JUST DIAGNOISED

[GRYNCH]

My doc has been following my PSA for about 3 years now from my first reading ( a high of 5.82 ) to subsequent readings in the upper 4's. In addition this he has performed a couple of series of biopsies each of which was negative.   This past November one of my brothers was diagnosed with prostate cancer and had a prostatectomy in January.   This news in conjunction with a spike in my own PSA ( 5.1 ) prompted my doctor to admit me to hospital for a third series of biopsies ( 16 punctures !! ) under anesthesia.

This series turned positive...  20 % tumor on left hand side, leading to a Gleasons score of 6 ( 3 / 3) and a recommendation from my doctor for a prostatectomy.

My doctor recommends traditional surgery ( retropubic ) saying that there is a debate currently as to the benefits of laparoscopic surgery, and that he is "more comfortable" with retropubic.  Obviously I'll be seeking further opinions before committing to anything, but I was hoping you could add comment to the risks / benefits of either type of surgery, and of course any other comments, and other info is more than welcome at this point.

[Ash Tewari, MD, M.Ch.]

With a localized prostate cancer  and a family history of prostate cancer in a first degree relative the treatment option would be surgery.

Radical prostatectomy is the gold standard for treatment of localized prostate cancer.
The cancerous prostate can be removed either by traditional open surgery( retropubic or perineal), or by minimally invasive means such as  Laparoscopic or Robotic Surgery.

Now the decision as to what type of surgery depends upon factors such as surgeon experience and comfort with a particular type of surgery and the  choice of the patient.

All three methods are comparable in terms of  cancer control and return of potency and continence. However minimally invasive methods offer advantages in terms of decreased post operative pain, decreased hospital stay , decreased blood transfusions and better patient comfort.

Also refer the following links for a better understanding of the advantages of robotic prostatectomy.

http://www.cornellurology.com/prostate/
http://www.cornellurology.com/uro/cornell/roboticprostatectomy/

This answer is not intended and does not substitute for medical advice- the information is for patient education only.

Follow-up with a urologist is essential.

[Ric1]

I was diagnosed with prostate cancer about 1 year ago and had the robotic surgery Sept 06.  My brother and father had prostate cancer and my needle biopsy resulted in a gleason score of 6 and a post-operative gleason score of 7.  The surgeon did my brother's surgery just 4 months prior to mine, so I had first hand feedback from someone I fully trusted.  I elected for the robotic surgery with a surgeon that had performed over 300 of the robotic procedures.  I am 50 and my brother is 57 and we are both in good health.  Neither of us had continence problems and were free from using the pads at about 6 - 8 weeks.  My potency gradually returning.  I have no regrets.  The key is finding a surgeon that has successfully performed the procedure many times.
I wish you all the best as you deal with your treatment decision.

[GRYNCH]

Thanks.........On referral from my GP I'll be seeing another Doctor tomorrow, who does double duty as a professor at the local UniversityHospital, and my GP says this is THE guy to talk to locally regards the benefits of either method of surgery.

Now since my diagnosis I've been reading everything I can... but can you provide any common sense questions that I may have forgotten, overlooked, or just plain not thought of ?

thanks again,

G