My Robotic Prostatectomy Experience
Comments
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Too Much Surgery
As I read some of these listings I am under the impression that too many men are in a hurry to get surgery. There is no good evidence that treating prostate cancer at psa readings this low and gleasons on 6 or so does anymore than inconvience the patient. I would never let someone cut on me unless there was good evidence of need.0 -
Too much surgery2ndBase said:Too Much Surgery
As I read some of these listings I am under the impression that too many men are in a hurry to get surgery. There is no good evidence that treating prostate cancer at psa readings this low and gleasons on 6 or so does anymore than inconvience the patient. I would never let someone cut on me unless there was good evidence of need.
Everyone is an individual, so each decision made has to be based on what the individual feels, hears from their doctor, and the mindset they possess to determine how they live with their situation.
There's no rolling the dice here, a person must make the best decision for themselves. Noone has a crystal ball. Some folks are bigger risk takers than others----bottom line individual's decision........ If your 49,like me, loving family, and the Doc said we got it all, did not go outside the prostate--you'll be around another 40 years------then I know I made the right decision---cancer-free.
Again, depends on the individual---when I get that nagging pain in my hip---I'm not thinking a cancer cell got away and the cancer is still in me---this is what works for me.
My perspective.0 -
Too much surgery... ?2ndBase said:Too Much Surgery
As I read some of these listings I am under the impression that too many men are in a hurry to get surgery. There is no good evidence that treating prostate cancer at psa readings this low and gleasons on 6 or so does anymore than inconvience the patient. I would never let someone cut on me unless there was good evidence of need.
I don't think anyone here is in any 'hurry' to have this kind of surgery.
2ndBase- If you've had different treatment, please share your results, both oncological and physical.
If people are posting up, they are doing their due diligence to educate themselves on treatment options and getting personal opinions and experiences.
There is plenty of good evidence that proves surgery is a valuable treatment for low PSA (which isn't a very good indicator of anything), Gleason scores of less than 7 and biopsies that show lower percentage core penetration.
Robotic is the gold standard for nerve sparing treatment, in the hands of a qualified surgeon.
In the end, it's up to the patient to decide whether to leave it in, watch and wait, run the risks and complications of a treatment if the cancer does make its way outside the prostate or is involved in the apex by the time treatment is decided or go ahead and pursue treatment when a biopsy shows a positive result of cancer inside the prostate.
Thing is, no one knows how fast the cancer will spread.
PSA isn't a good indication at all. It's an antigen that is excreted by prostate cells, and rises for many reasons (infections, ejaculation, cancer an sometimes- no reason at all). But it is proven to increase when prostate cells are cancerous.
I opted for the surgery because I understood the NEED. I needed to get it out, while it was still in an early state. Waiting for it to spread outside my prostate, potentially into my lymph nodes and into surrounding tissue or bone, wasn't something I wanted to gamble on. An inconvenience is certainly better than a pine box.0 -
Wasn't in a Hurrywhubbs said:Too much surgery... ?
I don't think anyone here is in any 'hurry' to have this kind of surgery.
2ndBase- If you've had different treatment, please share your results, both oncological and physical.
If people are posting up, they are doing their due diligence to educate themselves on treatment options and getting personal opinions and experiences.
There is plenty of good evidence that proves surgery is a valuable treatment for low PSA (which isn't a very good indicator of anything), Gleason scores of less than 7 and biopsies that show lower percentage core penetration.
Robotic is the gold standard for nerve sparing treatment, in the hands of a qualified surgeon.
In the end, it's up to the patient to decide whether to leave it in, watch and wait, run the risks and complications of a treatment if the cancer does make its way outside the prostate or is involved in the apex by the time treatment is decided or go ahead and pursue treatment when a biopsy shows a positive result of cancer inside the prostate.
Thing is, no one knows how fast the cancer will spread.
PSA isn't a good indication at all. It's an antigen that is excreted by prostate cells, and rises for many reasons (infections, ejaculation, cancer an sometimes- no reason at all). But it is proven to increase when prostate cells are cancerous.
I opted for the surgery because I understood the NEED. I needed to get it out, while it was still in an early state. Waiting for it to spread outside my prostate, potentially into my lymph nodes and into surrounding tissue or bone, wasn't something I wanted to gamble on. An inconvenience is certainly better than a pine box.
I can't say I didn't spend a month or two thinking the whole issue of surgery over before finally setting a date. Actually before I was diagnosed and questions arose concerning my PSA, I was determined to resort to "watchful waiting" as treatment. Once I got the news however the knowledge of what was inside my body and the possibilities of what could happen in the future brought me to the decision to have surgery. Sure I could have lived out my entire life and the cancer never progressed, but as a father and husband and an individual I didn't want to take the chance. It was a personal choice, one that each man has to make for himself. With all of the studies that have been released lately by the NEJOM concerning PSA testing, there has been alot of debate over these issues. As far as the doctors, it infuriates me when I hear them speak of PSA testing and it's overuse. It's easy for them to sit back in their lab coats and their 12:oo o'clock t-time and spout out this information. These are also the specialist who don't take into consideration that small group of men under age 50 that are diagnosed, or men with a family history, or African American men. It's easy to stand at a conferences and spout out the years of lab findings , it's another when you stand at a support group because you have it inside your body, then you're thankful for psa testing. As far as the surgery goes I progressively felt as though I really had no choice in the end. I came to the realization that I'm 40 years old and I have cancer in my body, do I really want to chance living with this for however long my body allows. I had someone point out to me that sometimes PC is slow growing and it may stay encapsulated. (I love that during this time people use words like "sometimes" and "may") So I gave them an analogy. I asked them, if someone found a bomb in your house and told you that "this" bomb sometimes doesn't explode necessarily, but it may one day. Now we can alter your house, and it may be that way the rest of the time you live there, but you won't have to worry about it blowing up. Or, you can just live with the bomb in your house and hope it doesn't explode, if it does, we can't guarantee if you'll make it out. Let's face it guys, we're not talking about anything minor, no matter how low on the scale of dangerous some people want to place prostate cancer you still spell it C-A-N-C-E-R. My wife even yells it now when she hears these debates on tv, "It's still cancer people!" I have no regrets about my surgery,I'm glad I was diagnosed in time that surgery was a hopeful option. It's every man's decision based on his heart and mind, and I support that wholeheartedly.0 -
Wasn't in a HurryOlee said:Wasn't in a Hurry
I can't say I didn't spend a month or two thinking the whole issue of surgery over before finally setting a date. Actually before I was diagnosed and questions arose concerning my PSA, I was determined to resort to "watchful waiting" as treatment. Once I got the news however the knowledge of what was inside my body and the possibilities of what could happen in the future brought me to the decision to have surgery. Sure I could have lived out my entire life and the cancer never progressed, but as a father and husband and an individual I didn't want to take the chance. It was a personal choice, one that each man has to make for himself. With all of the studies that have been released lately by the NEJOM concerning PSA testing, there has been alot of debate over these issues. As far as the doctors, it infuriates me when I hear them speak of PSA testing and it's overuse. It's easy for them to sit back in their lab coats and their 12:oo o'clock t-time and spout out this information. These are also the specialist who don't take into consideration that small group of men under age 50 that are diagnosed, or men with a family history, or African American men. It's easy to stand at a conferences and spout out the years of lab findings , it's another when you stand at a support group because you have it inside your body, then you're thankful for psa testing. As far as the surgery goes I progressively felt as though I really had no choice in the end. I came to the realization that I'm 40 years old and I have cancer in my body, do I really want to chance living with this for however long my body allows. I had someone point out to me that sometimes PC is slow growing and it may stay encapsulated. (I love that during this time people use words like "sometimes" and "may") So I gave them an analogy. I asked them, if someone found a bomb in your house and told you that "this" bomb sometimes doesn't explode necessarily, but it may one day. Now we can alter your house, and it may be that way the rest of the time you live there, but you won't have to worry about it blowing up. Or, you can just live with the bomb in your house and hope it doesn't explode, if it does, we can't guarantee if you'll make it out. Let's face it guys, we're not talking about anything minor, no matter how low on the scale of dangerous some people want to place prostate cancer you still spell it C-A-N-C-E-R. My wife even yells it now when she hears these debates on tv, "It's still cancer people!" I have no regrets about my surgery,I'm glad I was diagnosed in time that surgery was a hopeful option. It's every man's decision based on his heart and mind, and I support that wholeheartedly.
Well said Olee......well said.
Lion10 -
"author author" !!!!!lion1 said:Wasn't in a Hurry
Well said Olee......well said.
Lion1
How well you describe what some of us feel Olee... this is not a rush to surgery. I for one have fought within myself for the answer. But you know what, lightening doesn't strike, the earth doesn't rumble , a voice from heaven doesn't shatter windows. We have to make the educated choice that is right for us and our families. I still wish that "wait and watch" was a viable choice. But I am only 54 and want to have another 30 years with my kids, grandkids, and my wife. I don't feel that the gamble is worth giving up precious time I have left with my family.0 -
Wait?RRMCJIM said:"author author" !!!!!
How well you describe what some of us feel Olee... this is not a rush to surgery. I for one have fought within myself for the answer. But you know what, lightening doesn't strike, the earth doesn't rumble , a voice from heaven doesn't shatter windows. We have to make the educated choice that is right for us and our families. I still wish that "wait and watch" was a viable choice. But I am only 54 and want to have another 30 years with my kids, grandkids, and my wife. I don't feel that the gamble is worth giving up precious time I have left with my family.
Wait and watch? Wait for what?0 -
Diet & suppliments
Has anyone who has been diagnosed with PC, stage 1, middle gleason scores, tried watchful waiting while changing their diet...for example taking Lycopin, seritonin, or you name it...exercise....and found their PSA lowering and/or biopsy turning to negative? I go in for the robotic surgery in May but feel great with no symtons. Its great to have a sharing website with guys in the same boat.
Cheers,
George0 -
Waitgkoper said:Diet & suppliments
Has anyone who has been diagnosed with PC, stage 1, middle gleason scores, tried watchful waiting while changing their diet...for example taking Lycopin, seritonin, or you name it...exercise....and found their PSA lowering and/or biopsy turning to negative? I go in for the robotic surgery in May but feel great with no symtons. Its great to have a sharing website with guys in the same boat.
Cheers,
George
Hi, glad you're feeling good. Yeah, the hardest part is that you go into surgery and you have no pain, you won't come out feeling better, actually worse.
But waiting? Waiting for what? You want to wait until you feel bad? Until you feel like it might be too late? My advice, do it now.0 -
What are your numbers and age?gkoper said:Diet & suppliments
Has anyone who has been diagnosed with PC, stage 1, middle gleason scores, tried watchful waiting while changing their diet...for example taking Lycopin, seritonin, or you name it...exercise....and found their PSA lowering and/or biopsy turning to negative? I go in for the robotic surgery in May but feel great with no symtons. Its great to have a sharing website with guys in the same boat.
Cheers,
George
Two week ago I saw a surgeon to discuss robotic surgery, who recommended Active Waiting as a treatment for me( instead of robotic surgery). Part of the monitoring is annual MRI/MRS and biopsy as well as quarterly psa's. Now I'm going for the MRI/MRS tomorrow which may change my treatment to surgery. I tend to think that surgery is the gold standard.
At a support group that I attended, I bumped into a man who when he was diagnosed decided to do hormone therapy only, I think that he's been doing this for 5-6 yars now. I don't know much about this, but he did mention that he has adverse physical situations, but overall he is happy with his decision. As I understand , people generally do hormone therapy in conjuction with , or treatment for more advanced cases, but it may be worth exploring, if you don't mind having hot flashes, and impotence. I guess you need to speak with a medical oncologist.
Ira
Go0 -
6 Monthshopeful and optimistic said:What are your numbers and age?
Two week ago I saw a surgeon to discuss robotic surgery, who recommended Active Waiting as a treatment for me( instead of robotic surgery). Part of the monitoring is annual MRI/MRS and biopsy as well as quarterly psa's. Now I'm going for the MRI/MRS tomorrow which may change my treatment to surgery. I tend to think that surgery is the gold standard.
At a support group that I attended, I bumped into a man who when he was diagnosed decided to do hormone therapy only, I think that he's been doing this for 5-6 yars now. I don't know much about this, but he did mention that he has adverse physical situations, but overall he is happy with his decision. As I understand , people generally do hormone therapy in conjuction with , or treatment for more advanced cases, but it may be worth exploring, if you don't mind having hot flashes, and impotence. I guess you need to speak with a medical oncologist.
Ira
Go
In response, from what I understand of hormone therapy, if caught early enough, can stop the tumor (not get rid of it) and will result in complete inpotence and physical changes like swollen breasts and other issues. If you decide to go that way, please understand the effects and be sure to be OK with it.
I just had a 6 month PSA check after my robotic. PSA is still Non-detectable!
Feeling good and doc had some suggestions for dealing with mild issues remaining.
Life is good.0 -
Another psa rise
After getting a doubling psa of 3.9 last Nov., I tested stage 1 PC in mid march. Like many of us, I feel great BUT...had my psa done again this week and it now is 5.6. That convinces me surgery is necessary. I have scheduled the Da Vinci for May 21. I am 65 and feel blessed I have been healthly for so long.
Cheers,
George0 -
cystogramgkoper said:crystogram
You had the robotic surgery...did you get a crystogram? If so, what is it like? I am preparing myself for robotic surgery in 3 weeks.
Cheers,
George
Did you mean a cystogram?
No, I did not get one.
In fact, I think they are more used afterwards in the cases of continued incontinence to determine where leaks are occuring.
Good luck on your surgery!0 -
cystogramgkoper said:crystogram
You had the robotic surgery...did you get a crystogram? If so, what is it like? I am preparing myself for robotic surgery in 3 weeks.
Cheers,
George
Did you mean a cystogram?
No, I did not get one.
In fact, I think they are more used afterwards in the cases of continued incontinence to determine where leaks are occuring.
Good luck on your surgery!0 -
Exactly!Paraplu said:Wait?
Wait and watch? Wait for what?
Certainly watch and wait might be the right option for some, and clearly I wouldn't let someone cut on me for no reason. PSA results, (5.0) may not definitively indicate cancer, but I'm thankful I had my biopsy. I had positive cells in 4 of the 12 core samples with a Gleason of 3+3 back in September. I reviewed my options and felt that at 51, I also wanted to be around for awhile. Although I have some faith, I wasn't going to wait for it to get any worse.
I chose to have the DaVinci method, performed by Dr Simon Chung in Northern VA, near DC. That was completed in the middle of February, and I'm even happier that I made the decision that I did. The pathology report indicated positive margins and a bit higher Gleason, 4+3. Had I waited a few years, who knows where I'd be? Plus, who in their proper mind set would want to undergo that biopsy again?! Let me tell anyone who has recently undergone that and found out that they have cancer, the worst may be behind you! The surgery was easier than I could have imagined, the catheter being the main obstacle for a week or so. Continence came back in a few days after catheter removal, and with the help of Cialis, I already have some return to function. I was playing golf by April 1, with no pain at all.
The issue with the positive margins may require some followup, but knowing that there was cancer on the outer extremities of my prostate tells me I needed to get it out of me!0
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