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Bernie Hoth and Ginny live in New York, USA. He was 64 when he was diagnosed in December, 2007. His initial PSA was 8.77 ng/ml, his Gleason Score was 6, and he was staged T1c. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

In 2001 I had a higher then usual PSA had a biopsy and it was negative. My PSA went back to normal. That is until Nov 11, 07---My primary care doctor does the PSA annually and then I schedule an appointment with the urologist. Out of the blue my PSA went to 8.77 then redone and it was 6. The urologist did a biopsy on November 29, 2007 and report was in on December 8, 2007.

Of the thirteen cores , one core in right apical region had 18% cancer cells. Gleason 3+3 , stage T1c. My wife and I spent the next few weeks reading anything we could about treatment options. Urologist had said when reviewing the biopsy results no matter what treatment you choose you will do well. He described treatment options after saying his advice was to have a robotic radical prostatectomy, and he gave us Dr Samadi's card. He had referred his cousin to Dr Samadi. His advice was make sure any surgeon you choose that is doing robotic radical prostatectomy has done hundreds on these procedures. On December 18, 2007 I had a consult with Dr Samadi, and surgery was scheduled for February 6, 2008.

Day of the surgery, procedure started at 12pm, I was up walking at 9pm and walked until 1:30am. I was discharged from the hospital at 9:30am, walked to our car. My son, had driven my wife into Mt Sinai, and drove us out of NYC. We dropped him off at a RR station so he could go back to LI. We decided to drop off scripts on the way home and since we had 15 minutes to kill we went out to lunch! Yes, I had a light lunch as this was the first solid food I was having post op. I did not feel the need to take any pain medication post op.

My catheter is coming out on February 14 - counting the hours as this just an inconvenience. Will follow up as things progress. Hope other aspects of recovery go as well as post op.

Glad my wife worked in the medical field as she translated medical terms and procedures. Can not begin to tell you how great this site is.

BH

UPDATED

February 2008

Catheter removal was yesterday, and I have to say it was not a pleasant experience. Was the same level of discomfort as JP Drain removal. Was disappointed that the pathology reports was not available yesterday. Was told by nurse practioner that path usually comes in Thursday pm or Friday morning-- Hoping rest of recovery goes as smooth as the last week---other than dealing with the catheter.

Later:
Less than an hour ago Dr Samadi's Office called with the Pathology Report. Good News organ Confined---bad news Gleason is upgraded to 3+4 a 7 from 6. Also Ca was bilaterial. Will know more once I get to actually read the report myself.Glad I chose the Robotic Radical Prostatectomy.

Later:
Something I felt I needed to add---was my Clinical Stage (biopsy) wasT1c Gleason 3+3=6 one core of 13 18%ca rt apex. My Pathological Stage T2c showed I had bilateral cancer Gleason 3+4=7 and 70% of the slides had cancer cells so what I thought was insignificant indolent tumor was in actuality extensive cancer through out the gland. I had clear surgical margins, the ca was organ confined, no seminal vesicle involvement---I really made the right decision. Next step first PSA.

If anyone wishes to email me please put in subject that you are from this site no spam please.

UPDATED

May 2008

I had my first post PSA and it was undetectable on March 20, 2008.

Only have stress incontinence infrequently.

Have been on Viagra since the catheter was removed. Did have to ask for the script. My dose was bumped up top 100mg on 3/25.

UPDATED

August 2009

My next ultra sensitive PSA will be done in September, so far undetectable.

Have not had continence issues -- basically that was resolved by 7th week post op.

Using oral medications on nights I don't inject Bimix, and do not have any issues with that (ED).

Glad I chose RALP (Mt Sinai, NYC, Dr Samadi), as for me it was far from over-treatment. For what was at biopsy (done by local urologist), clinical stage, an insignificant, indolent cancer turned out to be in actuality, post op path EXTENSIVE, while organ contained.

I have become more conscious of my diet, and have modified it. Pre-op I stopped all caffeine and have continued that. Really don't miss the caffeine.

Bernie

UPDATED

September 2009

Just wanted to update. The results from latest Ultra-sensitive PSA are undetectable. I am happy with the choice of treatment I chose (RALP), and have no issue with using bimix injections.

UPDATED

February 2011

I made the correct decision choosing RALP. My advice to anyone is to make sure you choose a physician with experience. I also suggest that especially if you choose RALP, you write in on your consent form Dr._________, only at the controls of the robot, unless, he/she becomes disabled. What you do not want in a surgeon is a urologist that does one or two surgeries a year. This ensures the doctor you hired is doing the procedure.

Learn from my mistake, I allowed a local urologist (highly recommended by a doctor friend) to do a biopsy in 2001 and 2007, without asking how many prostate biopsies do you do in a year? I did get a second opinion the second time. At diagnosis I was told I had indolent, insignificant Prostate Cancer. Post operative pathology showed extensive bilateral, but organ contained.

I am more aware now of eating a well balanced diet. Eat mainly organic, free range chicken, egg whites and organic produce as much as possible. Pre op I eliminated caffeine from my diet and rarely have a drink. I have no issue using Bimix injection.

Bernie

UPDATED

March 2012

I know I made the right decision with the mode of treatment, RALP, I had in 2007. So far Ultra-sensitive PSA is undetectable. I want to stress to others ask if you are told you need a biopsy-----Dr how many biopsies do you do/yr, as you may want to seek out a surgeon that does many. Also, make sure you get a second opinion on your biopsy by a pathologist that specializes in prostate cancer. You want to have an accurate Gleason as well as staging.

Once you make a decision on mode of treatment make sure the physician you choose is EXPERIENCED. As for Robotic Assisted Lap Prostatectomy the learning curve is HIGH. Make sure the Surgeon has performed more than 1,500 procedures. Also, on any consent form write in Dr.______ only at the robot controls, unless he/she becomes disabled during the surgery. Request a copy of your biopsy, labs, or report and post op pathology----so you can make copies if you see another physician. Look up terms you don't know.

Bernie

UPDATED

April 2013

Current Ultra Sensitive PSA undetectable -- I am 5yrs post-RALP.

Yes, I would choose the same treatment if I had to do it again.

UPDATED

May 2014

Had my annual Uro check up and The ultra-sensitive PSA was negative.

UPDATED

June 2015

Still have an undetectable PSA. Use generic Viagra for O2 and Inj of Bimix. Yes there are side effects of treatment , but they are manageable. I would choose the same mode of treatment if I had to do it over again, but I caution anyone considering Robotic Surgery to make sure their surgeon his EXPERIENCED.

UPDATED

July 2016

My Ultra-sensitive PSA is undetectable.

Bernie's e-mail address is: ghbhpv@verizon.net


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