I'm a newbie to PC

zakpaga said:

Dreamer,
You already got
Dreamer,

You already got excellent advice from those who posted before me. I just want to tell you that I am 52 years old and was diagnosed with PCa in January 2010. Please don't stress yourself too much about your new situation. I know it is easier said than done. Educate your self; try to live life at the fullest and do not take any thing for granted. Get closer to your wife. She will be of good support during your new journey.


I wish you all the best.


Victor

chitown said:

Newbie too-need advise on waitime from biopsy to davinci surgery
Got positive biopsy about a month ago. Am 48, fit and healthy. PSA of 2.1 but a papable nodule motivated the biopsy. Gleason at 3:3. Have decided on da vinci. The question is if I can wait 2-3 months to surgery. Or is there a inherent risk to waiting. Doctors are split on this. Also, looking of surgery and post surgery advise and inspiration..Thanks in advance.

jminnj said:

A Little Younger Acutually
Dreamer, I am 47 and was diagnosed in November. I am 2 months post surgery and so far things are going well. You have already been given a lot of great advice from Larry, Randy and the others. These guys really helped me a great deal as I started my own journey.

As Victor said educate yourself, reach out to us if you have specific questions. There are a lot of treatment options out there, don't let anyone sway you into picking a treatment you are not 100% comfortable with; being comfortable with the decision is a huge part of the healing process. Make sure to include your wife in all the discussions as she needs to understand everything you are going through. My e-mail is ghostrdr2112@yahoo.com. If you want to ask me specific questions about my experience with the robotic surgery, let me know.

Take care,
Joe

Kongo said:

2600?
2600 DaVinci surgeries for one surgeon seems almost like a production line. DaVinci was approved by the FDA in 2000. There are roughly 250 days a year (M-F not counting holidays) that are considered "work days." Even if the good doctor is a saint and never takes a vacation, 2600 robotic surgeries would be more than one a day every day for the past ten years, not counting the 400-odd open surgeries Larry indicates he has done. Taking into account office visits and non-surgery work this doctor must do, I just can't imagine how he was able to do that many surgeries. The number seems highly inflated to me.

Kongo said:

2600?
2600 DaVinci surgeries for one surgeon seems almost like a production line. DaVinci was approved by the FDA in 2000. There are roughly 250 days a year (M-F not counting holidays) that are considered "work days." Even if the good doctor is a saint and never takes a vacation, 2600 robotic surgeries would be more than one a day every day for the past ten years, not counting the 400-odd open surgeries Larry indicates he has done. Taking into account office visits and non-surgery work this doctor must do, I just can't imagine how he was able to do that many surgeries. The number seems highly inflated to me.

Kongo said:

Lots of Confusion
There are so many studies, statistics, claims, and whatnot about this disease. I would rather have too much information than not enough but it takes awhile to get your head around it all.

My approach is to get as much information as possible, complie a "rack and stack" matrix where I compare pros, cons, and impact on the quality of life factors that are important to me, and then make the best informed decision I can at the time with input from my wife, family, and doctors I trust.

Haven't finished my research yet but am getting closer.

Good luck as you sort through all this.

randy_in_indy said:

Chitown
Ok, I do not in any way want to scare anyone...but I do have to say something to you that needs to be said. Based on my personal experience with da vinci surgery the wait time after the biopsy is a minimum of 6 weeks according to my surgeon so that complete healing of the prostate from the punctures can take place for several reasons:
1. nothing open on the prostate when they are in there trying to take it out - nothing to ooze or otherwise escape during the removal and be left behind as a positive margin.
2. the swelling from the prostate being punctured in the biopsey so the surgical field will be normal and not stressed in anyway for the removal.

Now, my word of caution when thinking about waiting and again this is coming from my personal case....I waited 70 days from my biopsy or 10 weeks of which was not for any other reason but scheduling and knowing I needed to complete in 2009 to avoid having to come up with a $950 deductable that had already been meet for 2009 and had I choose a date in January I would have had to repay immediately from the surgery.

But the important part here is really none of this but rather the fact...my biopsy was 3+3=6 in all three samples of 8 samples (smaller prostate gland - only 8 samples) with a nodgle on the right side felt in DRE. Post Op pathology put the nodgle less than 1mm....find a metric ruler and 1mm is one tenth of a centimeter which is on rulers....VERY VERY tiny....well that nodgle was less than 1mm from breaking through the prostate gland. Additionally, my gleason changed to 3+4=7 not the biopsy 3+3=6.


So my advice...find someone who is good at reading MRI with Coil or spectroscopy-preferred but more rare...and have that test done to try and determine first if you have a tumor/nodgle and second see if it's broken through the prostate. Then based on that information you may be better equiped with making a decision on the date to plan whatever treatment choice you are going with. In retrospect for myself I feel if I had waited much longer I might be dealing with positive margins and further treatment.

Now in your case you have all samples with cancerous cells from the biopsy...IF you were me....I would look for more testing to determine a. if you had a nodgle/tumor...if it looked close to escaping the prostate outer capsle. Now that is if you were me...I would be doing that...now you are not me...but that is what I would do.....everyone has to make up their own minds about what treatment, tests, healthcare choices you seek or do.

Hope I helped. Here is my stats and path

52 years old
PSA 9/09 7.25
PSA 10/09 6.125
Diagnosis confirmed Oct 27, 2009
8 Needle Biopsy = 5 clear , 3 postive
<20%, 10%, 10%
Gleason Score (3+3) 6 in all positive cores
11/09 Second Opinion on Biopsy slides from Dr. Koch
(4+3) = 7 5%
(3+4) = 7 10%
(3+4) = 7 10%
Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
da Vinci 12/29/09 - Dr. Hollensbee & Scott
Post Surgery Pathology:
Prostate size 5 x 4 x 3.5 cm Weight: 27 g
Gleason: Changed to (3+4) = 7
Primary Pattern 3, 80%
Secondary Pattern 4, 18%
Tertiary Pattern 5, 2%
Tumor Quantitation:
Greatest Dimension, Largest tumor focus: 19 mm
Additional Dimension 18 x 15 mm
Location, largest tumor focus: Right posterior quadrant
Multifocality: Yes
Greatest dimension second largest focus 10 mm
Location: second largest focus: Left Posterior quadrant
Extraprostatic extension: Yes
If yes, focal or non-focal: Nonfocal
If yes: location(s) right and left antero-lateral
Seminal vesicle invasion: No
Cancer at surgical margin: No
If no, closest distance with location: less than 1 mm, right posterior quadrant
Apex involvement: No
Bladder involvement: NO
Lymph-vascular invasion: No
Perineural invasion: Yes
Lymph nodes: 9 from right pelvic 0/9 positive
Stage: pT3a, pNo, pMX
All nerves sparred - found two additional pudendal arteries

FIRST PSA TEST 2-11-10 <0.1 NONDETECTABLE


Randy in indy</p>