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Da Vinci vs. Open Radical Prostatectomy

kevinwise
Posts: 4
Joined: Oct 2009

I am 50 years old and just found out last week that I have PC. Both my father and grandfather had it. My grandfather died of old age where as my dad had PC for almost 25 years before he eventually died from it. My PSA was 2.6 with 10 of the 12 biopsy samples being clean. The other two samples contained 5% and 40% cancer by volume with both of them having a Gleason score of 3+3=6.

Given my family history and my age I am leaning toward a radical prostatectomy. I think it is most important to get the cancer out of my body. This also allows radiation as on option if the cancer should recur later on. However, I am really confused about the pros and cons of an open RP vs. the Da Vinci method. Seems like many of the articles are contradicting, especially around removal of the lymph nodes. Some say the lymph nodes cannot be removed via Da Vinci and others say it can if the doctor is highly skilled. There also doesn't seem to be a great deal of information available about the long term results of the Da Vinci surgery.

I am able to have a normal erection now and would like to have the nerve sparing surgery. Once again, from what I have read so far, it sounds like the open RP allows the doctor more room to work around the nerve bundles. However, the Da Vinci method claims that the doctor can see things better and may be able to get to places that the human hands cannot.

Bottom line, I am very confused. Does anyone have any advice over which method is better? Also, does anyone have any good sources of information to recommend?

Thanks.

GTA
Posts: 4
Joined: Aug 2009

HI KEVIN,

Check the following forum where you can find lots of info. Prostate Cancer is so confusing all the information available leaves a guy boils in his stew, confused and almost helpless. Experts
make so many different statement and put out so many guidance makes a guy thinks he is living in "wonderland". Hopefully someday soon, the expert of the world will come out with a clear guidance on what a guy and his doctor to do instead of leaving a man who just been diagnosed with a deadly disease in a field full of so many mazes with no beginning or end.

I am in the same situation as yours. I consulted with many doctors and every time I came out more confused than the previous one. I am still in the learning and researching stage and have not decided yet. Doctors take them years of studies and experience to master their job, I think you and me need some time to catch up with them.

Do some research and go with you instinct. Good luck and the best of wishes.
GTA

You might need to copy & paste.
http://www.healingwell.com/community/default.aspx?f=35&m=1614725

kevinwise
Posts: 4
Joined: Oct 2009

Looks like we have experienced the same thing. Thanks so much for your advice and especially for the web address. There are lots of good comments on that site.

Good luck to you as well. I will be praying for both of us. Let me know if you find any more information and I will do the same.

txbarton's picture
txbarton
Posts: 89
Joined: Aug 2009

Kevn,

I wrote a long post but the board gremlin ate it.

It seems like if surgery is the option you chose daVinci is preferred, if you are elgible, for several reasons; less pain, less blood loss, less time in the hospital, less recovery time, higher fidelity of the surgery due to increased optics of the robot, fewer complications, higher odds of a return of comtinence and less impotence.

I assume you have seen the daVinci site - http://www.davinciprostatectomy.com/index.aspx. It discusses it and provides a list of certified hospitals and surgeons. To get certified the surgeon has to have approved training and perform a minimum of 20 procedures. If they are not listed on the site they are not certified by the device manufacturer. The learning curve is very high and begins to level off at about 100 procedures. My surgeon was one of the pioneers, limits his practice to daVinci and has performed about 1800 procedures. He is one of the top ten in the world so findng a surgeon who has done "thousands" may require you to travel. The actual surgery (cutting) takes about 1 1/2 to 2 hours but you will be absent for 3 1/2 to 4 hours.

My surgeon's website is - http://www.prostatecenterofaustin.com/. It provides some additional information to include a process from start to finish. It also has a video of the procedure if you can stand to watch it, I couldn't watch more than about 1-2 minutes.

I had my procedure on 7 Oct. Though I have had a few issues there is nothing that makes me regret my decisio of procedure or surgeon. He had to reconstruct the neck of my bladder so my incontinence is not where I would like it to be (I use 2 pads a day) but I am on 100 MG Viagra every other day and am seeing results; though it is not what it was I have had somethign "useable" the last 2-3 times I have taken it as well as a non-Viagra response yesterday.

The more information you have the better armed you are to make the right decision for you.

Good luck,
VB

NM
Posts: 214
Joined: Jul 2009

Hi Kevin you and I are very similar in our age(im52) and my dad also died of prostate cancer. Its a very tough time for you right now.

I chose Davinci over open because of the recovery period is much shorter and the side effects less.

I had surgery on sept 3rd of this month and dont regret it at all. I like you being young worry about the quality of life issues very much.First thing to do in my opinion is remove the cancer and lessen 1 worry.

I was lucky as I have no incontinence at all even while lifting running or anything.Honestly Ed is still a problem but theres hope on the horizon.

For additional info. I would suggest John Hopkins web site and John Hopkins if you havent got a second opinion yet.

On a final note there are no absolutes in life so whatever method of cancer treatment you choose go meet it head on with confidence and my prayers will be with you as also many here will add you to prayer lists.

If you need additional info ask and many here who havent experience all types of treatment will offer their experiences and help.

Nick

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