I am scheduled for Da Vinci surgery on 30 April 08 with Dr Fagin in Austin Texas. My wife and I will fly there from our home in El Paso Texas and meet with Dr Fagin on the 29th of April. A lot of soul-searching went into selecting Da Vinci but the over whelming primary reason was to attempt to extract the cancer entirely from my body. We realize that with a Gleason 8 the chances of it having spread beyond the prostate are quite high but we have accepted that possibility and will address that circumstance when and if it presents itself.
Of course we are hoping it is completely contained within the capsule. Bone scan and CT scans were negative which is encouraging but not within itself completely reliable...better than the alternative though.
I have read some glowing accounts of Dr Fagin's abilities...we feel Dr Fagin gives us the best shot in accomplishing our goal of extraction with negative margins outcome. I have not spoken directly with Dr Fagin and won't until the 29th of April...perhaps some of you might give me more insight into his operational skills as to obtaining negative margins, etc...does he rely on lab reports of dispatched specimens during the operation or is it mainly based on the appearance of the tissue in question...Any info would be deeply appreciated.
I have done all my pre-op requirements and now just waiting until the extraction date...we plan to stay in Austin until 8 May then return home. Will update and post outcomes after return home... Salty
Well folks I looked up at ole' man death and I poked my finger in his eye! I said, "Come back another time, I am not ready to go yet." And he politely turned away...
I am still not aware exactly what caused me to be two pints low on the blood supply the night of my surgery on 30 April 08...there wasn't anything to indicate any problem during the procedure as everything was accomplished just as planned as discussed in our consult the afternoon before. A possible answer is my age because, let me tell you folks if you are not already informed, this surgery thing is a young man's game not for old pharts like me. And the fact that I was a medical risk (though never discussed with Dr Fagin, and to his credit that he accepted me) I figured if I had any difficulty it would be my 4-bypass heart but it held up just fine...my only remaining kidney was the culprit when it just said that's enough and shut down and I wasn't putting out any urine.
They gave me 5 units of blood and that got it restarted. my blood pressure went down to something like 50-60 over 40. I didn't go into coma so I just lay there and watched the excellent Doctors and nursing staff of the Westlake Hospital scurrying about doing this and doing that and then one of the nurses cried out, "Hey, I see some urine coming out in his bed bag." I asked, "How much?" She responded, "Just a little trickle but that means the kidney has been jump-started!"
A doctor explained to me later that a body-defense mechanism allows the kidney to shut down when it is surrounded in blood. I received 5 pints of blood and my pressure started to climb...it was just not my time... I stayed on in intensive care until discharged on 6 May.
My wife and I saw Dr Fagin and had the catheter removed and got the Path report. While waiting for Dr Fagin to come in with the report I was preparing the wife for what I fully expected to be a less than favorable report and I had resigned myself to returning to El Paso and to continue some other type treatment options for the spreading disease. My pre-op Gleason of 4+4= 8 weighed heavily on my mind.
Then Fagin arrived with the glorious news that not only were my margins clear but the Gleason had been downgraded to a 3+4=7. Path finding: The right and left seminal vesicles and ampulla are free of tumor. The distal margin of the prostate is free of tumor. There is an adenocarcinoma in the prostate. It is a conventional acinar type. It is present in both sides of the prostate. On the right side it is present in five out of 10 levels. In the left side it is present in nine out of 10 levels. The predominant Gleason grade is 3. There are smaller areas of Gleason pattern 4. This is a Gleason's 3+4=7. THE TUMOR IS CONFINED TO THE PROSTATE . It DOES NOT extend into the extraprostatic tissue. The surgical margin is NEGATIVE. Stage pT2c.
Needless to say there were a few tears and neck hugging and an almost disbelief of our good fortune. After being reassured that this was indeed the case then the sheer reality of the moment captured us all and the hugging continued. I am sure that this fine human being and superior Doctor has experienced these types of scenes in his illustrious career many times over in previous encounters with his many patients.
He said no further treatment required. He told me to go home and rest, set in the sun and recover.... My wife and I returned yesterday the 8th of May to El Paso. Today is my birthday...yes 76 today and hopefully there will be a few more. So, I am sitting here soaked as I have started the battle now of continence...another hill to climb for this old soldier...
Thanks everyone for all your kind words and prayers...and..an especially great "Thanks" to Kris...We have shared the same foxhole...Thank you Friend. And to Glenn Corser of Austin Tx who helped me tremendously with his encouragement. It was especially pleasurable to meet Glenn at our little rented apartment in Austin the night before we returned home. Ordinarily. one should be looking for that first PSA report in about 60 days after surgery to be the determining factor in this cancer's life. But I feel I have gotten rid of the entire miserable little bugger and look forward to my first PSA with a positive anticipation with the feeling that I am 100% cured!!
See you in a couple of months.
P.S. Just before surgery I asked Dr Fagin what number I was...he checked some sort of hand held gadget and told me I was number 1348 that he has operated on with the da Vinci...that has become my lucky number.
I feel that I have defeated this insidious disease as my PSA's have all been less than 0.1 since my surgery. After the initial problems with my surgery I have experienced only positive results. I have never regretted having the surgery as I feel I ridded my body of all cancer cells.
Sorry that I haven't gotten back earlier to the readers of this site to report my good news but a little matter of just "getting on with my life" got in the way. Good luck to everyone who is facing this type of trip...just know, that it can be defeated and think positively...there is life after cancer and you can survive it.
I consider my surgery in April 2008 a complete success. My PSA has been undetectable after the surgery and throughout my recovery.
I did have the problem of leaking and ED but that problem was resolved by surgical installation of an artificial urinary sphincter and IPP (Inflatable Penile Prosthesis) in January 2009. Since the installation I have had absolutely no problems with leaking or ED. I am presently continuing with my life in a very normal fashion...
Wishing all who read this to not despair inordinately... There are some good people taking care of the less fortunate who are taken down by this disease... I was lucky to have found highly professional people that took care of my problems. You can be lucky also. Be of good cheer for there are good people available to help you.
[In response to a reminder, Salty wrote:]
Please hold for my next PSA exam that is scheduled for around 8 June. After this exam I will update my report to you.
It's been over five years since my prostatectomy and over four years since my AUS and IPP surgery and I am happy to report that I feel fine and haven't had any great setbacks that diminish my selected treatment. My PSA has been bouncing a bit but still at or below 0.1. At the tender age presently of 81 PCa is one of my lesser health problems. As a graduate of a 5-bypass surgery some 17 years ago, along with assorted aches and pains, veteran of two wars, and 100% disabled retired Army officer who has to use a power wheelchair to get around, I do not treat the PCa as a major problem at present. I treat each of my maladies with equal disdain and consider them as battles that I have won or still fighting until my war is over and they plant me in some distant field.
Well, here I am...a year older now standing at 82. No drastic changes since my last update except slight increase in PSA. There is a gentle rise in the PSA each time blood is drawn. I don't particularly know the reason for the rise...my doctor and I will keep checking every six months to see if the rise meets the threshold for clinical action. I think my next check is in December. I will update with the results.
History of PSA:
05/2010 and prior exams after surgery in 04/2008 <0.1
Well, I am 83 years old now and still kickin'.
My PSA is still rising. In May 2015 it set at 0.188 and Sep 2015 it topped out at .0205. So, looks like I am going to have to go on ADT treatment soon. I am waiting for the next one to finally decide. I will update you then.
Good luck to all you guys.
Correction on my last post...The dates of my last two PSA tests were Dec 2014 and June 2015. Next one is scheduled for somewhere near end of year.
My PSA continued to rise in small but trending upward steps until it reached .0449 so I started ADT treatment with injection of Lupron in Sept 2016 with succeeding injection every 4 months. CAT scan did not reveal any spreading of the cancer into other organs or bones. Next scheduled injection on 5 Jan 2017. PSA has drastically reduced in succeeding steps from .0449 to .036 to .01. Only noticeable physical change is smaller testicle size with corresponding reduction in libido. Testosterone went from 255 to 0.
My present age is 84 and was a determining factor in my deciding to undergo ADT. Radiation therapy was ruled out because of my artificial urinary sphincter (AUS). I have had the AUS for 8 years now and it still serves its purpose. I had terrible incontinence problem following my robot surgery.
Sigh...another year has past and still fighting this disease. I am and will continue fighting this wretched disease as you should too.
Good Luck to all!
Salty's e-mail address is: firstname.lastname@example.org