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Posted 3/23/2010 8:09 PM (GMT 0)
Greetings from the sunshine state

I've been cruising the forum for a few weeks since my husband's lastest psa-4.7, free 8.  He's 56, very active, doesn't smoke ect. ect. Last Wed. we got the biopsy report-pc, gleeson 6.  Fortunately, I had been reading posts here so I knew what to expect from the talk with the doctor and what questions to ask.  My husband urologist is 2 years younger than my husband and when I asked him what he would do in my husband's shoes, he said he may be someday and if he were my husband's age he would have DaVinci surgery.  From the research I've been doing I agree, as does my husband but I have to admit it's scary for both of us.  Not so much the surgery as the after effects and being tied to having psa tests every few months looking for more cancer-seems a cruel sentence.  We hope to go cruising next year on our sailboat-have no intention of letting this stop us, but are we being realistic? Also, our doctor recommended 3 doctors , but particularly Dr. Vipul Patil; global Robatic Inst. Orlando-does anyone out there have any experience with him?

Thanks for listening

Posted 3/23/2010 8:18 PM (GMT 0)
Welcome to the site...

Once you reach a certain age - looking for cancer becomes part of lifecool

I'd imagine at this point going sailing next year would be fine....Heck - odds are you could do surgery after that.

Posted 3/23/2010 8:24 PM (GMT 0)
Hi 47........sorry you have to be here, but glad you found us

I believe there are several guys on this forum who have had surgery by Dr. Patel, and they will chime in over time. Your husband is my age, and the stats and similarities are in line. I'm up here in the mid-atlantic region, but as others will tell you, the experience of the surgeon, or brachytherapist, or whatever mode of treatment you decide on will be the most important factor. You shouldn't think that your life will be put on hold after treatment necessarily. Immediately after, perhaps, but depending on when you have treatment, next year's sailing should stay on your calendar. Others will also tell you that you have time to make an informed and well researched decision about how to treat this. The good news is, there are many ways to treat this---the bad news is, there are many ways to treat this. And you have to make that choice--------but we'll help guide you, so stick around, ask any/all questions, and hopefully you will be guided on the right path for you.

Arnie in DE

Posted 3/23/2010 8:31 PM (GMT 0)
Welcome to HW, glad you decided to join us. When you get a chance, make a signature of your husbands stats at the bottom of your posts, makes it easier for us to follow what is going on.

We have several here from Florida, including Sonny who is in the Orlando area.

Please keep us posted, and keep hope, as you find more answers, and learn more ,as you are doing, some of that initial fear will go away, and you will be able to think clearer about the situation.

I love sailing too, what do you have for a boat?

David in SC
Posted 3/23/2010 8:32 PM (GMT 0)
I don't know anything about him, but I did a search (Google "Dr. Vipul Patil orlando") and found these:

http://www.globalroboticsinstitute.com/en/urology-robotic-prostatectomy/why-dr-patel

http://www.healthgrades.com/directory_search/physician/profiles/dr-md-reports/Dr-Vipul-Patel-MD-C54E3D2E.cfm

This is what we did when my wife was looking for a gynecologic oncologist after her ovarian cancer diagnosis last year. You should be able to find some patient reviews.
Posted 3/23/2010 8:38 PM (GMT 0)
Welcome...unfortunately you are here....I felt the same way 6 months ago with similar #'s that you have. Since then I have had a Biopsy seen
my surgeon in Dec had open surgery Feb 24th and received the news just yesterday that I am Cancer free...I feel great with very little incontinence and ready to start the next chapter of my life and feeling better physically and mentally than I did before this all happened.
This is not a death sentence by any means just a little blip of life....Educate yourself with your options and the most important thing I believe no matter which type of surgery you have is the experience of the surgeon. I am from Canada and had Dr. Chin in London Ont. and I owe everything to him....good luck....Healing well will help you with a lot the information you need.....good luck.....
Posted 3/23/2010 8:40 PM (GMT 0)
Dr. Patel is well regarded and has done MANY of these surgeries.

Don't cancel the sailing!

My dad died of this disease (the overwhelming majority don't die, but he had an agressive case and it was caught too late). But one thing he did really well was not waste a single day. Indeed, after he was diagnosed, he was even more focused on using every day well. Don't put life on hold. Get the surgery (or whatever), and then get out there on the boat.
Posted 3/23/2010 8:43 PM (GMT 0)
Welcome to the Forum. Sorry you're here but glad you came.. smilewinkgrin
Posted 3/23/2010 9:08 PM (GMT 0)
I think most of remember the feelings that run through your mind when the doctor tells you these things. I am glad you had some exposure to HW before the biopsy came back.

You guys have lots of options. Surgery is a very commonly used option, but for a Gleason 6, you may be able to pick a less invasive option such as Brachytherapy that will make your sailing date even more certain. The side effects of surgery can be very annoying.

As advised by others, take your time and learn all you can. There is no hurry, and once you take an option, it is kind of permanent.

Second opinions are advisable too, even another reading of the biopsy slides.

Welcome to HW. No question is considered unaskable on this site.

Good luck on your PC voyage, and your nautical one as well.
Posted 3/23/2010 9:23 PM (GMT 0)
Dear rhb:

Welcome to our forum, but I'm sorry you have to be here.  You will find that this is an excellent place for both information and support.  As David (Purgatory) said, it would be helpful if you would post a more complete set of hubby's stats so that we have a better picture of what you are facing.

Having said that, with a G6 you likely have some time to make an informed decision.  And, 1 week post diagnosis is WAY too soon to be settling on an option.  And, as goodlife said, you very likely have multiple options and you should research them all.  Surgery is a BIG DEAL with life changing side effects.  My advice is that you talk with a radiation oncologist, a prostate oncologist and maybe a urology practice that has experience with AS (depending on your husbands stats).  As long as you are in Florida, I would recommend a trip to the Dattoli Cancer center. http://www.dattoli.com/

They specialize in less invasive treatment and have high success rates.

If brachytherapy is of interest, please feel free to read my "journey" via the link in my signature and I, along with a few others here who are "seeded" will be glad to give you our biased opinions based on our personal successes with that treatment.

Best of luck,

Tudpock

 

Posted 3/24/2010 12:30 PM (GMT 0)
Thanks so much to all of you who responded to my post-your words of encouragement and advice are really going to be helpful to me and my husband going thru this adventure. We go back to the doctor next wed(31st). He wanted us to take a couple of weeks to digest the news and read Dr. Sheldon Marks book and study up on our options. We are doing surprisingly well mainly because we are very happy and optimistic people. I will post his stats next week when I get a copy from the doctor. Once again, thanks all. And to Dave in SC, we have a 34' steel boat built in Europe in 2003 -we love it but it's true-'Rust never sleeps!"
Posted 3/24/2010 3:34 PM (GMT 0)
TO rhb47:
I wanted to let you know that my 57 yr old husband had divinci done by Dr. Vipul Patel 90 days ago, and it was a very positive experience. He was Gleason 7 with a 100 gm prostate. He is completely leakfree and pad free. The surgeon was not able to spare one side of a nerve due to perineural invasion, but his ED was due to 2 years of Finasteride and Uroxital. He had a very easy recovery. The Robotic Institute is very specialized and adapted to Dr. Patel. They are a very professional office, but very personal. Your initial visit may take 3-4 hours for them to evaluate and educate you to help you make the right decision for you. The wait time after deciding on surgery is usually 90 days. Prostate cancer is usually slow growing, and this gives you time to heal from your biopsy and to get your general health in order. They are an Adventist Hospital in Celebration, but there is no religious agenda or pressure. The best place to stay post-op is Mona Lisa Suites because it is next to the hospital and they provide 24 hour shuttle to the hospital and have ample of walking space. You will be discharged the morning after your surgery, but will want to stay in town for a few days in case you have catheter problems. My husband had a fever the first night in the hotel, and the response from Dr. Patel's office was immediate, and I was able to reach the actual doctor within minutes. Read past posts, especially "Things I did not know before having PCa" This site helped me immensely in all the details to help my husband recover. He post-op PSA is <.01 - nondetectable!!! We had Avmed insurance and all we had to pay of the $50,000 bill was our tiny deductible - all pre-op visits and second opinions, post-op visits, all hospital costs and medications sent home, and all cystograms were all covered. We have been very pleased. Our local urologist only did open surgery and said he would recommend the divinci to anyone due to the ease of recovery - he is too old to learn all the skills of the robot. If you decide surgery, be SURE to DRINK and WALK as you KEGEL.

Sonny:
You have been so helpful to us over the last 5 months - you probably will not ever know the extent of your influence on so many people just by your information and encouragement. I will be praying for you as to your decisions with the new PSA numbers. Keep up the fight!!

I do not know how to add the signature at the bottom!
Posted 3/24/2010 7:45 PM (GMT 0)
Mom38

Thanks so much for your info about Dr. Patel-my husband's urologist suggested him and we have checked out the website for Global Robotics.  Having to have surgery or threatment is very hard for my husband because he is very healthy, not overweight , exercises every day ect. We have a great diet-lots of fruits veggies ect.  Anyway, your message and advice has already made me feel better and I will have my husband read it and all the other messages.  Glad to hear that your husbans's numbers are un-detectable and that he is doing so well.  Thanks again for taking the time to help. 

Posted 3/24/2010 8:59 PM (GMT 0)
Don't rush just yet for surgery. Go up to the links at the top of the topics list, find some good books and read. Your husband's low PSA and Gleason of 6 would generally indicate that you had lots of treatment choices and lots of time to choose. Seeds might be especially attractive. If you could post more detail of your husband's biopsy report -- number of cores, number of positive cores, %cancer, if would help in comparing his situation with that of others

I am afraid that whatever your choice of treatment, your husband is going to spend the rest of his life with regular PSA tests and the opportunity to worry about them.
Posted 3/25/2010 12:58 AM (GMT 0)
Hi Rhb47,

It sounds like you're at the stage that my husband (age 65 at diagnosis) and I were in this time last year.  Hubby had a gleason 6 with 2 positive cores and a small palpable nodule.  In addition to our local urologist, we consulted with the head of GU oncology at Moffitt Cancer Center in Tampa and with a nearby radiation oncology group that could provide seeds or CyberKnife procedures. 

All along the way we were told that his cancer was small and slow growing, and that we could take our time (up to 5 years) to decide upon a course of treatment.  After seeds and the CyberKnife treatment were ruled out due to his "unique" anatomy (born with only 1 kidney and a large bladder diverticulum), he decided to have surgery.  His local urologist recommended Dr. Patel at the Global Robotics Institute.  Hubby had his robotic radical prostatectomy in November of last year.  The good news was that he did very well and regained his continence almost as soon as his catheter was removed.  The bad news is that his cancer turned out to be much worse than everyone had believed - Gleason 5+3=8, positive margins, extraprostatic extension, perineural invasion. 

Dr. Patel and his staff have been absolutely wonderful.  The care at both his office and the hospital has been outstanding.  I'm a retired nurse and kept an eagle eye on everything that was said and done to him throughout our journey up to this point, and I can only echo the remarks made by a previous poster about her and her husband's experience.

Dr. Patel spends time with us, talks to us in terms we can understand, is honest and up front about the possibility of a recurrance due to the aggressive nature of hubby's cancer.  We've had two followup visits so far at 6 weeks and 3 months post-op, and so far his PSA's have been undetectable!  We go back again in June for another check.  Dr. Patel told us that if the PSA goes up at all, hubby will need to have radiation therapy, and also that there is a good chance that it will.  We're learning to live from PSA test to PSA test, and it will be that way for years to come. 

Best wishes to you both as you begin this journey!

Posted 3/25/2010 1:05 AM (GMT 0)
Welcome to the Forum, 47. Lots of good info here and lots of caring guys who have been down the road your about to travel. I couldn't have made the journey sanely without this bunch. Take your time. Check out the options, and don't look back. I didn't. good luck
Posted 3/26/2010 6:11 AM (GMT 0)
rhb47,

Dr. Patel was my robotic surgeon back when he was at OSUMC. Although I can't comment about the Global Robotics Institute, I can say that I was extremely pleased with the staff and the surgical outcome. In fact, I do not see how it could have possibly been any better. I was only 44 at the time and in excellent health, so this certainly helped with my recovery. Dr. Patel is one of a handful of surgeons that consistently come up as being at the very top of their profession.

CaPCa
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