A month ago I had RARP. I am very pleased with my outcome. Hopefully my experience helps someone.
A month on, all my wounds are almost completely healed. I am continent, back to the gym, feeling great and full of energy. E’s are taking a bit longer to get back to normal, but that’s the only side effect, and a small price to pay to be cured of cancer.
Here is my story.
I’m in my early 60s and had my PSA rise to 6.
Poor decision: - I had a bpMRI followed by a cognitive biopsy. This is the standard in Northern Ireland and probably standard in many locations.
The 28 core (!) biopsy showed one single 4mm cancer in 2 cores. The urologist suggested I have another biopsy just in case. It seemed I had no need to worry, One small cancer caught early. WRONG!.
Good decision:- Instead of agreeing to have another cognitive biopsy, I travelled to London and had an mpMRI fusion biopsy with contrast. It found SIX cancers.
In November (5 months from the first biopsy) I had a Reizus sparing RARP with Prof E. I cannot speak highly enough of the surgeon, the Santis team and the after care.
The final histology of my prostate once removed showed SEVEN cancers. One was 18mm. Another was less than 0.1 mm away from the edge. If I had trusted the first biopsy and waited, that cancer would have broken through, endangering my quality of life, and maybe life itself.
Here are my thoughts. Please bear in mind this is just one persons opinion...
- Any higher than normal PSA needs investigation. If you decide to wait and see if the cancer grows, make sure your biopsy is as accurate as possible. Earlier surgery may be less invasive with a better outcome.
- Biopsies are an imperfect diagnostic tool – however an mpMRI fusion biopsy with contrast is FAR more likely to tell the true story than a bpMRI with a cognisant biopsy.
- Robot assisted surgery (RARP) should lead to faster recovery from wounds.
- The surgery is difficult and complex. Many experienced surgeons now use the Retzius sparing technique, which is even more complex, but with less side effects. Choose your surgeon carefully if you can, the robot is only a tool.
- I choose surgery over radiotherapy since ....
- I wanted rid of the cancer. I didn’t want a graveyard of dead cancers inside me.
- I know RT can be still be done if I need it (but not the other way around)
- Later RT may be targeting early tiny dots since scanning is getting better all the time
- I have an assurance from my final histology that there was no cancer on the outside skin of my prostate.
- I worried RT can cause colon damage etc., later in life.
- Neurosafe means that during the surgery as soon as the prostate is removed the outside skin is painted and checked microscopically for cancer by a pathologist who reports back to the surgeon while he is still operating. In my case the outside was clear even though the cancer inside was a fraction of a mm from the edge. Without Neurosafe the surgeon could not have been sure there was no microscopic breakout. The surgeon explained that because the outside was clear, it is likely I am completely cured, even though it was close to the edge. The final pathology confirmed the outside skin was clear.
I believe that the decision to have a mpMRI fusion biopsy with contrast, and RARP with Prof E probably saved my life. It certainly saved my quality of life.
I had BUPA health insurance. Credit where its due, they have been excellent. I’m encouraging all my friends to do the same.
I appreciate many people will not be in a position to choose their treatment. However, if people are sufficiently informed to be able to ask questions, hopefully that may make a difference.
Good luck all.