2nd RO evaluation tomorrow

Glad you are being diligent with your research. You will come to a decision and things will slow down for you. It seemed to me that after I finally had a plan in place and we started forward with it I felt a little more at ease.
Keep posting and asking questions.

Battle on brother!

The Artistic One - Mark

Well Halbert I guess I would say that it has something to do with reading Dr. Walsh's book and the way he described actually handling and feeling the prostate and surrounding tissues as he was operating. That dovetails into a reason why I could very easily have surgery instead of any RT. I like the idea of being able to do Pathology on the entire Prostate post surgery. I like the idea of being able to say "all of the margins were clear". To be able to do and say those things it seems that it requires a real "hands on" by the surgeon.
Granted with RALP they will do Pathology post surgery but the reliance is on visual by the surgeon where with open surgery it is visual and tactile both. Thus I feel a greater chance that the margins will be clear.
For me to do either style of surgery or any of the styles of RT will still require that I feel I have a great "practitioner", that is what will finally decide me on a course of action.

Artist: Thanks for the pat on the back and the boost forward.

May you both be well.

Roger

Considering that Karma is a major part of my Spirituality, the way I deal with this situation is more important than the PC or even the outcome. I don't believe in accidents so therefore I must believe that in "ALL" things there is a reason. In my humble opinion, by dealing with a situation well allows for the release of that situation and therefore ensures one will never have to deal with that type of thing again.

Be well
Roger

I seriously considered the open over the robot myself. that robot was no cakewalk (for me) I woke up in a lot of pain in my anus. My abdomen was one big bruise....car wreck bruise...as in traumatized bruised.

being blown up like the Michelin man...with a hernia to boot....

"less invasive", to my feeble mind, it is not.

Good luck....

Another jack wouldn't hurt either....

As far as open vs. RALP, my initial Urologist (who only did open) said "it's a deep dark hole" accessing the prostate. I strongly believe RALP is by a long shot the preferred surgical method assuming you have a very experienced console operator/surgeon. Also open procedure patients usually spend two or three days in the hospital and RALP patients only one or two days.

However I think studies indicate with an experienced surgeon, either open or closed will have similar results - outcome depends on the surgeon.

I'm totally with you about pathology of the prostate - I also wanted to know the 'full' story of how invasive the cancer was. Based on the pathology of my prostate, I could have been done with treatment but with a positive node, that moved me into a higher risk category and I needed the 'triple-play' of Lupron and SRT.

I had Davinci 31 days ago. When researching, having ruled out radiation, my choices were open vs Robot. So...when considering surgery you want a surgeon who is not too young, not too old. I found two who had experience doing 4000 robotic operations.

As you mentioned, I liked the idea that they could take the removed prostate and tell me if they "got it all", which they did. However, I have not had my 6 week PSA test yet, which will really tell us if they got it all by having low lab numbers. I will say that the longer you are on this forum you will see that the guys who had negative margins after surgery, years later their numbers can creep up, so it's not a one and done type of thing.

Also, very importantly, Walsh's book is just a start. It is now old. And Dr. Walsh is of the older generation of PC surgeons, the prefer open to robotic. The younger generation prefers robots. Did you know that the robotic surgeon can sneeze or cough while he's doing it? They can also see much more whereas open is very bloody and hard for them to see what they're doing. So if you do choose surgery, I'd suggest robots and someone not too young, not too old.

Nick

Well I did the RO last monday and it looks like RT is off the board for me. Either I don't qualify ( prostate size ) or I don't want the treatment. 8-10 weeks, RT SE's and/or HT.

So I have decided !!!! It will be surgery. open or RALP is still the question but as I have an appt with DR. Ellis at UWMC Seattle next week and he is a Major RALP Dr. That is probably what will happen.

Thanks for the help ya'll up to this point.