G. A., New York, USA
I am a 56 year old male of Hispanic descent. I am married and have two children, ages 36 and 30. I’ve spent the majority of my professional life developing electronic equipment/controls for various industrial and medical applications. In the fall of 2005 (at the age of 55) a blood test revealed a PSA score of 4.6. My family physician, explaining to me that it was at the level of concern (for possible prostate cancer), immediately recommended that I see a urologist for further investigation and, if needed, treatment.
From the beginning my attitude was that this had to be a fluke since I did not have any symptoms to alert or concern me otherwise. I did not have pain, I did not have a problem urinating, I did not have sexual problems (other than the expected changes that occur at middle age). I felt strong, in good physical condition, able to perform vigorous workouts and exercise. I was convinced that the urologist, after performing a digital rectal exam (DRE), would tell me that it was nothing to be alarmed about and send me on my way.
Well, the first urologist I went to see did note a somewhat enlarged prostate (normal at my age), smooth (no lumps) but, because of my PSA number and the level of occurrence of prostate cancer in men in the U.S., he recommended that I have a biopsy performed. I could not believe this, I had heard of prostate biopsies previously and understood that it was not a pleasant procedure. Why in the world would I put myself through the torture, when I was convinced that I could not have cancer?
I went back to my physician with this information and he recommended that I see another urologist for a second opinion. I did, same thing. This time I reluctantly agreed to a biopsy. To make a long story short, they found cancer on one of the 12 core samples taken during the biopsy. The biopsy results: Gleason (cancer aggressiveness) = 6 (midway in a scale of 2 to 10), clinical stage (cancer size) = T1C (a tumor not usually felt during a DRE).
Hearing the news from the urologist was a heart breaker. It is good that he wrote the results for me, because when he told me that I had prostate cancer I immediately went into a ‘zoned out’ mode. I somehow managed to remember the urologist recommending that I carefully and thoroughly research the options available for treatment (he recommended popular cancer websites as a starting point).
The next four days after the news I plunged into a state of disbelief, disappointment, anger and self pity. This got old really quick, and after deciding that this condition was worth a fight, my wife and I started researching the treatment options available. I consider myself very lucky of having a spouse that has and continues to provide so much assistance and support during all this ordeal.
I first opted for radioactive seed implants, as it offered the simplest procedure (outpatient) and the results found through online research looked good. Prostatectomy on the other hand, seemed more complicated with a longer recovery time and perhaps more painful. I went back to the urologist and told him of my decision. He set up an appointment with a radiation oncologist. The visit went well, the oncologist gave me ample assurance of the success of the procedure. I was happy to hear this. I went back to the urologist and he set up another appointment with a fellow urologist/surgeon that would assist the radiation oncologist in planting the radioactive seeds.
In the meantime, I continued the online research on prostate cancer. As I read reports written by expert urologists one thing came through loud and clear: prostatectomy yields the highest rates of cancer cure of all the options available. Radiation is OK, however the chances of cure are lesser than the surgical option. With radiation, the long term after effects (incontinence and impotence) increase as time passes. I also found out about men that had the radioactive seeds implanted who had reoccurring periods of severe bowel pain and instability. This obviously concerned me, and prostatectomy concerned me too! Would opting for the latter mean giving up sexual potency? I could not decide on what to do.
When I went for my appointment with the urologist/surgeon for the radioactive seed implants I told him of my concern, and that I could not go ahead with the implant procedure without further researching the other options. He confirmed for me that there is no statistical data/results for the implant method beyond 10 years, versus the surgical prostatectomy method which is tried and true. It is to this urologist’s credit that I first found out about robotic assisted prostatectomy. He clearly stated that if I decided to have a prostatectomy, the (fairly new) nerve sparing, less invasive, robotic assisted prostatectomy (he mentioned the Da Vinci method) was the ticket. He recommended a couple of surgeons that he knew were performing this type of surgery. This is the turning point of this story, the stage had been set.
Two days passed and he called me again to see if I had further questions. He took the time to call me from his home, what service and dedication! I was convinced that I wanted Dr. Samadi to perform this operation.
The rest (I am happy to say) is now history. Everything went as stated by Dr. Samadi, like clockwork.
The surgical procedure at the Columbia Presbyterian Medical Center went well. Whatever apprehension I had when I entered the hospital was relieved by everyone’s friendliness and warmth.
I cannot say enough about the surgical team. From the nurses that prep'd me, to the anesthesiologist, to the team that greeted me in the Operating Room. What a great crew, as I entered the O.R. (I walked in), my apprehension immediately dissipated with their warm welcome and light heartedness. Of course I don't remember anything while in surgery (I just know that I was somewhere, in a comfortable place...), however my excellent post surgery condition told me that the team had done a 'bang up' job.
They discharged me from the hospital the following day and I walked out and rode a shuttle over to the nearby hotel where we were staying.
I was pleasantly surprised to see how small the incisions were, 5 of them around the belly button, all less than one inch long. The pain, on a scale of 0 –10, I say that it was 2. My abdominal area felt sore, like having done a lot of sit-ups. This is an insignificant price to pay in exchange for eradicating the prostate cancer!
I wore a catheter for seven days, which got uncomfortable after a couple of days, however I believe it is an important step in healing the re-connection of the urethra to the bladder, it also allows proper urine flow while post-surgery swelling goes down. About a week after the catheter was removed I experienced some bleeding and small clots while urinating (which lasted about a week). I had resumed more activity than recommended, the bleeding told me so. The advice to pass on: be very patient and careful while recovering, allow the body to heal before resuming normal activities.
Just yesterday I got the results of my one month post surgery blood test, the PSA level is less than 0.1, thank you Dr. Samadi!
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