Surgery Question

I am 2 months post diagnosis. G6 in 3 cores, max 15% so am on AS and Proscar until my next appointment in two weeks. My prostate size was 137 so I am may not be a candidate for seeds which is my first inclination. Will get appointment with radiation oncologist to discuss radiation options.

My urologists does robotic surgery but says I may not be a candidate as I am 66 with history of heart condition. He says the robotic surgery is 4 hours vs two for open and that robotic puts more pressure on the heart as the patient is "almost standing on his head". For those that had RP, does that sound right?

4/12 psa 4.0
4/13 psa 4.35
9/13 psa 4.7
12/13 biopsy

I'm lying in the hospital right now, and I'll vouch for the inversion, my surgeon told me 30 degrees nose down. I'm 20hrs post op and no swelling of the face. I would think that if your Doctor is uncomfortable doing the RALP you should also. Like Inch states they are both good procedures, it's the surgeon that makes the difference. Wish you well! Cheers, Doug.

I don't know about robotic surgery, but I had open surgery and it isn't that bad. I chose a surgeon who preferred open and I ended up going with his preference.

I was thinking I wanted the robot too. When I talked to an oncologist to get an unbiased opinion, he said, "in a year you won't care that it took an extra week to recover." He was right. You might think about this in that context.

Good luck, whatever you decide.

My surgeon has done more Da Vinci's than anyone, currently over 6,000. I asked him how long did the surgery take and he looked at his notes and said he was with me for 90 minutes. But he has a team prepping the patient and finishing up so it was probably longer than 90 minutes. He also told me that they tilted the table but not very much. That is to move some of your organs out of the way for surgery. I had no side effects from the inversion position. I know he did 7 surgeries the day he did mine because I met everyone later so I do not believe it took 4 hours for each.

Your case is different, you have a large prostate and heart problems, All that needs to be considered. I don't believe your age is a factor at all unless you wait a few more years.

If you have surgery, find the best surgeon that you can. There are no do overs. If you have to travel to find the best, so be it. I was lucky, my surgeon practices here in Florida.

Remember, ALL treatment options have side effects. Pick what is best for you and don't look back once you decide.

Good luck

Bill from Florida

Shiny, why can't you stay on AS? Your PSA level seems okay given your age when coupled with your G6.

Surgery went great for me and I did not have those issues, but at your age I would have spent more time considering BT.

I've seen the BT crowd here respond in the past about folks with large prostates who were told they couldn't have BT. As I recall, they seemed to dispel that notion. Perhaps one will chime in shortly.

jacknsan said...
Shiny, I could be wrong, but my brachytherapist, who has done thousands of HDR procedures said he does prostates of all sizes. You may want to look into it as it is much less invasive than surgery. IMRT is even less invasive that BT.

However, if I were you, with a GL6, I would stay on AS. The Proscar should eventually shrink the size of the prostate in the event you wanted treatment down the road if your PSA climbed too quickly. Avodart, I believe, is even more effective. You may want to look at Dr. Snuffy Myers work. He has had patients with GL6 on AS taking Avodart along with a good diet, and, a year or so later, they can find no cancer.

It sure beats the stress of surgery and the possibility of having to spend the rest of your golden years in diapers. In any case, you should discuss it further with your doctor.

Shiny, all very good points there! When I was trying to make my decision, I talked with the Brachy/EBR guys in Atlanta. I had a large prostate- 87 gms- and they indicated before they could do the Brachy they would give me enough hormones to shrink it down 1st.

I would really look into all of that if I was you, with that Gleason 6.
Bill

I had open,1 nerve spared, surgery. It was 4 1/2 hours long, hospital stay 52 hours, one 4-5" scar. The length was probably due to teaching the students how to dissect 27 lymph nodes, not to due to criticality of diagnosis, as U of W had me @ 3+4 up from local path of 3+3. Final post op path was 4+3 tert5 ,gl9. Added to that was prattdrain in for 5weeks, followed by 2 golfball size lymphoceles 2 mos postop, self resolve after 3weeks of low grade fever and malaise. Oh and an absolute mystical recovery in a campus apt, with my spouse and our youngest son. Only downer was an emotional meltdown from too much morphine drip on my second nite. Old hippies never die, they,... well you know the rest! psa <.1 14 mos ago. Not sure when, if ever, I will ck psa again. Leaning to when symptomatic, if that should occur. The way I look at it, why screw with my quality of life till I have to. Time is a human invention anyway, from my perspective. Im ready anytime and actually am looking forward to the adventure, you know, space, the final frontier. Live long and... er never mind.