HealingWell
Search Close Search
☰

Worried wife

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/16/2011 1:09 AM (GMT 0)
 

 My husband was diagnosed with prostate cancer last April this year.We talked to radiologists and surgeons to have some knowledge on what kind of treatment we want to.Finally, I decided to have him undergo surgery but right now, we are not yet settled on what kind of surgery whether open surgery or robotic. I was trying to find some testimonies of people who had undergone these kinds of surgeries.Which has the longest survival rate and the less possibility of spreading the cancer while undergoing the surgery.I am hoping some members here can enlighten me and help me..

AGE:55

PSA:3.3

Gleason: 3+3=6

 

Posted 7/16/2011 1:59 AM (GMT 0)
Hello Cutie, and welcome to our forum. I am sorry you have a need to be here. Yours is an often asked question, and you'll get several different perspectives from the guys here....all of them sincere.

I had the open. Obviously, it leaves a larger scar. At age 58, I'm okay with that. I was a gleason 9 which, typically, carries a higher risk of spread prior to surgery.
My Uro surgeon has done both. With higher risk patients such as me, he prefers open because he feels he is less likely to have a positive margin with the open process. He also has stated very firmly to me that his open patients do as well, and often better than robotic patients. By far, most of his patients go home after only one night in the hospital.

Given your husbands relatively low psa, and only a gleason 6, he will not go wrong either way, and will "probably" achieve a cure.

Now, having said all that, I strongly believe that what is MUCH more important, is the skill of the surgeon doing the procedure. Ask lots of questions, but most importantly, ask the dr you select how many of "x" procedure have you done, and what is your % of positive margins.

Keep checking back. You will receive some great information and advice right here.....more so than any other forum on the internet. There is lots of wisdom hanging around this forum.

Take care, and please keep us posted.
Posted 7/16/2011 2:31 AM (GMT 0)
I'm not sure if there are any studies that indicate which surgical type has a better success rate. Robotic is fairly new, although that doesn't mean it's any better than open.

Most likely your best option is to find a good reputable surgeon.
Posted 7/16/2011 2:41 AM (GMT 0)
I had open surgery by choice, and due to complications, it was a good thing I didn't go robotic, as it would have to had been aborted and switched to open. I was in the hospital for 4 1/2 days. The real key is the skill of the surgeon, even more so than the method of surgery. open surgery has been around for many decades, so there are a lot of good highly experienced open surgeons out there. With either method, you must remember that they are both major complex surgeries. To me, whether I had one larger scar, or 4-6 smaller ones, was a mute point. Blood loss was not an issue with my open surgery, though they had banked a couple of pints just in case.

Good luck in your decision.

David in SC
Posted 7/16/2011 3:16 AM (GMT 0)
Thank you guys for the quick responses.They lightened my load.It's really

hard to be in this kind of situation especially if there's no one to talk to or

share our worries.As of now my mind is leaning towards the robotic surgery

and according to the surgeon that we talked to he had done more than

1000 surgeries already.
Posted 7/16/2011 3:43 AM (GMT 0)
Cutie,

Be sure you really understand the potential side effects of surgery. Sometimes in the rush to "get that stuff out", we tend to gloss over incontinence and impotence. They can be really tough things to deal with when they are personalized.

With your stats thatvyou have shared, your husband would be an ideal candidate for Brachythery, which has an equal cure rate to surgery, and fewer side effects as least initially.

Just be careful to research all options. I can tell you as someone who didn't have very good Gleason score, and felt as tho surgery was my best option, that incontinence and impotence are tough to deal with.

Good luck. I would say that with a Gleason 6 and a low PSA, that you have time to make a good decision.
Posted 7/16/2011 4:20 AM (GMT 0)
HI goodlife!thanks for the response,So in your own personal view robotic isn't a good option?It's been over 3 months since the biopsy that we've been thinking what treatment is good for my husband.Are you having problems with recovery?It's been a year since you had your surgery right?Are you still in pain?
Posted 7/16/2011 5:05 AM (GMT 0)
Hi Cutie --- first, sorry that your husband has PCa, especially as he's such a young man.

While you both can't help but be frightened by the cancer word, (there is a reason my HW name is 'sleepless') making good treatment choices is more important than making fast treatment choices with the stats you've given us. Unfortunately a good choice doesn't mean a single specific choice that's evident through understanding medical science and PCa. Each treatment choice has good and not so good, elements. The best choice for your husband may well be (and likely is) a different choice than I would make if I was his age and had excactly the same cancer stats. The best choice is the one you and he make once you know something about the great, the good, the bad and the ugly about each treatment choice. The best choice is the one you say, "this is right for me. I can live with the consequences."

While each case is different and each treatment choice a highly personal unique decision, there is one thing I can say with certainty: Before you do anything more you need to get his slides re-read by a pathologist who has lots of experience reading prostate cancer tissue. He may have the best pathologist in the world reading his slides now --- but you still need a second opinion.

The four things you're looking for are: Does the second pathologist agree the cancer is Gleason 6 --- or, might he/she say it's 3+4, a Gleason 7? There is a significant difference between the two. Then, does the second pathologist agree on the number of cores containing cancer? Third, is there agreement on the volume of cancer in the cores with cancer? And four, does the second pathologist have any comments different than the first?

While reading prostate tissue slides is science, it is also an art, and you need at least two pathologists --- especially when he's a Gleason 6. I don't believe you can make a reasoned treatment decision without that second read and I also believe that second read will be key in your making your decision.

As for open or robotic, the da Vinci robot hasn't been around long enough to know if in 10/15 years one sort of surgery will have a better outcome than another. I went the robotic route and I'm glad I did. It was the right choice for me.

Sheldon AKA Sleepless
Posted 7/16/2011 5:53 AM (GMT 0)
Hi Cutie!  I am so sorry you have a need for this forum, but you need to know you are not alone.  I was in your shoes just 15 months ago.  My husband needed me to do the research.   I was frightened and overwhelmed.   Coming to this wonderful forum was a blessing!

My situation was unique in that there happen to be SIX of us ladies here with July/August surgeries.  So, we had a special thread.  There were three very nice gentlemen who joined us.  I know the "August Surgeries" thread is here somewhere.  Many of the other gentlemen were around to answer our many questions.

At the end of my post, you will see Ron's signature.  This tells you more about his health profile.  Yes, the first step is finding a fine surgeon.  Your DH (darling husband) should have more information as Sheldon suggests.  Your husband's doctor has had the right amount of surgical procedures.  YAY!

Ron's doctor waited 4 months, so it gave us lots of time to think and talk things over.  He then went to the hospital to meet with a variety of doctors to determine which procedure was the best.   So, he actually had the opinion of four doctors.  It was an all morning seminar.   The radiologist steered him away from radiation.  Because he wasn't overweight and in good shape, we went with the DaVinci prostatectomy.  You may see the phrase, "Dance with DaVinci" - it truly was the best procedure for him!  His hospital has been doing the robotic surgery for seven years.

As Goodlife mentions, incontinence and impotence are tough to deal with.  However, if you saw my husband playing with our Grandchildren, you would  agree this was the right method for him.  It sounds like this is the direction your DH is being steered towards.  I read a book and many articles, plus got advice from the guys here.  The notes helped Ron in dealing with his feelings.  That information was from those who post here.  IT WAS SO HELPFUL!

Incontinence was an issue for awhile, but now Ron almost never has a problem except if he walks too long.  Sadly, impotence is still a major issue; however, we have worked around this.  That is like the second part of the story.  For some men, it isn't an issue.  Your DH is younger than mine.  Our goal was to get the PCa out before it spread.

I will be glad to help in any way I can.  You should have seen the lists of helpful hints I copied for Ron.  Be prepared to ask the doctor the right questions; that made it so much easier.  So, be sure to write things down.   Be sure to ask about Kegel exercises.  He may want your DH to start them now.   Some even suggest a tape recorder for the visits.   Cutie, for us the "Dance with DaVinci" worked out.  Good luck in your research.   (Ron has another problem totally unrelated to the cancer.  We are now working on that.)

It makes it a little easier if you would share your husband's first name instead of DH.   Cutie, knowledge is power.  You and your husband WILL make it through this together! 

 

Many blessings,

Aimzee

  

Posted 7/16/2011 6:59 AM (GMT 0)
Cutie, one thing I did learn here is that no question is a silly question!  So, please feel free to ask.   This is truly a journey together - you and your husband.

I wanted this thread to be at the top.

Much blessings,

Aimzee

 

Posted 7/16/2011 10:26 AM (GMT 0)
1. (open or robotic) I would, and did, choose robotic.

2. (testimonies of people who had undergone these kinds of surgeries)

So far I am very pleased with the results.  Each surgeon and patient is

different, no results will be the same, to many variables.  My true

outcome is yet to be determined, but so far so good.

3. (Which has the longest survival rate and the less possibility of spreading the cancer while undergoing the surgery)

It's not the surgery chosen, it's the microscopic cells that can't be detected, and skill of surgeon. Years of PSA's is the

only true test if it all has been removed.  There has been so called failed surgeries with no PSA rise, and successful

surgeries that have.

4. The surgeon is way more important than the procedure chosen. 

Posted 7/16/2011 11:48 AM (GMT 0)
Cutie, sorry to hear about your husband's PCa diagnosis.

My husband had robotic surgery over 3 years ago. When it comes to pain, my John confesses to being a baby. The worst part for him was the darn catheter which your husband would have for a week or so regardless of which type of surgery he has. As far as pain, John said he had discomfort for a little bit but no pain. In fact, the surgeon gave us a prescription for pain medication which I filled the day John came home from the hospital. It sat unused for a year and I finally tossed it. During laprascopic surgery (which robotic is), the surgeon inflates the abdominal area with CO2 to help move the organs out of their field of vision. Some men complain of bad stomach pain for a day or two after surgery - kind of like a bad case of trapped gas. Once your husband "passes the gas", he should feel alot better.

As far as which type of surgery is better for cancer treatment and control, I don't believe there are any major differences between the two types of surgery. The more traditional (called "open" surgery) comes with a larger incision. Some will argue that it provides the surgeon with a better "feel" of the prostate. Some will argue that the robotic procedure gives the surgeon a better view of everything since the camera used provides a 360 degree look-see before cutting. This can be especially important if any of the cancer is close to the edge of the prostate and can help the surgeon plan their approach in terms of where to cut and how much to cut.

As already said, which type of surgery is chosen is not as important as the skill and experience of the surgeon. One word of caution wife-to-wife: some surgeons will tell you that they achieve a high percentage of continency and/or sexual function. Maybe they do but maybe they also overstate their success rate with these areas. Both issues can be side effects of either surgical method. They may be temporary or they may be long term - there just doesn't seem to be any way to know before hand how well your man will do with healing.

We wish you and your husband the best of luck as you walk this road we've all been on. Please come back and keep us posted.
Posted 7/16/2011 6:11 PM (GMT 0)
Cutie,

I had robotic by a highly skilled and experienced surgeon. I felt that my Gleason 9 left me little choice. I would go robotic again.

My post was intended to make sure both of you really understand the words incontinence and impotence. They are real possible side effects of surgery. I have heard many guys write if they had really known what it would be like to wear pads or not have normal sex again, they may have made a different choice.

As for me, I am excited to be alive, am living the Good Life, and enjoying every day. We just deal with side effects, and move on.

Goodlife
Posted 7/16/2011 6:32 PM (GMT 0)
I had robotic and am pleased with results so far.

With your husband's stats, he has excellent chance of cure with either method. Either method in the hands of a highly skilled and experienced practitioner has almost the same chance of cure and almost the same chance of side effects. In other words, the differences between methods are much smaller than the differences between doctors, so it is a better use of your time and energy to focus on finding the best doc, and not so much on the small differences between the two methods.
Posted 7/16/2011 7:20 PM (GMT 0)
Cutie,
I subscribe to what many doctors specializing in PC do. The maximum knowldege about your disease and the minimum intervention neessary to cure it.
What is his psa density? His doubling time and velocity. How many cores positive and what %. Did he have a scan such as an MRIS or a color doppler to identify the location of his tumor. What is his tumor volume(use a tumor volume calculator or a scan). What do the partin tables and nomograms say about probability of organ containment. All patients should go through at least these basics in finding out what the biology of the cancer is telling about its agressiveness. With non agressive tumors, which on the surface it appears your husband has, there are many other treatments such as low or high dose brachytherapy or proton beam or IMRT that will do just as good a job if not better at cancer control and have much less probability of long term side effects such as ED and incontinence.
Your statement "I decided to have him undergo surgery" is very strange. Are you making all his medical decisions or is he cabable of making his own? After all it is he that will be living with the consequences of a life altering decision.
JohnT
Posted 7/17/2011 3:35 PM (GMT 0)
".Finally, I decided to have him undergo surgery but right now, we are not yet settled on what kind of surgery whether open surgery or robotic."

YOU decided?? HHHmmmmmmm...

Like Purgatory said, it's not the type of surgery but the skill of the surgeon that counts. When you find the surgeon that's right for you, you do the method that surgeon prefers..PC surgical outcomes mostly depend on the SKILL of the surgeon, NOT the type of surgery....
Posted 7/17/2011 4:05 PM (GMT 0)
Hi Sephie ~  You wrote:

The worst part for him was the darn catheter which your husband would have for a week or so regardless of which type of surgery he has.

 

This is exactly what Ron said!!  He had his catheter in for 13 days and hated it.  I took one of the guy's suggestions and bought him an oval bucket to hold the bag both when he slept and walked.  He would walk in the yard or side drive-way using it.  It was his choice to use the overnight bag and pretty much stayed out of the public's view.

You brought out some excellent points for Cutie to consider.  I hope she returns to read the responses given. 

Best wishes for you and John,

Aimzee

Posted 7/17/2011 4:10 PM (GMT 0)
Whichever route you take it has to be your husband's decision (hopefully, you'll agree with him). 

I had robotic surgery, and even though my wife is a registered nurse and let me know she thought that was the right way to go, it was completely my decision, and any side effects, consequences, are because I made that choice.

Obviously, you have a tremendous amount of influence, but he needs to be the one making the final decision.

As other have said, be sure to find a very good doctor, whichever treatment option you choose, and then never second guess yourselves later.  Good luck to both of you.

Posted 7/17/2011 5:58 PM (GMT 0)
My husband had robotic surgery and it is now 6 months out and he is doing well. His first psa was 0.1 which is great. Either way will take care of the problem but why get cut open when you can have a few small incisions and much less pain. My husband came back to his room after his surgery and got off the recovery room stretcher and walked in to his bed. You just can't do that with the open method. They have all this modern technology out there and we decided to go with it. Good luck with your choice.
✚ New Topic ✚ Reply