J. M., Los Angeles, California
In 1999 at the tender age 42, I first discovered that I had an elevated PSA of 4.3 after a routine physical exam. I spent the next seven years “watchfully waiting” for the axe to fall. During that time I endured four prostate biopsies while my PSA bounced up and down between 5 and 7. I was diagnosed with cancer in May 2006; however, the cancer was confined to the capsule and relatively low grade (Gleason 6).
Fortunately, my wife is a physician and she quickly took the mystery out of the treatment decision. At my young age of 49 with a young beautiful wife and two young children, the only real option to ensure survival was surgery. We were immediately very attracted to the less invasive, robotically assisted approach as opposed to open surgery; however, we were very cautious when it came to choosing the surgeon. None of the surgeons in the LA area had the requisite number of robotic cases to give us a comfort level, or if they did, we did not get glowing recommendations. After narrowing down the list of potential surgeons to only the most experienced and reputable, we interviewed Dr. Mani Menan at the Ford Institute in Detroit and Dr. Samadi. Despite the fact that Dr. Menan’s team had handled many more cases, we chose Dr. Samadi because of his expertise in all surgical disciplines (open, laparoscopic, and robotic) and his close personal involvement in each case. The fact that he would actually be present in the OR during the entire surgery, would personally conduct the surgery and was properly trained to use a different approach if needed was very comforting and instilled confidence. He was also remarkable in responding to our many questions and concerns via email or by telephone, at all times of the day and night, usually within a couple of hours. I can’t imagine this is easy for his family, but I admire and appreciate his dedication and commitment greatly.
It was a big decision to place my life in the hands of a surgeon on the opposite side of the country, but I’m glad that I did. I checked in for my surgery very early on Friday morning July 15th, woke up in the recovery room within an hour of my surgery to good news that the margins were clean, was on my feet walking later that afternoon, and walked out of the hospital unassisted when I checked out the next day. His team at the hospital is fantastic and I received top notch care the entire time. Dr. Samadi was a great source of comfort and compassion, not only to me but to my wife, throughout this entire ordeal. Although I had no serious complications, he was very responsive to our calls and emails in the weeks following the surgery.
My wife and I stayed in Manhattan for the next six days and on day five I had the Foley catheter removed which was a big relief. (We walked to a nice lunch every day it was Restaurant Week!) I would rate the pain level at a 2 to a 3. (My pain prior to back surgery several years earlier was much, much worse!) The worst part of the experience was the last two days with the catheter, which was not especially painful but was very uncomfortable. I was able to sleep through the night with no leaking on the first day, and I was back at my office the next week. I didn’t have any significant daytime leaking after the first week or two, and was able to get rid of urinary pads completely within about two months. Now I am completely dry. My erectile function is gradually returning and with 50mg of Viagra it’s nearly as good as before the surgery.
With early detection prostate cancer is one of the most curable forms. Having said that, it strikes at the core of one’s manhood and it’s scary. Even though I had years to prepare myself mentally the fact is it came as quite a shock when I was diagnosed. I would advise any prostate cancer patient to thoroughly investigate the treatment options. Surgery was the obvious choice for me at my age, but that is not always the case.
(I strenuously disagree with the “wait and see” approach if one is diagnosed with early stage prostate cancer. Why play with a loaded gun when you have the gold standard of treatment options available to you?) I tell all of my friends and anyone else who’ll listen to be vigilant about DREs and PSAs. I also caution them that a clean prostate biopsy is not a “get out of jail free card”. If your PSA remains high, you need to be vigilant and have biopsies again every few years, medieval as they may be. I was vigilant, and fortunately my cancer was detected very early because of it. Patients also need to understand that the biopsy is inexact. The needle may miss the cancer growing within you, only to be detected later when it™s bigger. In my case, the lab results post surgery indicated my cancer was far more advanced than the biopsy indicated. Still, I was lucky because it was confined to the capsule.
My PSA now is <0.1 which is undetectable. I thank Dr. Samadi not only for saving my life, but for making a very difficult situation bearable, and for being a friend. The lesson learned is, if you have an elevated PSA you need to stay on top of it because the alternative is unacceptable. And, if you are diagnosed and decide on surgery, GO ROBOTIC WITH DR SAMADI if you can. He is a great surgeon and a wonderful human being. You will be in the best of hands.
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