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Richard D and CT live in Georgia, USA. He was 65 when he was diagnosed in August, 2009. His initial PSA was 4.60 ng/ml, his Gleason Score was 7, and he was staged T1c. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

I was diagnosed on August 20, 2009 and had robotic surgery on January 5, 2010.

My reasons for choosing robotic surgery were:

(1) family history,
(2) presence of a Gleason 7,
(3) 5 out of 12 biopsy samples proved positive for cancer,
(4) surgery limitations if I had chosen radiation and it did not work, and
(5) several discussions with friends who had unsatisfactory results from other treatments.
(6) Finally, I am located near one of the very top robotic surgery centers in the south and had access to a skilled surgeon who has performed over 2,500 procedures.

Pathology results from the surgery showed cancer in only 4% of the prostate, and only on the right side. I am optimistic regarding long terms results, based at least on the positive short term results.

UPDATED

April 2011

Current PSA is zero 15 months after robotic surgery. No issues whatsoever with post-surgery incontinence.

Significant ED issues persist. Have used Cialis and recently switched to Viagra. I fear that this could be a permanent problem, but I try to remain optimistic.

UPDATED

July 2012

I am now 2.5 years past my robotic surgery (I'll be 68 years old in October). I do not visit my surgeon (urologist) any longer, but rather see my regular internist. PSA every six months has been consistently less that 0.1. No incontinence problems at all.

My ED problems do persist. The ED problems appear now to be permanent. Almost three years ago, my goals were to (1) get rid of the prostate cancer, (2) minimal incontinence issues, and (3) minimal ED problems. It looks I was successful on the first 2 out of the list of 3, so I am happy.

UPDATED

August 2013

Status is the same. Was diagnosed with prostate cancer 4 years ago. Still pleased with my choice of robotic surgery. My only problem is moderate ED and I am addressing that with somewhat successful treatment.

UPDATED

November 2014

No real status change since last year. Was diagnosed with prostate cancer 5 years ago. Still pleased with my choice of robotic surgery. I am coming up on my fifth year post-surgery. No incontinence issues at all. My only issue continues to be moderate ED.

UPDATED

December 2015

I had da Vinci robotic surgery almost 6 years ago (in Atlanta GA, USA). My PSA was undetectable for five years, then moved up to 0.2 about 5 years after the date of my surgery. My urologist is now getting readings every 3 or 4 months to get a "trajectory" of how fast the PSA is moving upward. I was only seeing my internist after the surgery, but now have gone back to my urologist since the PSA moved up to 0.2. The urologist uses a type of PSA test that allows a more precise reading of the PSA numbers. I am now 71 years old, and the idea (in his mind) is that if the cancer is indeed growing then he needs to know how fast. If it going to be 15 or 20 years before it becomes life threatening, then we may not undergo radiation since that would be about my projected life span anyway.

In summary, my PSA number is up a bit 5 years after surgery, an I suppose that we are doing a "watchful waiting and observation" type of treatment until we know more. I am prepared to go in for radiation treatment if the cancer starts on an accelerated trajectory.

ED is my only post-operative symptom and I am managing that successfully with drugs.

UPDATED

February 2017

I am now 7 years post robotic surgery (prostate removed). My cancer has returned 6 years post-surgery in 2016 (PSA of 0.5). My PSA had thus been undetectable for over 5 years post-surgery. Doctors were not shocked since the immediate analysis of the prostate gland after surgery (in the lab) indicated some cancer cells at the perimeter area of the removed prostate.

In 2016, upon my Dr.'s recommendation (urologist and oncologist), I went through 39 radiation treatments with a radiation oncologist in the summer of 2016. My first PSA reading in late 2016 after the radiation was down to 0.1, so that gives me hope that my next reading in a few months will be undetectable again. As an aside, I did not realize that it takes many months after radiation treatments for the PSA reading to get back to undetectable (if indeed the radiation works and the PSA readings are actually going to get back to "undetectable"). Knowing what I know now, I might have been more diligent 7 years ago when I first had the prostate removed. That is, if there were cancer cells observed at the perimeter of the prostate (when it was examined in the lab after surgery), should there have been a serious discussion regarding radiation at that time? I do not recall that issue ever being raised, and maybe it was not a realistic possibility but I do not even remember the issue being discussed.

With all that being said, my life has been good. I am active and otherwise healthy. I have serious ED, but that is being effectively addressed through injection therapy. I have no incontinence issues.

Richard's e-mail address is: rdeane AT gsu.edu (replace "AT" with "@")


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