Robert H., USA

Dear Dr. Samadi,

At my last checkup you asked if I would describe my experience and feelings on being diagnosed and treated for prostate cancer. I’m sorry it's taken me so long to respond, but here goes.

On April 22, 2008 I went in for my annual physical exam and all seemed normal. Several days later my doctor called with the results of my blood work and other tests, saying that all looked fine except my PSA levels, which had doubled since my last exam and were at the top of the normal range. He advised me to have a prostate biopsy. I was concerned, of course, but didn't lose any sleep over the matter.

I promptly scheduled the biopsy, which was performed on April 30. The results came back a few days later and on April 5 I met with the urologist. He indicated the results were positive and that I had prostate cancer, but that it appeared to be in the early stages and probably had not progressed beyond the prostate itself. He said that five of the twelve biopsy samples contained cancer and the cancer was fairly aggressive (Gleason scores of 6-7). I was initially stunned and then I began experiencing fear. I remember feeling like I was sinking into the chair and felt the blood draining from my face and hands. It was one of the very few times I had been exposed to a potentially fatal situation and I did not deal with it well.

My father had died of prostate cancer three years earlier at the age of 89 and that experience was still very fresh in my mind. He had prostate problems for many years and I think he finally tired of hearing his doctor tell him he had problems that needed to be treated. He simply stopped going to see his doctor and the disease eventually claimed him. I'm 64 years old and have enjoyed remarkably good heath during my lifetime. I had never been hospitalized and never experienced any significant illnesses beyond the normal everyday maladies that are easily treated at home.

I remember sitting in the urologist's office that day struggling to absorb the information the doctor was delivering. After he told me I had cancer I think I processed about half of his message. I walked out of his office and drove home, feeling numb and very=2 0anxious. When I told my wife, she thought I was kidding, as we are prone do with one another on serious matters. Once she saw I wasn't teasing, her jaw dropped open, at which point I started to panic in addition to being scared. I tried to stay positive, but my wife was asking all sorts of questions that I couldn't answer because in my fear I hadn't heard the doctor, or I had not had the presence of mind to ask even basis questions.Family members soon started calling, since they knew I was seeing the doctor that day. When I told them I had been diagnosed with prostate cancer they were shocked, but tried to reassure me saying the disease is highly treatable, especially in the early stages such as mine appeared to be. After talking further with my wife and others in the family, particularly my youngest brother, a veterinarian, I felt somewhat better and mildly reassured. Just taking with those that love and care for you does have a soothing effect. After I had recovered from the initial shock I started the process of planning my treatment with much help and support from my wife.

I scheduled further tests to determine whether the cancer had spread beyond the prostate. I also scheduled an appointment with our family doctor, who expressed his sympathy, but gave reassurances similar to those extended family members. He thought I should have the pros tate surgically removed in view of my age (relatively young) and family history of prostate cancer. Again I was a bit stunned. I had been thinking I would have the cancer treated with radiation, avoiding surgery.He has been our family doctor for nearly thirty years and we think very highly of him. He's a great diagnostician and has always given us sound advice, very effective treatment and wonderful referrals. He gave us the name of a urologist, Carl Olssen, at Columbia Presbyterian whom he highly recommended. It took me a few days to accept the idea that I should have surgery and to fully understand the changes that surgery would bring. I know several people who have been successfully treated for prostate cancer with radiation and it was hard for me to embrace the fact that surgery was the best thing for me.

I bit the bullet, however, and scheduled an appointment with the urologist (turned out Carl Olssen had recently left Columbia for North Shore LIJ) recommended by my doctor and also arranged to have several scans performed to determine if the cancer had spread. Several days later the scans were completed, but the results would not be available for another fortnight. I can say that the next 8-10 days of waiting for the results were the longest, most anxious days of my life. I was on edge with worry the entire time and was not sleeping well. I couldn't concentrate on even simple things for thinking about what I'd do if the tests revealed that the cancer had spread. I knew that once the cancer spreads beyond the prostate the chances of successful treatment and cure decline dramatically. When I finally learned that the cancer was contained within the prostate and hadn't spread I was greatly relieved and comforted. I was further comforted when I met with Dr. Olsen on June 6.He described the traditional surgical procedure which he performs as well as the relatively new robotic procedure available at Mt. Sinai and a few other hospitals in the New York area. He said that if I opted for the robotic procedure that you were the best man to do the job. We left Dr. Olsen's office and immediately called your office and scheduled an appointment for later that day. You saw us that afternoon and were very reassuring about my prospects with surgery. I and my wife left that meeting with an overwhelming sense of relief that we were doing the right thing with the right people at the right institution. You, your staff and Mt. Sinai have confirmed at every step since we first meet with you that we made the right choice. The professionalism, competence and caring attitude of your staff, the hospital and its staff put us at ease and made us comfortable and reassured us during what was a difficult time for us.

I was operated on July 7 and went home on July 9, physically uncomfortable but secure in the knowledge that the procedure was successful and that in all likelihood I had been cured. The pathology report and all subsequent tests have confirmed that I am indeed cured.

The most difficult aspect throughout the process of diagnosis, testing and treatment was the constant uncertainty. Not knowing if I had cancer, then how serious it was, whether it had spread, the prospects for cure, how would recovery progress go and would I fully regain functions. These factors and many others were all unknown from the beginning and contributed to the high levels of anxiety that I, my wife and our family experienced during the ordeal. You and you staff did a marvelous job of minimizing, or eliminating these uncertainties, of restoring our confidence. We are deeply grateful to you and your caring, dedicated staff as well to Mt. Sinai and its friendly, compassionate people. Thank you for everything.

Sincerely,

Robert H.

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* The benefits of robotic surgery cannot be guaranteed as surgery is both patient and procedure specific. Previous surgical results do not guarantee future outcomes.




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