I am a wife and new here- sooo many questions!

Hi everyone I hope you can help me. My husband was given a gleason scale of 3 out of 6 being Gleason score of 8 and 9. The other 3 were 5-7. He just turned 64, his PSA was 6.3.

Dr wants to do radical pros.  my husband really is not happy about the idea of beint cut open to that extent. He wants DeVinchi surgery and believes this will have less side effects and is just as effective.

My concern is that my insurance covers all of the radical less a $500 deductible, otherwise it is a 40 mile commute, and maybe will cover 20%.

I trust the doctors in our area, I am a surgical nurse.

Am I being unreasonable???

He is considering waiting another year until medicare kicks in! I think this is a gamble!

Thanks for your help!

ML

Thanks for your quick reply and thoughts! I called my husband and hopefully he will join this wonderful resourse! His DRE was positive for hardness. His prostate is not enlarged, no symptoms at all. During the biopsy the Dr pointed out the "dark spot". This is all in the Left side, Right biopsies were neg. CT and Bone Scan were neg. As the Dr said, this a "good window of opportunity" to treat this!
He has always been well and this is a shock for all of us. The DaVinci is an out of network facility. about 40 miles south of Ft Myers, Fl. Any thoughts about the rate of success of DaVinci vs open related to the Gleason score?? After reading a few postings I am especially concerned about his gleason score. I agree about the waiting thing, that really scares me!! He was hoping the Lupron will hold him.
YIKES!
ML

ML,

Is there a good surgeon who does a lap procedure in your area? This would be the next best thing to having a robotic asssisted lap. Surgery is definately his choice? Forget the money (if possible). Get him healthy and ready for that retirement party no matter what his choice!! The only decision he may wind up regretting is waiting another year. Personal opinion, not fact.

Good Luck,
swim

I agree with Mike. I think attitude is a HUGE part of the process. Hopefully, you can find a great surgeon in your insurance network that will cover the Davinci. I can't imagine that you won't be able to find a number of good surgeons that are covered. If for some odd reason that you can't, you could always make an appeal to your insurance. While the cost for the Davinci might be a little more for the actual surgery portion, the overall costs vs the open are similar, if not less. (One night stay in the hospital vs. 3). Just my opinion :) Good luck and keep us posted!

Doting

Hey ML,

The skill and experience of the surgeon seem to be more important than whether open or DaVinci surgery is used. I had open surgery, was in the hospital 2 nights, had the catheter in for 6 days and was fully continent the day after the catheter came out and both nerve bundles were spared.

Good luck and please stay with us...

Jim

Welcome to the forum.  I, too, was nervously leary of the prospect of an open surgery, but it was, in fact, not that big a deal.  The daVinci procedure is newer and effective with a faster recovery.

The most important consideration, with a positive DRE and a higher Gleason number, is to treat the cancer as soon as possible.  Waiting a year is Russian roulette.

I would suggest discussing your options--open surgery vs. daVinci--with the insurance provider.  Most will cover either procedure, but may require pre-authorization.  I'd keep pressing them on this if your husband wants to do daVinci robotic.

Hope you will continue to stay with us here and keep posting.  There are some wonderful, warm people on this forum and lots of solid, helpful information for you related to prostate cancer.

Take care and hang in there...Tim

Welcome to this very informative and helpful forum.  With the higher Gleason and something felt on the DRE, I would suggest a color doppler which will show the location and extent of the tumor and this info can be used as a tool for a treatment decision. Best wishes.

Dutch   

I am reading all your postings to my husband and it is a comfort to him as well as myself! The nurse still has not called back from the DeVinci people in Naples today. We both left requests to call us. Makes you wonder......Still will consider but I think Bill is becoming more comfortable with the open because of your postings and also the Dr has a lot of experience. I have personally cared for many of his patients as a surgical progressive care nurse and I have always been impressed with the concern for the patients from all the Dr's in this group. My husband sees me as his wife, not as a nurse. Tough for me to remember this.
Still hoping Bill chimes in.....I am glad you all will be around for us!
ML
PS will work on posting his info.

Greetings, ML and Bill.  As others here have indicated the skill of your surgeon is the most important factor.  My surgeon is known for the open procedure and he did a great job.  I was only in the hospital 2 nights and had the catheter for a total of 9 days.  My surgery was on Feb 4 - just over 4 weeks ago.  I wore pads for about 2 or 3 days after the catheter came out but soon realized that I wasn't dripping much at all.  I gave up the pads 3 days after the catheter was out and have done fine in the couple of weeks since then. 

I, too, am married to a nurse and she has taken wonderful care of me.  I went back to work part time at 3 weeks and plan to go to full time next week (5 week point).  I worked all day today and did fine although was a little tired when I got home. 

With gleason scores of 8 and 9 I would encourage you to consider your options and make a decision quickly.  I am grateful that mine was caught early and from all indications my surgeon got it all.  My gleason was a 6 at biopsy time and was upgraded to 7 with the pathology report. 

You have found a great place for help - everyone has been great to us.  We look forward to reciprocating and providing encouragement where we can.  We'll be praying for you as you make decisions and for a rapid recovery and full healing.  David

Hi dlbsm

I also have a GS 9 with all 6 of 6 left side samples containing cancer and 2 of 6 on the right side. My biopsy was done 1/10/08 and my urologist stage me T1C.  I first went to MD Anderson and found they will not do surgery or proton therapy on a GS 9. Bone scan, CT of chest and Pelvic were negative. They recommended Hormone therapy and Radiation.  My doctor said surgery was not out of line if I could find a surgeon who felt surgery was not a risk based on past medical history.  I consulted a very experience DaVinci surgeon in Texas and he discouraged me from considering surgery.  I finally settled on no surgery and trying  the University of Florida Proton Therapy Institute (Jacksonville, FL) for Proton Radiation.  They sent me a packet and I mailed off all my information to include path reports, films, and CD last Friday and received a call today with an Appointment next Thursday the 13th of March. 

I know Medicare covers proton treatment. I don't know about other insurance but you might call there intake coordinator at 904-588-1280.

I guess all I can add is that you and your husband  have to do your research and do what ya'll feel is the best option.   I would not wait and if necessary I would take my fight to the insurance company. 

We will keep ya'll in our prayers

Great that you have decided on a treatment. I had the DiVinci on August 14 07 and things went well, however you never know if the DiVinci will be performed as there is always the possibility of converting to open surgery after the operation starts. Usually most Surgeons like to wait 7 to 8 weeks after the biopsies before surgery to allow inflammation and swelling to reside. Just a couple of notes to make the trip easier for your husband, get a rubber donut not the plastic air filled kind for his trip home and a few days after. I got one of the air units and it was not comfortable at any pressure. I took it back and got the 18 inch sponge rubber unit with removable cloth washable cover, cost $9.96 I used it on a 3000 mile trip just shortly after the surgery. No problems. The surgeon will recommend stool softeners. A good one is Ducolax about $10 for 25 or you can get a generic for about $6. One other item if you are very far from home you might want to reserve a hotel room for a day or so after the surgery. I had to travel a long distance by car for my surgery and another day near the hospital was fine although it wasn't mandatory. Good attitudes and TLC will make a new man of your husband. God Bless, Uncle Dan

HI. We are all glad you came to this site. As for me I had open surgery, spent two nights in the hospital(Duke University), had no blood loss that required replacement. No pain meds after leaving the hospital, not even for the 4 hour car ride back hom. My broken arm from 06 was a thousand percent more painful and spent 8 weeks in rehab. Stayed out of work 6 weeks because my wife said so. And continent within two months. I would not wait a year. It may not be safe to do. I know there are others who had treatments beside surgery, but as for me, I wanted the cancer out of me as soon as I could get it out. I am almost back to normal even with the ED thing, having surgery on May 30 of 2007. Take care, make your decision, don't look back and think positive thoughts about all this. Take care.

Mika

Hey Billy and ML,

You have made your treatment decision, now don't look back. Become a cheer leader for you surgical team. Remember that the only two things you can take into the OR are your naked body and a great attitude. Your recovery from surgery will be greatly aided by your confidence in your surgeon and your expectation of a great post-op path report.

Our thoughts and prayers are with you, please stay with us. We can all get well together...

Jim