I was diagnosed with cancer of the prostate in October 2004 following a slightly elevated PSA (6.5) and a 12 needle biopsy which revealed cancer in 10% of the right lobe samples and 25% of the left lobe. The Gleason was 6 (3+3) and I was graded T1c. After evaluating all the treatment options, I decided to go aggressive and have the prostate removed. I elected to use the services of Dr. Mark Kawachi at City of Hope in Duarte, California, who is an artist in the use of the DaVinci robotic laparoscopic system.
On Tuesday the 14th of December, checked in at the Sheraton Four Points Hotel in Monrovia. Wednesday morning, checked in at COH at 6:45 AM for pre-surgery preparations.
I was wheeled into the OR and introduced to the DaVinci "robot." It is an intimidating looking device - something I could imagine as a prop in an old episode of Lost in Space ("Danger Will Robinson!"). Dr. Kawachi's station was a console located in the corner of the OR about 10 feet away from the actual robotic arms. Just as I was admiring my surroundings, the anesthesiologist turned out my lights. Time was about 8:45 AM.
I awoke in the recovery area at around 1:00 PM. As I surveyed my situation, I realized the procedure had been done and other than some dull soreness in my abdomen, I didn't feel too bad. I had six small cuts forming an arc and all but one were sealed with surgical glue. The one cut near my navel had a bandage and some internal stitches. That incision was about an inch long and was used to pull out the surgical bag containing my prostate. Later that evening, a nurse assisted me out of the bed and we walked around the wing for about 20 minutes. That evening I slept well. In the morning, about 8:30, I was visited by Dr. Kawachi and a group of his assistants. He related that the procedure had gone exceptionally well. Monday the 20th of December I returned for a consult and removal of the Foley catheter. Speaking of the Foley, I had read many stories of patients who had experienced problems with the catheter. I had it in for five days and for the most part it was not a big bother. The catheter removal went fast and was not painful. I had some leakage right off but that is pretty normal. Made it through my first night home with a dry pad and voided normally in the morning. Now, six days later, I wear no pad at night and only one for the day. I am about 90% continent. I was prescribed a 10 mg dose of Levitra each evening and on the second morning, awoke with a pleasant surprise! So I guess it is safe to say I am a big proponent of the robotic laparoscopic procedure. All I can speak for is myself, but I have been very impressed with the absence of pain and speed or recovery.
Got the pathology report from Dr. Kawachi on the 23rd and was relieved to hear the words "organ confined." Additionally, the post-op Gleason score remained at 6 (3+3) which was encouraging. I will return to COH the middle of January for my PSA test. I plan to update this narrative as time passes.
Had my first month post-op checkup yesterday (1/10/05) which included an ultrasound of my bladder/urethra and a PSA test. So far, all the news is good - no sign of scar tissue in the ultrasound photos and a PSA of 0.04 ng/ml.
Continence is now at about 90% and potency (with Levitra)is excellent. I have read many times that a successful outcome from this surgery is directly proportional to the skill of the physician. In this case, I have to give praise to Dr. Mark Kawachi for the excellent job he did on me!
On 5/9/2005, had my 2nd post-op PSA test and was happy to see it come in at less than 0.04 ng/ml. Now almost five months post-op, I am down to one pad per 24 hours and potency (with the help of Levitra) is good. I am still an advocate of the RLRP procedure, especially when done at a faciity with good experience in this area (like City of Hope, where I went) and a surgical "artist" like Mark Kawachi!
I had my third post-op PSA test in mid-August and it came in at < 0.04 ng/ml. At the time of the visit, the doctor did his usual DRE and said everything looks good. So he moved my PSA cycle from 90 days to six months. My next check is in January, 2006.
In the meantime, I am fully continent and still doing well with the potency issue with the help of Cialis.
Had my one-year (+) checkup and had a great reading on PSA of less than 0.04 ng/nl (the lower limit of the assay method they used). Have been fully continent for almost seven months and potency is good with Levitra. I have one more six-month check then the doctor will go to a once-a-year regimen. I am still a big proponent of RLRP.
Just completed my 18-month post-op PSA test and it is still holding at less than 0.04 ng/ml (this is the lowest they can go with the assay they are using at my urologist). Not much else has changed. Still need Levitra to counter ED but no complaints. Continence has been good and at 68, I am finally thinking about actually retiring!
I just had my two-year checkup and once again, had good results with a PSA of less than 0.04. About the only change in my situation is a diminution in libido but I blame this on my age more than the result of the surgery. I still have to monitor how much coffee I drink because it is the one liquid that will cause some leakage when I am doing physical tasks. As long as I don't go overboard, there are no problems. Even beer doesn't cause a problem, only coffee.
Best wishes to all the men who are fighting the good fight.
I just had my semi-annual PSA check and everything is still looking good at less than 0.04 ng/ml (that is the lowest the doc's lab can read and has been my reading for 2 1/2 years now).
My wife finally nagged me into getting my first colonoscopy last week. Definitely not as bad as I had envisioned, other than the "prep." The doctor removed four polyps that turned out to be non-threatening (whew!) So there is one more item we men have to be concerned with, as if prostate issues weren't enough!
Just passed a big milestone - the three year point and still registering zero on the PSA.
That is the great news. But I have run into an odd side effect of the LRP surgery. It's called an "incisional hernia" and I have developed one just above the naval. My local urologist related that this is not unusual since the naval is the largest incision made during the LRP (this is where they remove the prostate in a small bag), and the muscles in that area are weakened by the incision, thus the name: incisional hernia. So the end of this month, I have an appointment with a surgeon to schedule another surgery to insert a mesh to repair the hernia. Ironically, this too is a laparoscopic procedure! [This type of hernia - an inguinal hernia - is a good deal more common than Jack has been lead to believe. One study indicates that about 30% of men undergoing laparoscopic surgery can expect to have such an event.]
Best of luck to all the men fighting the good fight!
Just completed my 3 1/2 year mark PSA test and still at the "zero" point (less than 0.04) for the assay used by my urologist's lab. If I can continue at that level for 1 1/2 more years, I will shift to an annual PSA test. Always very happy to see those continuing low readings.
My last PSA was still in the undetectable range (July 2009) and I am now going for checks on an annual basis vice bi-annual.
I will have achieved the five year mark in December of this year (2009) and overall, the choice I made to remove the prostate has been validated.
Thanks to Terry for hosting this informative and valuable site!
A few days ago, I hit the five year milestone. I celebrated with a .04 PSA (zero) and look forward to the next five years with the same readings. I have noticed that five years post-op, I have seen the return of occasional leakage so maybe I need to go back to the exercises! Otherwise, life is good.
I had my annual PSA test in January and it is hanging in at .05 ng/ml. It is .01 higher than last year but I was told by my urologist that is within the tolerances of the assay.
I am feeling well - I notice that the older I get, the more I have to taper off coffee (much as I love a good cup of coffee). Either that of be very conscious of the fact that a mild strain can cause a bit of leakage. I don't attribute that to my surgery; just getting older.
Cheers and hats off to another year of good living!
The last PSA check was a few months ago and it went from .04 to .05, but I checked with a friend who is a renowned Urologist and he said that was within the "noise level" of the ultra-sensitive test. This coincides with your writeup in today's newsletter.
Nonetheless, I will take another test in January 2012 to get a better benchmark. Thanks for keeping the forum alive. It is a valuable serice to folks who have/are dealing with prostate cancer.
All the best, Jack!
I had my annual PSA test in March and it came in at 0.05 ng/ml, same as last year. At this point of time, I am considering having the test done once every two years. Seems to make more sense at this point. Still have to watch the coffee drinking - it can lead to some unwanted leakage when I strain in any way. My wife tells me "Yeah dummy, it's a diuretic!" All the same, I love coffee!
It has been over eight years now since I had my robotic surgery. Still have an occasional bout with leakage but that usually happens when I overdo the Colombia Supremo (I am a coffee addict!).
I am considering reducing my annual PSA checks to a two year cycle. My doctor tells me that the odds of a recurrence at this point are pretty small. I did dodge one other bullet recently, however. During a routine colonoscopy, they removed some polyps and noticed a very suspicious area in the transverse colon. A biopsy was taken, and sure enough, it was adenocarcinoma, a term prostate cancer folks know only too well. I didn't delay at all. I set a date for surgery two weeks later. About a foot of colon was removed laparoscopically and the post-op pathology report said it was a T1, which is the best news since it indicates the tumor is fully contained in the removed section. So no chemo, no radiation, and only more frequent colonoscopies are in my future. It just goes to show that prostate cancer is not the only enemy of aging males. I fully support regular colonoscopies. It is not as unpleasant as most men think it is and it can save your life!
All the best - Jack
I am now approaching the big 10 year mark post-op and still doing well. I still make an annual trip to my urologist for a checkup and take the PSA test. He said that although some men have a late recurrence, the odds are pretty low after 10 years. I recently had a colonoscopy to check for any other problems in there following last year's cancer surgery. All is well and I am back to a three year periodicity for the colonoscopies (whew!). It WAS once a year. The PSA checks remain in the undetectable range and the only problem is mild incontinence related to my affinity for good coffee. Not a big deal and not something for which I am willing to forego coffee. Turning 76 in April and feeling great! Except for a few bouts of cancer, I am in excellent shape :-)
This past month, I had my annual physical check and PSA test. The PSA remains at the undetectable level and my overall health is good; no meds, no problems. The doctor recommended I stop the PSA tests since at this point (I turn 77 in April), there is no point, since even if the cancer did return, I would die of other causes before it could create any problems. I can't argue with that logic. So I am pretty much waving goodbye to PSA tests and thoughts about prostate cancer and relegating them to the distant past. I am still glad I removed the gland, just because it provided the peace of mind that comes from the post-op pathology report that stated the disease was organ confined. That alone was welcome news that would not have been know had I opted for other forms of treatment. Of course, that is just my outlook and every man's approach to dealing with this is a personal choice only he can make.
I wish every man good luck in their own battle with this awful disease.
I have finally kicked the habit of taking an annual PSA test. My doctor noted that I have been showing no signs of recurrence for over a decade and even if it did decide to come back, I would die of other causes (old age!) before any cancer came to play. So I just turned 78 and feel great. Off to Italy later this month with my son.
Best wishes to everybody!
Jack's e-mail address is: firstname.lastname@example.org