I have had Benign Enlarged Prostate for many years and have been taking Flomax to help with urinary flow. PSA in 2008 was 7.8 and I had a 10 sample biopsy which was negative.
In September 2010, PSA had gone up to 8.9 and I was referred to a urologist who did another PSA (12.0) and scheduled a biopsy. Initial pathology report came back with a Gleason 2+2=4 grading; Asked for a second opinion and the slides were sent to the Chief of Pathology at a major hospital in Southern California. The second opinion was a grading of 3+3=6, and this is the opinion that I am using to decide what treatments to consider. After many hours of reading, especially on the YANA web site, I am leaning towards having the Da Vinci surgery at City of Hope, Duarte, California. I have a consultation scheduled with the surgeon on February 9, 2011.
Later: Next Monday(February 21, 2011) will be an important stop in my journey. I am scheduled for a Color Doppler Ultrasound with Dr. Duke Bahn in Ventura, California. It is almost certain that he will do targeted tissue biopsy based on the Ultrasound pictures. This makes a lot more sense to me than the random biopsy that a I had in November, 2010.
The results of this biopsy will help me decide what treatment, if any, I take in the near future. (BTW, as of January 1, 2011, Dr. Bahn is cash only - no insurance, Medicare or Supplemental.) My hope is that the pathology report will show that the logical choice for me is AS (Active Surveillance). My second choice would be the Da Vinci surgery at City of Hope, Arcadia, CA.
Will post again after getting the report and making a decision.
Received the results of my Color Doppler Ultrasound biopsy from Dr. Duke Bahn in Ventura on Monday. It is not what I had hoped for. The Gleason score was upgraded to 3+ 4=7 and pathological staging at T2b. From the cover letter, "The right mid-to-apex transition zone extending towards the left apex transition zone shows up to 62% malignancy." AS is not recommended.
Possible treatment options suggesed were surgical prostatectomy, radiation therapy, or hormone therapy. Based on the information at hand, I feel my best option is the Da Vinci surgery by Dr. Mark Kawachi at City of Hope in Duarte, CA. Dr. Bahn is familiar with Dr. Kawachi's skill set and experience and believes he will be able (as well as anyone) to extract the concentration of cancer next to the urethra.
I have scheduled my surgery for Tuesday, April 26,2011. I am dreading the surgery, et al, but I feel I have made the only logical choice for me. A word on prostate biopsies: IMHO standard biopsies are like throwing darts at a wall with no target. It is really a hit and miss proposition. My November 2010 biopsy came back with a Gleason 2 + 2= 4. Yahoo!!! AS for me. No surgery , no radiation, no hormones. It was pure BS. The transrectal Color Dopple Ultrasound biopsy is targeted to specific areas of concern. You look at the same monitor pictures of your prostate while the Doctor points out areas to take tissue samples based on blood flow patterns and other markers. I did not like the answers I got from the pathology report, but at least I had accurate information on which to make a treatment decision.
First, the pre-op session: City of Hope , April 9th,2011: EKG, Chest x-ray, and five vials of blood. A female doctor (unknown to me) wanted to do a DRE. I refused. I told her, " Hey, I have PCa which has been confirmed by three pathology reports of those tissue samples. A DRE serves no purpose for me."
Second, the operation: City of Hope, April 26th,2011: Wheeled on a gurney into the operating room for the Da Vinci operation. The last thing I remember is noticing all the stainless steel equipment. My operation was scheduled first for 7:30 AM. I woke up that afternoon in a hospital room that I thought was the Recovery Room. I am told that I chased away my wife and relatives, saying that I did not feel like visiting. The next morning I was walking the halls of the hospital hanging on the IV cart and was discharged later that afternoon.
Third, first week at home recovering, April 27th,2011 to May 2nd, 2011: Recovered my strength quickly and actually took my dog, Oreo, for his nightly walk. Now there's a little guy that knows how to do "Kegels". Pee, walk, Pee, walk, Pee, etc. No wonder he can hold it so well in the house. Slept well and ate well. Even had a bowel movement the first day. Worse part of the week was the catheter. Uncomfortable. Could hardly wait to get it taken out.
Fourth, Consult with surgeon and catheter removal, May 2nd, 2011: Good news, bad news. Dr. Kawachi says it appears that the cancer was confined to the prostate gland, but that it had "invaded the Seminal Vesicles". Says that 80% of the time that is not a problem , but he wants the pathology department to do further tests on my Seminal Vesicles to determine the probability of micro-mets. Will meet with him again on May 23rd,2011 to get those results. A friend of mine had told me how excruciating painful it was to have his catheter removed and so I asked the middle-aged nurse if she was experienced at removal, and she replied, with a straight face, "Sir, this is my first day". It hurt my stomach to laugh so hard. She was quick and the catheter was out without any noticeable discomfort.
Fifth, Life after surgery and catheter removal to date: Resumed driving and going to work half-days exactly one week after the operation. Life is good and am looking forward to some good news when I meet with my surgeon on Monday, May 23rd.
Approaching the one year Anniversary of my Prostate Removal Operation. Glad to report that there was no Seminal Vesicle Involvement and that my quarterly PSA readings have all been 0.004. The doctor has now scheduled the next PSA blood test for six month intervals.
I am extremely grateful that I found this web site when I was first diagnosed and while I was investigating the various treatments available. God Bless Terry, his support staff, and all the Prostate Cancer patients that have contributed to this wonderful source of knowledge.
Good blood tests so far. In fact, just changed to 12 month followups from six month tests. Happy with surgery choice and the results.
Over six years since my operation and all is good. Thankful for this site and the City of Hope for helping me through the process.
It's been eight years since my prostate removal surgery. Life is good.
Not even required to get periodic blood tests. Apart from ED, I am happy with the choice I made for the DaVinci Robotic Prostate surgery. I will be 80 years old this coming September and still work three days a week.
Hard to believe that it is almost ten years since the DaVinci prostate removal operation at City of Hope, Duarte, California.
Cancer free and don't have to go in for PSA blood tests. Feeling good and just turned 80 last September. ED was not a surprise. The cancer was in an area where certain nerves were going to be damaged. The choice was simple, life without sex or death. I chose life and have no regrets.
Hope this information helps someone.
Sincerely, Gary P
No reoccurance of the cancer. Glad that I chose removal of the prostate gland.
Extremely happy with the results of my prostate removal operations.
Gary's e-mail address is: carpetgary AT aol.com (replace "AT" with "@")
