Posted 10/24/2009 1:59 PM (GMT 0)
Hello to all
I found this forum only last week, and it has still been helpful after the event.
I'm an Englishman who lives in The Netherlands and I had a Da Vinci Radical Prostatectomy about 13 weeks ago at the national cancer institute in Amsterdam.
I’m posting this before I’ve had my first post-op PSA test and I thus don’t know if I have had a fully successful treatment or not, but like so many of you I have something to say and say it in the hope that it may help someone else.
I can’t deny I’ve had my doubts about whether or not surgery was the right decision for my situation but the doubts were not as strong as the conviction that I needed to do something. And the crucial part of deciding to do something was to accept that, yes, I may well be doing something too soon, but that was ALWAYS going to be better than doing it too late.
Yes, on the whole prostate cancer grows slowly, but I didn’t want to be one of those where it grows fast, so that by the time I did decide to have an operation it would prove too late. And I feel that getting a post-op Gleason of 7 after a pre-op 6 tends to support that line of thinking. Also the tumour had spread to the seminal vesicles and the tumour inside the prostate was at the top and very close to the bladder, so it simply could not have been long before there was a likelihood that it would have made things much worse.
Even if this is a slow-growing cancer I was told it still more or less doubles in size every five years and so being only 48 at diagnosis I could do the arithmetic and work out approximately when the cancer would, could or might be (too) big. My father lived till he was 95 and I didn’t want to have PCa kill me at a much younger age!
My high initial PSA reading showed up when I hadn’t even gone to the doctor to have it tested. I went to have a general physical and did not even know the PSA test existed, but when the she offered it I thought it would be handy to have it done to give me a base line, neither she nor I expected it to come back so high, so that she would immediately have to refer me to a urologist for a biopsy etc.
As for whether or not surgery is the right option or the best one I’d like to mention something that was done to assess me that I have not seen any mention of in these forums.
In The Netherlands they are developing some kind of mathematical model to assess patients. Into this they entered stuff like my age, PSA, biopsy results etc and it came back with some numbers, something along the lines that it was more likely things were bad than good (75/25). I found that a very helpful tool.
I also come from a medical family, (loads of doctors, surgeons and nurses) and thus I had worked out the need to spend plenty of time assessing my options right from the day I was given the PSA test results. I reckon I made an informed decision and the right one.
As for health care on this side of the Atlantic. The Dutch system is that EVERYONE has to have basic private health insurance, the pooper people in society also have to have private health insurance, but they have the premiums paid for them by the tax payer if their income is too low. You can also have more than the basic package by paying higher premiums. (As a simple example my treatment the operation etc was paid for by the insurer, but if I had had more cover it would also have paid for the cost of transporting me home after the operation, though I was given a lift by a good friend) I’ve heard that Obama wants something more like this Dutch system than the UK National Health Service.
My summary below looks very good, but I’m not drawing conclusion until after they test my PSA again.
Alfred
Age: 49 5ft 9in. 178lbs
Married 25 years, and I cannot thank my wife enough for her help, support and understanding!!
Family history of Prostate Cancer: None
PSA April 2009: 8.6 (The first time my PSA was measured.)
DRE: negative
Biopsy April 2009: Tumour found in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29 th July 2009
In hospital for ONE night
Partial erections on 1 st and 2 nd Aug 2009 with catheter still in.
Catheter out on 6 th Aug 2009. Dry at night, but wearing pads 24/7
Post-op pathology : G leason 3+4. Seminal Vesicles invaded, but otherwise negative margins,
Erection 100% & orgasm without help from anything on 15 th Aug 2009
Stopped wearing pads on 21 st Sept 2009
Pre-op style intercourse possible on 24 th Oct 2009
No use of tablets, injections, pumps etc. at any time.