M. T.

US, USA

Dr. Samadi:

The remainder of my life will always be defined by two conversations I had with you.

The first took place on June 27, 2005 when you informed me that my prostate biopsy had come back positive for cancer. The second, on August 11, 2005, was much more comforting. You told me that my pathology report indicated my surgery had been extremely successful and that I was cancer-free.

You may recall that after we discussed the pathology report, I asked, “What do you say to a man who has saved your life?” Well, I’ve come to the conclusion that there are no words that can adequately express how I feel about your life-saving gifts and the understanding you exhibited throughout my ordeal. I decided to send you an anecdotal summary of my recent experience, in the hope that you will find a way to share it with other men who find themselves in the same position. Perhaps this will, in a small way, help them get through this most trying experience and thus, periodically remind you of my eternal gratitude.

As mentioned above, my saga began when an elevated PSA led me to my second biopsy in seven years. After receiving your call, I met with you at 3:00 P.M. that day. My first question to you was, “Is it operable?” You assured me that it was. You carefully laid out my options, answered a slew of questions that filled an entire sheet of legal stationery and told me I had to wait  four to six weeks after the biopsy to have surgery. You stated that I was a perfect candidate for the robotic laparoscopic procedure because of my Gleason score and the “stage” of the cancer. You explained there would be hardly any loss of blood, that there was very little chance I would need a transfusion, that my hospital stay would be only one night, and that, in all likelihood, both crucial nerve bundles would be preserved. Instead of a lengthy abdominal incision, there would be 5 small incisions which would quickly heal. This sounded a lot better than what I had heard about the recovery from open surgery.

My next major hurdle was waiting for the results of the bone and abdominal CAT scans. This was a difficult week, to say the least. You phoned me with the results and, as you predicted, both were clear. We scheduled the operation for August 5th.

Several acquaintances questioned my choice of surgery over radiation. I instinctively knew that, despite former Mayor Guiliani’s choice, radiation would not be right for me. I remembered having read in a newspaper article that if surgery was unsuccessful, there was always the backup of radiation. The reverse scenario, however, is not necessarily possible . Also, I recalled hearing of a study which concluded that surgery seemed to provide a better chance of long-term remission. Because my Gleason score, an indicator of aggressiveness, was 7, I felt there was some urgency in making a decision. “Watchful waiting” was not a viable option.

While anxiously waiting for the 5th to arrive, I read all I could on the internet, keeping in mind that some of the information was not always 100% accurate. I met with friends who had already been through the procedure and asked them a ton of questions about what they had experienced so I would know what to expect.

I also read and re-read an invaluable article on mimimally invasive surgery which appeared in the January 14, 2002 issue of New York Magazine. It pointed out that “at New York-Presbyterian, surgeons have repaired holes in the heart through entirely closed-chest surgery with the help of the robot.” I also knew that Columbia-Presbyterian’s Dr. Richard Whelan laparoscopically removed a cancerous tumor from the colon of my friend’s mother. She was back on her feet almost immediately. In addition, I knew that you had studied in France under the doctor who first performed the robotic laparoscopic prostatectomy procedure and that you had performed hundreds of these on your own. I concluded that laparoscopy was the way to go. Robotic laparoscopy, I reasoned, was even more precise and I was in the best of hands at the best hospital in New York. You assured me that all would go well. I was now ready.

For the sake of brevity, let me just say that the surgery went according to plan.  It turned out, after the incisions were made, you saw that scar tissue from my appendectomy of 40 years ago was adhering to my colon. Fortunately for me, you were able to remove the adhesions  laparoscopically. Although this added 25 minutes to the operation, it was time well spent. To no avail, I had been complaining about a “pulling sensation” in the abdominal area for over a year. (Those pains are now just a memory!)

As you promised, I spent one night in the hospital and was home the next day. I lost only 50cc of blood. Immediately after the surgery, you informed my devoted sister that I would be fine and that you were able to spare the crucial nerve bundles – just as you had predicted.

The catheter was, indeed, the worst part of the entire process. I could walk. I could lie down. Sitting down was a bit too much for me to endure. The catheter itself, however, was surprisingly not painful per se, just uncomfortable. I believe I took regular Tylenol a few times.

On August 11th, a date I will never forget, you removed the catheter and carefully explained my pathology report’s findings. The lymph nodes you removed were clear. Although cancer was found in all four quadrants of the gland, none was found at the  “margins.” This is the best news one can hope for. It’s as close to being “cured” as is physically possible.

All post-surgical prostate patients have to follow up with PSA tests to make certain that no cancer cells  remain. My first one will be in about 10 days. The 5 small incisions you made are healing nicely.

In addition to your surgical prowess, you demonstrated a bedside manner second to none. To people receiving a diagnosis of cancer, this can be as important as a doctor’s medical expertise. I know I called and emailed you many more times than the average patient. You consistently returned my calls and/or email and patiently addressed each and every one of my concerns. You continually told me I would be fine. Having lost a close friend to prostate cancer a few years ago, I needed that reassurance.

I thank you for your many kindnesses and for my life.

Respectfully,
M. Teplitzky, New York

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