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Posted 10/29/2007 3:57 PM (GMT 0)

PSA = 3.6  Gleason 6

46 yrs old

Biopsy Positive 9/2007

First time reader & poster to forum.  The Dr. presented me with all my options (surgery, ext. beam & seeds) and said I would do well with any of them.  After much thought & research I have chosen surgery using the Da vinci.  As D day approaches I find myself second guessing not only my options but whether or not I can simply postpone this procedure until next year.  It's been a whirlwind from being diagnosed to scheduling surgery all within 6 weeks. 

I'm not afraid of the procedure itself, going under the knife, not waking up, etc.  I'm worried about the AFTERMATH.  Presently, I am in good health, have normal sex drive, functions, etc.  After the surgery I realize this won't be the case.  This forum is encouraging but yet it is sobering.  Life will be different & I'm just beginning to embrace that fact.

Many thanks to all those who post on this forum providing much needed information about sensitive subjects.  Whichever path I choose I'll try to reciprocate with any words of wisdom I glean along my journey.

Posted 10/29/2007 4:05 PM (GMT 0)
Welcome, your case sounds almost exactly like mine, however I was 45 when diagnosed.  I went with Da Vinci and I think I made the right choice.  Get yourself a skilled surgeon and your chances of negative side effects is low.  Andy by the way it is normal to have alot of anxiety and depression so don't beat yourself up during this journey.  You will be through it before you know it and on your way to a full and lasting recovery.
Posted 10/29/2007 5:42 PM (GMT 0)
Sitting here with all of this now a year behind us since surgery, we're glad we did what was needed to get to this stage. Also, although our numbers were promising after biopsy the pathology report did indicate a SECOND cancer which was more aggressive that wasn't visible during biopsy.

If we had chosen to wait, our completely clear outcome would definitely not have been the same a year later.

Good luck; draw strength from the experiences in this forum and let the factor of your young age allow you to look forward to positive results all around.

:o) Linda & Bob
Posted 10/29/2007 8:00 PM (GMT 0)
I suggest that you read everything that you can find regarding all of the treatment options.  Also educate yourself on the vocabulary regarding PC, gleason score, stages, etc.  For me I decided quickly that surgery was the only option although my biopsy results reported only one definite cancerous sample.  The pathology report showed a very different picture.  I had put off the surgery for a couple of months because of other things happening in the family, but I would not suggest a long delay in treatment even if it is supposed to be a slow moving cancer.  Fortunately my cancer had not spread outside of the prostate and it appears that no other treatment will be needed, although we have not done another PSA test yet.  You will read conflicting recommendations about radiation and surgey so, again, be as prepared as you can when you sit down to make the decision with your doctor.  By the way, if you stick with the decision for surgery, I can tell you that there was a very small amount of pain the afternoon after surgery, several days of low energy (I had pneumonia, which doesn't usually happen) and the only real problem has been incontinence, which doesn't present a big problem for everyone.

Post Edited (gtmriviera) : 10/29/2007 2:05:24 PM (GMT-6)

Posted 10/29/2007 8:12 PM (GMT 0)

I just had Da Vinci surgery 10 days ago, and you can read my post from yesterday. I am 44 years old and had similar concerns. A big benefit of surgery is the final pathology, and with a little luck, it will be fine and you go on with your life with very high confidence that the cancer has been cured.

Your age is an advantage although you probably aren't feeling very lucky about that right now. Odds of full continence are extremely high with a good surgeon. Sex drive should not change since the prostate has little to do with the chemistry. Other than possible depression, there is no reason sex drive should change. Odds are sexual function will return to normal, especially with bilateral nerve sparing. Even if you have to take a pill for the rest of your life, it is not a bad outcome. Orgasms are dry, and you will be infertile, but this is a consequence of any other procedure as I understand it.

It can be difficult to willingly put yourself through any procedure that will affect this area of your body. It was for me, even though I knew it was the right choice for me. Hang in there.

Posted 10/29/2007 8:41 PM (GMT 0)
Chas, as the wife of someone who has chosen the brachytherapy route, it really bothers me when I read comments like this:

"Definitely go with the surgery,,,you are too young to take a chance on radiation and then having the cancer return 10 or 12 years down the road. With surgery, at least you know you got it all."

My husband and I don't feel at all like we are "taking a chance on radiation" and risking having the cancer return in 10 years. In fact, brachytherapy has the same rates of success as surgery in studies that have been done. And if any cancer is missed, a reseeding can be performed. A surgeon is just as likely to miss a few cells (and that's all it would take) as a radiation oncologist. You never truly know if you got it all. After pretty substantial research, the only advantage we found to surgery would be knowing the true pathology. For us, given my husband's age, overall health, and apparently early stage of the cancer, that wasn't enough in light of other factors important to us. For others, I'm sure it would be. Each individual needs to make his own decision based on his own priorities and the facts.

RTR: All the best with your surgery.

Ellen
Posted 10/29/2007 9:15 PM (GMT 0)
We ultimately decided to join the "Get it over with now" club. At my age, with good general health and a fair exercise regimen, we wanted to remove the cancer and begin the healing. After a year, I'm glad I did. There are still issues, but PSA tests reveal the cancer is gone and we can deal with that. I also had a problem with waiting while I knew something was growing inside - regardless of the speed. I also did not want to opt for radiation as the success of surgery later if required would be lessened. Best of luck with your decision.

Posted 10/29/2007 9:43 PM (GMT 0)
RTR,

You are getting a lot of recommendations to go with the surgery. While that is the choice I made I strongly believe that you have to totally buy into your decision and one made in haste may not be one you really want. Your age is a strong factor in your treatment decision so do a lot of research on treatments chosen by younger guys. In my case I was leaning toward proton beam because of the very good experiences of a couple of my high school classmates which I was linked to through our class web site. It finally came down to peace of mind as what I wanted as an outcome and surgery with the post op path analysis was the only treatment that gave me that.

You are exactly right, no matter what treatment you choose it will never be the same afterwards.

Tamu
Posted 10/29/2007 11:17 PM (GMT 0)
I can only repeat what I have written before - no treatment will give you a definite "cure".  My brother and also another close friend both had surgery with great path reports - both had recurrence - my brother after 6 yr, but my friend after only 8 mo.  Best of luck in your research RTR for the treatment that best fits YOUR needs.

Dutch

Posted 10/30/2007 12:45 AM (GMT 0)
Thank you for all the responses regarding my reservations about following thru with this surgical procedure. It really helps to hear the direct experiences of others. Despite my aforementioned vacillation I know I need to deal with this now not later. I just needed to hear it from others. All things considered surgery is best for me.

Surgery is scheduled at UAB in Birmingham, AL. Dr. Christopher Amling was recommended (by my local urologist), his credentials appear excellent, has performed all 3 types of surgeries (full incision, laparoscopic & da Vinci). He has performed 250+ using the da Vinci, 900 plus total surgeries.

I know a successful outcome of surgery depends greatly on the skill of the surgeon. I'm curious how others evaluated their surgeons? I've researched Amling's credentials and queried him one on one. Apparently he is held in high esteem by UAB as he was appointed director of the surgery division of urology. I'm comfortable with Dr. Amling but I want to make sure I've done a thorough evaluation. Are there other steps I should take in this evaluation process?
Posted 10/30/2007 7:01 AM (GMT 0)
Hi RTR,

Re. your question, " I'm curious how others evaluated their surgeons?"- We chose our Surgeon based on reputation and experience too (open surgery however), and did the following things:

1.  Looked up some of his published research (just a google search initially).  We also asked him about this research at a consultation,  particularly with regard to younger men/outcomes etc, and he was able to explain it all in simple language. Therefore he seemed up to date with all developments in the field and making a contribution etc..  

2. In addition I would personally suggest maybe asking some nurses who work with him (if this is possible), how they find working with him?  If they whole-heartedly recommend him as excellent this is a very good sign. They (nurses working with him), should have high regard for his work, regardless of his personality if he is really good. Of course you may not feel comfortable doing that, but we did...

If the specialist is open and confident in his own reputation he should not mind being checked out so openly. At least this is what we have found. A good Surgeon usually has a happy and well functioning team - they have to....for best results and best service at this difficult time..

3. We also rang up two patients of the particular Surgeon (we got the contacts from a local support group. Both men also highly recommended him in their recovery periods..

That just about sealed the decision for us. We found phoning local support groups helpful for checking out his reputation etc and all men who had put themselves down for being called, answered freely all our questions. We did not find anyone under 50 to ask in the local support group..... but other men who had the same doc and similar Gleesons, helped immensely with our ultimate choice.

All the best with your decisions. This may not help, but just a few other avenues to consider if you have not already done so... Good luck, Lana.

 

Posted 10/30/2007 11:04 AM (GMT 0)
RTR,
First, let me say that my "6 gleeson" and age suggested I could wait a year.
However, the tumor was touching the edge of the gland and it would have been a serious rroll of the dice.
Once you do your research and you make your decision, don't wait any longer than necessary to get a good physician and proceed with the treatment of choice.

I know you will hear 1000 is the magic number for da Vinci surgeons.
Personally, if I liked the Dr. you have described and trusted him, I think his 250/900 and reputation sound solid.

I have had quite a few major surgeries and I agree with Creed/Lana 100 per cent about talking to the nurses (especially O.R nurses) if you can and other patients.
Swim also advises asking the physician point blank what his/her success/complication rates are with incontinence and E.D.
While some here seem cured of these two from the moment the catheter is pulled.....
3 to 4 months for recovery from incontinence is realistic -
and with work, one to two years to overcome E.D. I would ask recovery rates within different time frames.

I'm not the most perceptive. I just noticed your age and gleeson and I'm not familiar with the "UAB."
If you, while logged on click on Control Panel in the top left of the screen, you can post a signature with some key information that will likely give you more informative posts.

Stay with us and feel free to ask anything. I find the men and women here are intelligent, informed, and compassionate.
I don't discuss my prostrate cancer with more than a dozen people total in my family (warn your male siblings!), church and at work. I discuss it freely here.
This forum is a great group of informed people. You can drop by any time.

CCedar
ICTHUS!
Posted 10/30/2007 12:31 PM (GMT 0)
Lana, you are a keeper... :>)

Talk to nurses about how a surgeon is in the OR? I like your personality exception!! So many are dear sweet people. Then, there are those spirited ones. What does love got to do with it, eh?

I know of 2 brilliant surgeons personally who habitually throw the tools of their trade across ORs and swear like sailors at their staff. One would wonder why anyone would stay under such stressful conditions but, they do. The best have no problem getting and keeping good staff dispite the small ducking clause..don't duck fast enough, ya might get hit :>) Actually, I haven't heard of anyone being hit by flying forceps. Those highly spirited surgeons must have good aim. Asking a nurse how it is working with a surgeon gets some pretty good answers. I highly suggest it!

Swim
Posted 10/30/2007 1:28 PM (GMT 0)
We picked my surgeon via personal recommendation by a friend, listing on daVinci website and one on one interview. A friend's father-in-law used/liked the doctor, who was also listed on the daVinci site at a facility near me. We made an appointment, drove to Birmingham and interviewed him. He proved to be what I wanted in a surgeon. Credentials don't mean as much if he/she is a jerk. Compassion, bedside manner and his experience added up to a very good choice for me.


Posted 10/30/2007 6:13 PM (GMT 0)
I live in Alabama and when diagnosed by my local uro I told him that I wanted a second opinion on treatment and said that I would go to UAB. He suggested that I check out Vanderbilt in Nashville. Prior to my appointment I did some research on the Vanderbilt Urologis Surgical Clinic and knew that they have been doing both open and Da Vinci for a long time. I had an appointment with an open guy but as I was in the waiting room I kept hearing good comments about my Da Vinci surgeon from staff and patients. The first person I met with was a CNP. She spent 30 minutes with my wife and I going through everything on treatments including complication rates. After meeting with the open guy I made a decision to go ahead and schedule a Da Vinci. I came back in a couple of weeks and met my surgeon and was totally impressed. While I had my surgery scheduled, due to the backlog, I was still considering proton beam. It was another month before I finally settled on the surgery.

Tamu
Posted 10/30/2007 6:52 PM (GMT 0)
I chose my treatment for the same reasons. At my age I would tolerate surgery well and of course, i wanted that post op pathology, instead of the anxiety of not knowing if the treatment was a success. Well the pathology was not good. And if I had chosen radiation as a primary treatment, I might have sat on an untreated time bomb. The fact of the matter is that protons or photons would not have been treatment enough and time would have been wasted. While I did add IMRT eventually, I know that surgery was the right choice. That stated, what I gained was a head start on treating metastatic disease before it made its come back.

Tony
Posted 10/30/2007 9:03 PM (GMT 0)
RTR, Although I do not know your doctor, as I'm sure that you are aware, there are two hospitals in our part of the country that seem to be the standard for cancer treatment.  Those are MD Anderson and UAB.  I would probably have gone to UAB, but my insurance would not pay for me to go out of state.  As for your decision to have surgery, I had the same reasoning and I'm very glad that I made that decision now that I have the pathology report.
Posted 10/31/2007 3:45 PM (GMT 0)

Thanks for all the information regarding the process of selecting the "best surgeon".    My local urologist's CNP gave the surgeon high marks based on patients they've referred.  I thought I might call the surgeon's office and ask if their is a list of patients who are on some sort of list available to provide references.  I'm doubtful such a list exists in this age of HIPPA regulations.   At this juncture I'm more or less validating my selection.  Absent any alarming information I turn up I'm comfortable with my choice.

Posted 11/9/2007 1:48 PM (GMT 0)
  Hi ~ RTR & Loved Ones,   Gentle Hugs and Warm Thoughts   We know ~ we can “all” make “Your Journey” smoother just by being here for you!   This is truly a great forum!!! ~ You have joined!  You are now part our forum family ~ a group of wonderful individuals who are so willing to share...   It helps “all of us” ~ to help you ~ if we know where you are on your path. So ~ Please stay with us and take our hand when you need it!   Keep posting.... OKAY!!   KNOWLEDGE     IS     POWER   ...   and   POWER conquers   fear   YOU MAKE THE DECISIONS… YOU HAVE OPTIONS… ~ and ~ Your decision will be the right decision for you!!!     Thank you for letting us know the specifics… …this helps all of us to know where you are on your journey.    Buddy & I invite you to visit our personal thread listed in our signature below … We would like to help make your journey a little smoother.. so pull from us what fits your needs.   Make sure you visit the links in your Welcome message … there is so much information to help you through this!   This path is best traveled with friends.   The stepping-stones ahead will be smoother if you stay close to all of us. http://i206.photobucket.com/albums/bb179/mamabluebird1955/Stepping-StonestoHealingWell.jpg   Keeping you close in thoughts and prayers ~ as you travel this new path with new friends. In Friendship ~ Lee & Buddy     "GOD Bless You" It's a little prayer "GOD Bless You"...   but it means so much each day, It means may angels guard you and guide you on your way.     Threads started by:   RTR Supplies - Post Surgery Newbie - Surgery Looming < 30 days
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