Prostactomy Robotic Surgery with the Da Vinci

A lot of patients have prostatectomies, mostly with Da Vinci Surgery.

However, it's a bit unusual to have this if you are diagnosed Stage 4. Sounds like the TRoMbone trial, except that's closed.

I looked into the Atlanta trial when my husband was diagnosed with spread to lymph node and bones. The only thing of course is that you can’t choose which arm of the trial you are allocated to.

As it turned out, a different opinion said it wasn’t in his bone. He had the robotic prostatectomy with the removal of 14 lymph nodes of which one was infected. We wanted this option for the reasons that Lyn has stated above. Luckily he handled the op really well and recovered great too….he still suffers with ED but seeing some improvements even without medication.

He was always told he would most likely need radiotherapy after the op, but at 12 months post op his PSA is still undetectable. So just a waiting game and I guess he will have more treatment if and when required. Still pray it will never happen, but in reality it’s very possible.

We’re really happy with the choices we made though and have no regrets.

Good luck with your treatment.

Hi

I have stage 4 with mets to bones,removal of the prostate has never been mentioned at my onco appointments and the option has never been given.

Regards Phil 

Yes it’s not a standard treatment once PCa has spread but there is a trial taking place ‘Atlanta’ which I got information about when my husband was diagnosed.

He was never offered surgery just HT with chemo or enzalutimide. I had to find someone who would be willing to operate. We paid private but surgeon did offer for us to be referred on the NHS.

I initially watched some YouTube videos with an American doctor who talked about Oligo metastasis and how they could treat maybe up to 5 sites of spread but anymore they probably wouldn’t. I’m really not sure if anyone is ever offered this in the UK or not though. 

I think spread to organs excludes the patient from being able to apply for Atlanta

Hi Elaine.

Did your OH original scans show enlarged lymph nodes?

Thanks

There is some thinking that the cancerous prostate sends out chemical messages to circulating cancer cells in the body instructing them to seed and grow it's the Mothership theory, there is a very interesting book by DR Patrick Walsh called Surviving Prostate Cancer where he examines this theory .My cancer was found to have spread after my prostectomy and the PSA was doubling very quickly with involvement of several lymph nodes . hence I was put on Enzatutamide and had RT .Removal of the prostate meant my cancer load was low and a low cancer load is easier to treat and has better outcomes .Hence here I am 31 months later undetectable PSA and no evidence of spread on the scans I have just had .It makes sense that if the cancer has not spread too far in the body that removal of the mothership would have benefit and this is being now trialled. However there is a cost consideration as the old thinking has been well the cancer has spread so what's the point of removing the prostate it makes treatment more expensive .However it has become apparent that there is benefit in terms of length of progression free survival if the prostate is removed in all cases where spread is not too advanced.

Yes this is what is being trialled at the moment and it makes perfect sense that removal of the cancerous prostate removes the bulk of the cancer and the chemical messages it can send out  .I am very grateful to have benefitted from having my prostate removed in the initial stage prior to  the salvage treatment I  had to have .It meant there was a much lower load of cancer to treat than if the prostate was still in situ .