Medical Forum / Diseases and Disorders / Prostate Cancer / February 2006
robotic prostectomy/east coast
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Ed Kratz - 16 Feb 2006 10:56 GMT While I'm hoping for the best while working with variation in my PSA, and hoping it's resolved, I'm considering my options. (A PSA of 5.4 in October after a year ago being 1.6. Re-test in November 1.9, then repeat in January 2.5. Scheduled for another re-test in two weeks. Negative DRE by internist, and URO.)
Just wondering if anyone had opinions or experience , pro or con with robotic prostectomy. I'm in Philadelphia, but willing to travel. Believe I've heard good things about Dr. Tewari, and about a Dr. Lee (I think) recently moved to U of Penn in Philadelphia.
Any comments would be appreciated.
Thanks, Ed
From Bob - 16 Feb 2006 11:51 GMT No personal experience, but their are 2 issues, the prostate must be small, and you must not be over weight, also read that the procedure takes 6 (six) hours. Cancer must also be confined (early stages), and not spread beyond capsule. Good luck
KenA - 17 Feb 2006 02:42 GMT My RLRP (with no complications) took 4 hours - start to finish. Discharged 28 hours after start of surgery. KenA ======
> No personal experience, but their are 2 issues, the prostate must be > small, and you must not be over weight, also read that the procedure > takes 6 (six) hours. Cancer must also be confined (early stages), > and not spread beyond capsule. > Good luck Leonard Evens - 16 Feb 2006 15:06 GMT Ed Kratz wrote:
> While I'm hoping for the best while working with variation in my PSA, and > hoping it's resolved, I'm considering my options. > (A PSA of 5.4 in October after a year ago being 1.6. Re-test in November > 1.9, then repeat in January 2.5. Scheduled for another re-test > in two weeks. Negative DRE by internist, and URO.) I'm not sure why you assume you have prostate cancer? Have you had a biopsy yet? Depending on your age, your PSA history is quite consistent with a bout of prostatitis. If your doctors want to avoid a biopsy, it might be worthwhile doing a fee PSA test.
In any case, a biopsy stands a good chance of settling the matter.
> Just wondering if anyone had opinions or experience , pro or con with > robotic prostectomy. [quoted text clipped - 6 lines] > Thanks, > Ed Ed Kratz - 16 Feb 2006 23:24 GMT Leonard, Thanks for the comments. I will see what happens in the next PSA. If it's still at 2.5 URO and internist agree biopsy is next. Thanks for your comments. Ed
> Ed Kratz wrote: >> While I'm hoping for the best while working with variation in my PSA, and [quoted text clipped - 20 lines] >> Thanks, >> Ed Scott Brody - 17 Feb 2006 08:02 GMT Assuming that a Biopsy confirms that you have PC you can check out the web site for Intuitive Surgical Instruments... the manufacturer of the daVinci equipment...
http://www.intuitivesurgical.com/products/davinci_surgicalsystem/
I am sure that the procedure is done near you... remember you will only be in the hospital for 1-2 days (max), but you will have a catheter for 5-6 days... so, you will have to be near your MD for that time... after the catheter is removed you could see any MD for your follow up visits... but it is best to see your surgeon... The key in selecting the surgeon is to find someone who has done the procedure 200+ times... they get faster at it with "practice"
I had mine last March... 2.5 hrs long... 3-4 tablespoons of blood loss... virtually zero pain.... only minor discomfort... home in my own bed 30 hours post op.... catheter removed 5 days later... incontinecy over mid August... and potency is coming back... Need I say more!
Since my surgery I have been a major advocate of men's health care... and a very active support person... feel free to call me for whatever additional information or support that you require...
Check out these sites:
http://www.davinciprostatectomy.com/video.html
Actual webcast of an RRLP http://www.stronghealth.com/services/urology/webcast.cfm
http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.46638/k.865C/Prostate _Cancer_Treatments.htm#top
>While I'm hoping for the best while working with variation in my PSA, and >hoping it's resolved, I'm considering my options. [quoted text clipped - 12 lines] >Thanks, >Ed Ed Kratz - 17 Feb 2006 10:43 GMT Scott, Thanks. I'll check out the links. Ed
> Assuming that a Biopsy confirms that you have PC you can check out > the web site for Intuitive Surgical Instruments... the manufacturer of [quoted text clipped - 45 lines] >>Thanks, >>Ed Alan Meyer - 20 Feb 2006 17:12 GMT > ... > Actual webcast of an RRLP > http://www.stronghealth.com/services/urology/webcast.cfm > ... That is some video. Makes me glad I'm a computer programmer and not a surgeon.
Alan
Buck - 17 Feb 2006 08:47 GMT It would be a good idea to consult with the best experts available on diagnosis as well as treatment. A test of free PSA would seem to be in order before a biopsy. Should you have cancer and you meet the criteria for robotic surgery, in my opinion it's the way to go. I've never heard of the surgery taking six hours. Mine was done in considerably less time. There is less bleeding and greater precision. The recovery was quick and easy. Although there are other factors, the skill of the surgeon is an important factor that impacts incontinence and potency. I have had no problem with incontinence and after four months am starting to recover potency. I'm sure there have to be qualified surgeons with substantial robotic experience in the Philadelphia area. If not, you are probably within two hours of Johns Hopkins, which is rated as the number one urology hospital in the nation. I traveled about an hour and a half to my surgeon and it wasn't that big of a deal. The result is far better than I could have obtained locally. Good luck!
Ed Kratz - 17 Feb 2006 10:44 GMT Buck, Thanks for your comments. Johns Hopkins is a place I'd consider. Ed
> It would be a good idea to consult with the best experts available on > diagnosis as well as treatment. A test of free PSA would seem to be in [quoted text clipped - 11 lines] > a half to my surgeon and it wasn't that big of a deal. The result is > far better than I could have obtained locally. Good luck! JerryW - 18 Feb 2006 02:08 GMT Ed,
If the Dr. Lee you refer to is the same Dr. Lee who had such an excellent reputation with the DaVinci RLRP recently in Arlington, TX before leaving here, I know at least one of his patients personally who recommends him very highly. As I said, Dr. Lee was considered "one of the best" with this equipment and procedure in this area. If you wind up with PCa, and it certainly does not sound like a certainty at this point, and you have an interest in RLRP as a treatment, you would do well to check out Dr. Lee.
 Signature JerryW
Please respond to group; email address is not valid
2/11/04 PSA 2.6, Suspicious DRE (age 62) 2/23/04 Biopsy: Gleason 3+4=7, T2a, left lobe 5/18/04 RRP, Path: Gleason 4+3=7, T2c, both lobes 7/13/04 PSA <0.1 10/12/04 PSA <0.1 1/18/05 PSA <0.1 4/26/05 PSA <0.1 10/13/05 PSA <0.1
> While I'm hoping for the best while working with variation in my PSA, and > hoping it's resolved, I'm considering my options. [quoted text clipped - 12 lines] > Thanks, > Ed Steve Kramer - 18 Feb 2006 11:41 GMT Ed,
After your PSA went from 1.6 to 5.4, I would have been concerned about (not convinced of) prostate cancer with a doubling rate of less than one year. Now, with two subsequent PSAs of less of 1.9 and 2.5, I'm almost moved to say that prostate cancer is least likely.
There are a few things that can cause a prostate to produce an elevated PSA, including infection. Did you take Cipro or some other strong antibiotic after the 5.4 reading? If so, you may be cured.
There are many things, including sexual intercourse and DRE, that can elevate PSA from 1.9 to over 2.0.
You may have a perfectly normal prostate that at one time caught a virus or infection.
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 Non Illegitimi Carborundum
> While I'm hoping for the best while working with variation in my PSA, and > hoping it's resolved, I'm considering my options. [quoted text clipped - 12 lines] > Thanks, > Ed Ed Kratz - 18 Feb 2006 12:34 GMT Steve, Thanks for your comments. After the 5.4 reading, I took levaquin for two weeks. I did see a URO after the 1.9 reading. He did a DRE and recommended I get one more PSA, and if it was in the neighborhood of 2-2.3 just get PSA's every six months. When the repeat was 2.5, my internist thought he'd try a 4 week round of Levaquin, wait two weeks, then repeat the PSA test, and test urine. I'll be going in for that the week after next. And I'll be avoiding exerecise, etc. for a few days before the second PSA. He won't do a DRE, since I had a DRE in November with him, and December with the URO. I'm cautiously optomistic, but I tend to be a worrier, and feel it's good to hope for the best, but to be semi-prepared for the worst so one is ready to deal with bad news. Thanks for your comments.
Ed
> Ed, > [quoted text clipped - 29 lines] >> Thanks, >> Ed
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