I am a member of Kaiser Foundation Health Plan, Northern California. In December, 2007 I got a increased PSA score and the test was ordered to be repeated in 6 months. When that test confirmed an increase I was given a needle biopsy on July 1, 2008. The results were delivered by the urologist on July 10. I had a 7 = 3 + 4, which is better than a 4 + 3.
From the onset I really felt my only correct option was surgery, but which type. Through this website I gained many insights and once I confirmed that Kaiser had a Da Vinci Robotic system, it was only a matter of selecting the surgeon. I asked who had done the most, since Kaiser has only had the system about a year. I was given a name and told that there may be a "long" waiting period. It turned out the wait was not long at all. I selected October 1, 2008 as my surgery date, as that coincided well with other things in my life, but I could have had it sooner.
I could have not wished for a better outcome from any surgery! Wednesday 10/1 2½ hour surgery in Walnut (appropriate) Creek. I was pretty much out of it all day. I awoke at Midnight to get up and walk around and enjoy some Jello. I don't really think I slept much the rest of the night, but other than urinary or penile discomforts from the catheter, I had no pain. I went home around 10:30 am Thursday. Saturday I quit taking pain medications, but I still had discomfort in the genital area. I was told in the hospital it was probably bladder spasm, so Sunday I got some medication for that - no go! Monday with a call to the advise nurse, we decided it was just catheter irritation and was to get KY Jelly to lube up. It worked. I went back to work on Monday and have had minimal discomfort since then.
The catheter has a smaller calf bag option, so that you can wear it under your pants and look normal. I joked that my greatest fear was now to have one yellow sock! Well, dummy me made that happen on Friday. I forgot to close the valve. Oh, well. If that is the most embarrassing part of having Prostate Cancer, I will take it.
I get the biopsy results on Monday October 13 to confirm that the cancer cells were contained in that which is now on a lab table. The largest incision was vertical and about 1½", right above my navel. There are 5 other ¾" or less horizontal incisions. The pain is little more than having done a couple of extra sit ups. I must limit physical exertion for about 1 month (lift nothing more than 10 pounds) and no driving until the catheter is out (about 10 days.) In short the recovery period from the surgery was only about 4 days for me, not counting the distractions of a catheter. This has been a wonderful experience, even though I wish I never had to have gone through it. I am firmly convinced I made the right choice and would strongly encourage it for anyone with early stage. It may not be the best choice if the cancer is not contained within the prostate, but it really is the least invasive.
I will be back with biopsy and bodily function reports as they unfold.
Later: 12 days after surgery I had my catheter removed and was given the results from pathology.
The cancer was close to the margin, but did not appear to extend beyond the prostate. I had given the surgeon permission to be a bit more aggressive on the nerve ends, thereby reducing the risk of leaving cancerous prostate margin. I think this was a good choice, based upon the biopsy results.
I have had only minimal continence problems since removal of the catheter (1 week ago,) but it looks like impotence may be part of my future. My wife & I had discussed this before surgery and this was something we were very willing to forfeit in exchange for life.
I am on twice week Cialis that may help to bring some of that activity back on line. Physically I am in wonder shape. The doctor stated that one of the drawbacks of the da Vinci surgery is that patients feel so well immediately after surgery, that they forget that they are not to over extend. I have been behaving and not lifting heavy items, but I do have to stop and think. This restriction is only for one month and I have a long list of heavy duty items I need to get caught up on. I am extremely happy with the results of this surgery choice and pleased that the cancer was detected soon enough that it was a viable option.
No driving until the catheter came out, but I did drive home from the hospital after it's removal. No, removing the catheter was not as painful as I was imaging, just a rather strange sensation as it is pulled out.
It is now three months since surgery. I got a letter from the urologist today: "Good news! Your PSA is undetectable! Hope you are doing well." I am doing well. I am firmly convinced that I made the best decision I could have made for my circumstances. The robot assisted surgery was truly amazing. Six weeks after surgery I was hefting sheetrock and doing major remodeling projects.
I am still battling with frequent urination. I had hoped that was a by-product of the enlarged prostate, but I still have to get up frequently at night. Hytrin seems to help some, but I long for a real "all nighter!" I have not had any significant problems with incontinence. There have been a couple of time when I was doing significant physical exertion that I have leaked a small amount. No problems with coughing or sneezing. A life of Depends was definitely something that I dreaded and seem to have dodged.
Erections do not seem to be forthcoming, but that is a small price to pay for what will hopefully be a long cancer free life. 42 years with the same loving wife who has also accepted this as a positive thing.
Basically no change in any of the situations. PSA is still not detectable.
Over 3 years now and no change.
All in all, I still feel that I made a good choice with good outcome.
I am rapidly approaching my 5 year anniversary. I am still very happy about all aspects of my choice of treatment and its outcome.
I will soon be celebrating my 70th birthday and I am still glad I made the choice that I did. I am able to be here to enjoy my wife and family, now one generation larger.
Remember the choice is yours. Get all the information you can and whatever you choose, it will be the right choice for you.
It has now been more than 7 years since this part of my life began. It would appear that the surgery took all of the cancer and all I can do now about Prostate Cancer is celebrate its death in me.
Prostate Cancer is such a thing of the past for me that I never think about it. Definitely a wonderful outcome.
George's e-mail address is: potemup AT gmail.com (replace "AT" with "@")