Wednesday, January 11, 2006

Prostate Surgery date set…

My last update on this was several months ago. Tuesday, February 7th, is now set as the day for my “surgical procedure”; i.e. a “Radical Prostatectomy”, i.e. the removal of my cancerous prostate gland.

The particular procedure I’ve chosen is Laparoscopic radical prostatectomy, using the Da Vinci system. In traditional Prostatectomy’s (retropubic and perineal prostatectomy’s), the surgeon makes a long incision (8-10 inches), opens you up, and removes your prostate. In the Laparoscopic method, the surgeon makes several small incisions, usually 5, and inserts robotic arms into these incisions to manipulate and remove the prostate gland. Currently, the most advanced Laparoscopic system is the Da Vinci system; this is where the surgeon controls everything through a robotic interface. The surgeon sits at the robotic console, across the room from the patient, and manipulates the robotic arms. In addition to the operating instrument at the end of each arm, the arms are also equipped with 3-D cameras. Images from these are transmitted to the Console, allowing the surgeon a clear view of what is going on inside you. Because the surgeon is seated during the procedure, there is less fatigue for him/her and the use of the robotic arms allows any hand tremors that might occur to be filtered out. This leads to greater precision and control during the procedure.

The net result of this method, and the reason I chose it, is that it is reported to have the following benefits;

1) Less blood loss
2) Less risk of infection
3) Less pain (post-operative)
4) Less scarring
5) Shorter hospital stay
6) Shorter recovery time
7) Better results with “nerve-sparing” (i.e. lower incidences of incontinence and erectile dysfunction

The only downside with this method is for the surgeon him/herself – the procedure takes longer. But as I will be under anesthetic for the procedure, I won’t notice it. And the surgeon I have chosen prefers this method because he says it allows him to do a better job.

I didn’t (and don’t) want to do this procedure. It IS major surgery. People die from this stuff. One of the potential problems is a heart attack during or after surgery. During a physical I had a couple of months ago, my doctor found an abnormality in my EKG. I was referred to the local Heart specialists who performed a stress-EKG on me. No problems were found, but it makes me nervous. I lost a good friend to a heart-related condition after he underwent back surgery last year. Prior to the surgery, the doctor’s had OK’d his heart, but obviously they were wrong. According to one study, nearly 200,000 people die each year in America in hospitals due to potentially preventable in-hospital medical errors. That’s a big number. But one has to balance that number against another one; 99.3% of Prostate Cancer patients, if the cancer is caught and treated soon enough, survive (i.e., they die of something other than Prostate Cancer).

I’ve spent time during the past several months looking for an alternative that I could, literally, bet my life on. But there are none out there. There was a very interesting study which concluded that moving to a strictly vegetarian lifestyle could actually reverse prostate cancer. But it was only one study and had only a small number of patients. Maybe in 5 years or so, they can validate this approach, but I obviously can’t wait that long. Radiation therapy, too, has its benefits, especially with the “seeding” method now commonly used. But if it fails to stop the spread of cancer, there is no backup – you cannot do surgery after failed radiation therapy, whereas you CAN do radiation therapy (and chemotherapy), if necessary, if the surgery fails to stop the spread of cancer.

There is a wealth of information available about Cancer treatments on the Internet. The best site I found discussing Prostate Surgery is the one from the American Cancer society and can be found here.

So that’s the scoop. I will be posting updates occasionally as the time gets closer and, hopefully, of course, will be posting updates afterwards…

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