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Posted 2/7/2007 10:06 PM (GMT 0)

I posted something earlier, but I thought it would be helpful to pull things together.  I was referred by my doc to a urologist to examine a small prostate growth and moving psa number.  My first doctor was rather negative, but I found a competent Doc who knew how to listen.  Biopsy showed a Gleason 4=4=8 and a grade T2A.  After much discussion my wife and I decided that the DaVinci surgery would be our choice.  confused I am 65, but despite aches and pains I am pretty fit for my age. 

It seems everything takes a long time in the treatment of prostate cancer.  I went from June 2006 to January 2007 before I finally rolled into the operating room. Today I am just over three weeks out of surgery and I find this forum to be very very helpful in my time of recovery. I still don't understand all of the implications and numbers and grades and scores... (I'm not sure I have everything correct in signature..even) but my Doc says everything looks pretty good.  All cancer contained and removed.  Left side nerves left intact. and now the realities of getting well again.

I got my Foley catheter out after 8 days, so I guess it has been out for about two weeks.  I had prescheduled appointments with a physical therapist. He really helped. I still drip now and then but I haven't needed a pad in three days.  I might still wear one as a confidence precaution for a while when meeting my public.  I haven't seen anything resembling an erection, but I just want to get everything else functioning before I start working on that...(so to speak).  yeah

I posted something else on the "chronic pain" forum.  My aches and pains somewhat complicate my recovery, but I am trying to deal with that aside from the things cancer has done to me.  I have the usual questions and fears.  I am really tired and I guess there is a good reason for that. I am glad that so far I seem to be able to control my urinary urges.  I see that as a significant victory.  A lot of my discomfort from surgery seems to have passed.  However, I do take pain medication for other problems and I'm sure that masks my post surgery discomfort.

Well thats it for today...I think I'll go takea nap...

Posted 2/8/2007 12:54 AM (GMT 0)

Life,

Congratulations.  It sounds like the hard part is behind you and as you say," You're movin on down the road."

My stats were a bit different than yours, but it sounds like we are similar in age.

All things considered, I found my recovery after the DiVinci to be fairly rapid.  It wasn't, however, linear.  I'd go along for a few days and then suddenly be better.  Then go along a few more days and suddenly be better.

We are all impatient, but some things just can't be rushed.  It sounds like you are right on track.  Once you get that first PSA test that comes back "undetectable" it will do wonders for your outlook.

Bent1

Posted 2/9/2007 5:19 AM (GMT 0)

Do You know what is real dangerous? (answer) Sitting around the house with too much time on your hands, reading web sites and second guessing yourself...

I had a bad day today.  Pain, frequent urination and my imagination run wild...

I started reading more about all the guys who love their Proton Beam therapy.  I started thinking of my two close friends who are currently having brachy therapy. I start thinking about how miserable I am today. 

Did I make the right choice?  Why? What? How?

Yes, Of course I made the right choice, because it is the choice I made, it is the right .......

Tomorrow should be better.  Only three and one half weeks since surgery

Does everyone go through this?

Posted 2/9/2007 5:33 AM (GMT 0)
Hey Life,

Yeah I have days like that. I posted one last week and Pete came back with "Its better than a dirt hole!" I had to agree, not that I like the down times. They pass.

As far as which treatment a man chooses, you know that what you did is best for you. I would have the same surgery if I had to choose again today, no matter what others say about DaVinci, seeds, proton therapy or any other. The reasons I chose are still as valid for me now as they were last November. Once we (my wife and I) made the decision for RRP, all the anxiety and worry left. I wouldn't trade that feeling for anything.

Tomorrow will be better my friend....

Jim
Posted 2/9/2007 1:52 PM (GMT 0)
Down days, you bet.  2 months since surgery for me and today is one of those days I think would I have been better off not knowing about the cancer.  Sure I remember what I had and what removal means and for the last couple years my prostrate has been enlarged meaning my urine flow was a dribble and now it is a stream like when I was 17.  But the ED is putting me in the darkest areas I have every experienced in 59 plus years.  Donna says to give it time and things will happen but . . . . .
Posted 2/9/2007 11:49 PM (GMT 0)
Hi Lifeguyd and all: Boy, can I relate with what you all said. It's a darned rollercoaster is what it is. I'm almost four weeks post Da Vinci now and the energy level is about the same as the first week after. I've had unexpected complicatrions like a killer inflamed varicose vein in my left leg for a week, a swollen tender right nut for 1 1/2 weeks, and blood and clots coming out in my urine since the day before yesterday -- every one of these turns on the anxiety and saps the energy out of me. So yes, there are good days and bad days. And we all have fear simmering in the back of our minds. I'm just so glad I found this site, because I know now that high levels of fear and anxiety can be a part of this journey. And just because I am scared, doesn;t mean I'm a "glass is half empty" type of person. I'm just human. Don't you all love when healthy friends, acquaintances and especially the doctors say things like "You need to keep that attitude up! It's all about attitude!." Or, "What are you nervous about ?" Or, "If I were in your shoes, I'd ...blah blah?" Yeah, and I think, bull$#it, you don't have a clue and I'd like to see how you'd act if you found out you had cancer, God forbid. Or if you were facing your first post-op PSA test. If there's anything I've learned from others who have been though this it is to do things at your own pace; don't beat up on yourself and understand that you will have some scary thoughts. It's all part of the program. So let's all hang in. Patience is the operative word, although it's often easier said than done. Let's all look forward to a physically and mentally healing weekend.
Posted 2/10/2007 5:06 AM (GMT 0)
Hi Lifeguyd

Don't second guess the treatment you selected (i.e., robotic surgery) after the fact. I met with a top medical oncologist before making my treatment decision. The last advice he gave me was never to look back after the treatment and wonder if you made a mistake, even if the cancer recurs. You hopefully made the best decision you could at the time and felt it was the best treatment for you. With your Gleason 8, perhaps surgery was the best option. As you know, after surgery, your PSA should go to zero and you can chart if from there. Also, the true pathology of your prostate can be determined after surgery. Radiation does not provide these immediate benefits. As you well know, selecting any treatment is still like gambling on the ultimate outcome (i.e., whether a cure will be achieved). The probability of achieving a cure is about the same today with either surgery or the various forms of radiation, assuming that you are in an earlier stage of PC. For many men, they just want the cancer out of their body--I assume this weighed heavily on your decision. You have had major surgery and it will just take time to heal. Bravo to you for selecting surgery as it is the toughest treatment choice to get through, but this treatment choice can provide the greatest comfort (i.e., that hopefully all of the cancer has been removed). The key is for all prostate cancer patients is to carefully consider all of the treatment options, carefully evaluate their potential benefits as well as their potential negative side effects, and then make a final decision with no regrets. Good luck to you in your recovery and I hope that you are able to eventually lessen your body pain unrelated to your PC operation.

Dave

P.S. Just for the record, I changed my mind about robotic surgery (my choice at first) in favor of radiation, but I must tell you that I sometimes question my decision and wonder if surgery would have been the better choice for me. I still think that robotic surgery is an excellent choice for many men depending on age and PC stats. So you are not alone in looking back at times, but these thoughts are counter productive!
Posted 2/10/2007 6:13 AM (GMT 0)
Hi Lifeguyd,
Just my 2 cents. I am about 8 years younger than you and, admittedly out of shape, am 5 months out from my daVinci surgery with its quicker healing, but I was still tired and dragged out all the time, until about a month or two ago. Everybody recovers at their own rate, so it is probable that this is normal for you. Also, at five months, and with the daVinci, I still have aches and pains from the navel (exit for beast) to the bone area between my right thigh and the midline of the crotch. This is about where I think the pain would be referred to from where my doc did the plastic surgery on my right nerve that couldn't be spared. He told me this could be the sensation of the nerve growing back together (I hope the nerve is growing back together, because another "bone" is depending on it).

As for surgery versus anything else, I, for one and maybe only one, think you made the right decision, NOT just the right decision for you. I have a really strong opinion about this, so I apologize to the proton and seed people, but I made a different decision. I am a worrier and not a gambler. My doc gave me the odds of a 91% chance of nonrecurrence with surgery, but a 75% chance of nonrecurrence with any kind of radiation or the cryo procedure. Sixteen percentage points is not negligible to me.

Also, when I got the final pathology report back, it included a comment on bladder neck tissue. This was not just to show that there was no tumor extension into the bladder; it was to show that he went well into the bladder area and there was no prostate tissue left in my body. This is important because the nature of prostate cancer is such that cancer cells arise all over the gland independently, not only by extension, and maybe not all at the same time. This is why they take out the whole gland and not just the part with the tumor(s) in it. Something biochemical has happened in the body, that has triggered this cancer and it seems to be able to affect the whole gland, maybe microscopically in some areas. Therefore, I believe it is crucial to get every last prostate cell out of the body, even possibly normal ones like nearest the bladder neck, before they turn cancerous. Radiation obviously can't do this, and it doesn't matter to me what the stats comparing radiation or proton beam with surgery say. Count me in the camp of what Swimom says are men who want the cancer out.

Therefore, fatigue and all, pains and all, I think WE did right.
All the best. Keep us posted on your recovery.
dj
Posted 2/10/2007 5:44 PM (GMT 0)
djhouston

i am very respectful of your response above to lifeguyd, but i would like to make some comments. you indicated that your surgeon gave you a 91% chance of success or non-recurrence with surgery and 75% with the various forms of radiation treatment. keep in mind that surgeons are biased toward toward surgery and radiologists are biased toward radiology. did you question the validity of the 75% success rate for radiation quoted to you by your surgeon? did he show you any authoritative statistics to back-up his claim? it has been well demonstrated that the success rates for surgery and the various forms of radiation are quite comparable in the earlier stages of prostate cancer. as you move away from the earlier stages of cancer, the success rates begin to decline. at that point, selecting surgery may offer a little more hope for success, but there are no guarantees. age is also a very important factor in deciding on treatment. it seems that younger men prefer the surgery to get the cancer out of their body and i don't necessarily disagree with that approach. when i met with a top medical oncologist to objectively evaluate my treatment options based on my PC stats, he demonstrated to me that i had about an equal chance of success with surgery, seeds, x-ray radiation and proton radiation. i chose proton radiation because it is a safer form of radiation than x-ray radiation (i.e., photon radiation), with less of a chance of damaging or destroying good tissue surrounding the prostate. because it is a safer form of radiation, the potential for negative side effects is less than other forms of radiation treatment. Loma Linda has been performing the proton radiation treatments since 1990 and has successfully treated thousands of men with that approach. Massachusetts General Hospital (MGH) in Boston opened a new proton center in 2001 (replacing a smaller one in affiliation with Harvard) which was established in the 1950's. Dr. Anthony Zietman is a highly regarded radiation oncologist at MGH who oversees the proton therapy. Two new proton centers were opened in 2006, one at the MD Anderson Cancer center in Texas and one at the University of Florida. The University of Pa. is expected to open a new proton center in the next two years. proton therapy is used not only for prostate cancer, but for many other types of cancers. many men who elect surgery do not know about proton therapy. it is important that all prostate cancer patients become thoroughly familiar with all of the options for treating prostate cancer before making their final decision, so that there will be no regrets later on. i am not promoting proton therapy over surgery. my mission is to educate prostate cancer patients that proton therapy is a viable treatment option with excellent success rates that should be considered depending on your PC stats.

why did i select proton therapy over surgery? my age played an important role. i am in an earlier stage of PC. I did not want to have to deal with what i thought could well be 100% immediate impotence and the potential difficultly of regaining some degree of potency. i was even more concerned about the possibility of some degree of incontinence. in my final years, i want a reasonable hope for a cure, but also a good quality of life. having to wear pads and diapers potentially for the rest of my life was not for me. i have read some of the heart breaking stories in these message boards of men struggling with the nasty side effects of surgery. some side effects improve or go away, but sometimes they don't. let's face it, choosing a treatment is a gambling game. you have to weigh the odds. i also felt that proton therapy would be non-invasive compared to surgery, and is considered one of the safest forms of radiation, offering hope for minimal side effects. there is no question that radiation (including proton) can eventually lead to some degree of impotence down the road. however, in those cases, drugs such as viagra have been known to overcome the impotency in many cases. incontinence usually does not happen after proton therapy.

dj, you seem to be at peace with your surgery decision and that is what is most important for you. once you are at peace with your decision, it makes the whole process much easier to move on with your life after treatment and hopefully get back to a normal routine again. best of luck to you!

Dave
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