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Diagnosed this week and planning robotic surgery

User
Posted 10 Oct 2014 at 21:48

Hi all,

I received the news I was pretty much expecting this week, having had a PSA level of 12 on a recent test and a fairly conclusive sounding MRI a couple of weeks ago, followed by a biopsy. With both my father and paternal grandfather suffering from PC (Dad was diagnosed at 50 and is still going strong at 68), I already feared the worst. I'm 43 with 2 fantastic children (10 and 3) and a very supportive wife of 17 years.

I'm under a consultant at The Manor hospital in Oxford. It seems like a good centre, and my consultant (name removed by Moderator) also performs Robotic Prostatectomy at the Churchill in Oxford. I would be interested if any others have undergone the same surgery at the Churchill. I'm also keen to talk to anyone of a similar age to me.

My diagnosis was cancer mainly in the LHS near the capsular wall but with some on the RHS. My Gleason score is 7 (3+4). The MRI suggested T2 with some chance of microscopic T3a on the LHS.

My biggest dilemma is whether to go for nerve sparing on the RHS. On the one hand I like the idea of having a chance of maintaining some function. On the other hand given that there may be some local advancement / positive margins I'm scared of taking the risk of it returning given that I'm intending to last another 40 years if I have my way.

So that's me. I guess we've all got our own experiences but I'm hoping that a bit of sharing the trials and tribulations will help.

Edited by moderator 10 Oct 2014 at 22:04  | Reason: Not specified

User
Posted 11 Oct 2014 at 19:03

 

Hi Tom,

 

Sorry you had to join us at a young age but welcome anyway.

With the genetic angle you certainly need to treat aggressively which it sounds like you are already agreed to.

The surgeon may be able to look at the nerve area on the rhs & make the decision for you. i.e if the tissue looks suspicious or not when operating. Obviously the MRI only goes down to see a certain size & that is the usual problem. Just not knowing if there are bad cells which will cause trouble or just die off.

I'm sure you are aware radiotherapy can be used as a salvage/second treatment if the histology proved the capsule breached or psa began to rise after surgery. Certainly removing the primary tumours gives you an advantage. What's gone can't regrow. Others might suggest go for external beam R/T in the hope that nerves would recover in time. But there's always the chance the prostate will not be truly ablated ( as in my case & others here ).

It may well be that you can indicate preference to the surgeon with the proviso that if he feels a wider margin should be done, then he will do so on the day. Either way, your psa will need careful monitoring with follow-up R/T promptly used if required.

User
Posted 12 Oct 2014 at 08:53

Hi Tom you look like your about at the same point as me , pondering which route to take I have my appointment with surgeon on the 21 & rt on 28 to make desicon .good luck in your treatment Teddy

User
Posted 18 Oct 2014 at 08:56

Hi Tom

I had same gleason score Surgeon advised me that if possible he would try and save nerves if not he would take everything away I agreed with him, fortunately he was able to save nerves on one side and I am able to get erections. I would imagine your surgeon will take no chances if he can save nerves he will. I had surgery 31/03/2014 took lymph nodes on right side, histology confirmed 3+4 gleason no cancer found in lymph nodes. I have has 2 psa tests since which have come back as 0.01 so very pleased also now dry and back to normal, working, exercise ect. 

If you would know about my experience of  surgery etc just let me  know.

Good luck going forward

Frank

User
Posted 18 Oct 2014 at 09:20

Hello Tom,Probably the toughest part of the PCa issue and dealing with it is the decision process, what to do for the best? And as far as I am aware there is s till no "best option" for anyone?When I had my surgery I made it absolutely clear to the surgeon that if there was anything that looked dodgy or might cause me any issues later I wanted him to remove it. I did not want to be sitting in front of him with PCa or other cancer with him apologising for leaving something in that he was "umming and aahing" about.

 

Good luck what ever you decide.

 

Edited to add I had robotic surgery May 2013.  It can go very well, mine did not go as well as most.  The post op recovery was interesting and I also had some issues, still have minor issues of some of the warned about side effects of the op. But, despite that, I would  not change my choice of treatment.

 

Dave

Edited by member 18 Oct 2014 at 09:27  | Reason: Not specified

User
Posted 18 Oct 2014 at 10:29

I agree with Querty/Countryboy55 ,

sometimes when they do the surgery they find its worse than they thought,  ( the opposite can apply too), there are no 100% gurantee's in this business unfortunately...but good luck and wish you well

 

                                                                                     john

 
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