4 months ago I had a normal general checkup. DRE (Digital Rectal Examination) showed normal but I had a PSA of 5.0 ng/ml (I had no symptoms). A second PSA, 10 days later came in at 6.0 ng/ml. As a result I had a biopsy (done under general anaesthetic) which revealed right side cancer with Gleason 3+4=7
After weighing all options I elected for a (nerve sparing) robotic radical prostatectomy with Prof Tony Costello in Melbourne, Australia ( a very good site to visit, folks). This was a month ago.
My referring Brisbane urologist did not tell me about this interstate procedure, recommending open surgery by one of his peers in Brisbane. He remains negative about the DaVinci robot even though I reported my own experience and my conversations with the ward nursing staff who, without exception, said there was no comparison between OPEN and ROBOTIC and that the latter was the only way to go. The Mebourne hospital is EPWORTH and Costello has a team which supervises the nursing staff. It's all very professional.
I was DaVinci robot number 199 and was in hospital 2 days. I remained in Melbourne for a week until the catheter was removed. I would grade the exercise 4-5 out of 10 in a pain scale and 6-7 on a discomfort scale.
The results of the pathology on the removed organ showed Gleeson 3+3 (no 4 identified) and the margins were fine.
Continence is not an issue at all a month down the track (I did my pelvic floor excercises religiously!) but there is no sign of the mile long dog barking.
I go back for a one month check next week, and presumably a course of Viagra.
When I got the diagnosis I went into serious training for the operation, and lost 10kg. Also went on a vitamin regime and mostly organic foods. Plus acupuncture and Chinese herbs pre and post, and this has assisted recovery. I believe that this protocol, coupled with a positive attitude, helped knock off the Gleeson 4's! Also there is almost no external evidence of the operation.
Some of my friends rushed off for PSA tests after my diagnosis. I'm staggered that in three cases their GP's talked them out of tests on the basis that it could 'open a can of worms- probably unnecessarily because PSA is not an accurate indicator'. I'm astounded that this is the advice doctors are giving. I think it borders on negligence. If this advice has been given to me I would have ended up a basket case.
Summary: You will be overwhelmed with advice, Trust your instinct and run with the method you think is right for you. Make up your own mind and don't let the doctor make the decision for you. (One of the deciders for me was the fact that surgery is not really an option after radiation, but the other way round is possible still). If you elect to go down the path of surgery, I would recommend robotic laprascopic. But whichever knife path you chose, make sure you have the right surgeon!
One final comment: Some very good natural therapists in Australia are recommending GREEN TEA EXTRACT for prostate problems.
Now 15 months since operation and two PSA tests have been 0. All normal other than ability to get an erection - except with injections and then a pretty ordinary result. I was warned that it would take 18 months to 2 years...hmmm. No sign yet, but ever hopeful. Whilst the problem and odds were mentioned by everyone I consulted I now have the feeling that the chances of failure were very much underplayed by the medical practitioners.
I would still go the DaVinci robot method and doubt that I would have made another decision other then getting the bloody thing out.
There are no other side effects other than the foregoing.
There is no change to circumstances or opinions reported in August 2006.
In my case, latest PSA = 0. No other changes in either direction!
In response to a bit of prodding for an update, Henry said:
Sorry for the delayed reponse, but I am alive! Please record in update - NO CHANGE TO LAST POSTING
Thanks Terry - you do a hell of job!!
All good at this end - no change to last report. Recent PSA test returned less than 0.1
No erection and I have had to accept this as reality and my future. (I do think the medicos understate the likelihood of this outcome)
All well and good some years down the track apart from the noted side effect. Not a small issue but better than being dead I suppose. In my opinion my medical advisers played down this side-effect as it seems common.
No changes and healthy!
No changes to previous history. Healthy and well with previous reported side effects.
No change to previous.
Henry's e-mail address is: henrycrawford AT mac.com (replace "AT" with "@")