your case (meaning your body type, prior extent of surgery,…). If you don’t feel he/she is comfortable consider a second opinion.
Prior abdominal surgery is not uncommon in us guys. If you have had larger hernia repairs, have a large amount of mesh, or had extensive prior surgery like that after a trauma or complicated diverticulitis then it could be that Proton or other therapy that is non-surgical is best for you. I hope this helps and good luck.

jc

Old Salt

Ask for a second opinion from a well-respected specialist on the surgery (prior scar) issue.