Luck to him.
Another update here. After all the scans and consultations, Dad is having surgery tomorrow morning, to remove his prostrate.
Because of the complexity of my Dad’s body (overweight, held together by metal plates…), the doctor scheduled him for the first surgery of the day, and expects it to take about three hours.
Dad’s had plenty of surgeries before, but this one is the most intrusive. I’m more nervous than normal, especially because the potential side effects can seriously impact his quality of life. The surgeon is very good, and we’re at Cleveland Clinic…so we have high hopes of things going smoothly.
In an odd twist, I’m going out of town tomorrow afternoon, once he gets to the recovery room.
(I’m spending the morning and however long I’m needed afterwards with Mom at the hospital…my sister will take over helping out while I’m gone.)
I’ll try to stop by and update the thread before I leave…otherwise, I’ll be back on Thursday to report in on him and his recovery.
-D/a
Gah. My son is working on a new diagnosis and treatment machine that uses high frequency ultrasound to destroy the cancer in the prostate. It’s completely non-invasive and highly effective. It’s been successfully used off-shore for years but the FDA is slow to approve anything new. Fortunately they’re in their final stages of approval but not soon enough for your father to use this method. Good luck and keep us posted!
Best of luck to your father.
Out of curiosity, do you know if he’s having conventional or robotic surgery? Given the location, I’d guess the latter; but not all surgeons are proponents of the system.
(Actually, the long-term outcomes for both when you have a skilled surgeon using up-to-date techniques are pretty similar. In any case, the Bad Old Days™ of a prostatectomy automatically condemning one to a permanent life of impotence and diapers are, thankfully, behind us.)
The next couple of weeks won’t be pleasant, but if I made it through the immediate aftereffects, he can.
Best of luck to you and your dad.
Thanks, guys. He isn’t getting the robot treatment, but the surgeon certainly seems to know what he’s doing.
Ruby, at least it’ll be there to help someone else…hopefully soon. Medical treatment is advancing so fast in so many ways. Since I’m considered high risk, I’m certainly interested in it!
OttoDaFe, anything specific to look out for during recovery?
-D/a
Luck to him.
Good luck to him, if I knew his first name, I’d add him to the prayer book and pray individually, but for now, I’ll pray for him as “digital is the new analog’s Dad” 
Just curious, 10 samples taken 9 clean one dirty, how is that? Is the 1st sample some kind of error? or something?
I don’t understand how these things work.
I remember having a biopsy on my throat (NOT FUN) and they took several samples and found cancer in all of them.
Best advice I can give is for your father to ask for specifics about what he’s likely to experience post-op, and preferably to get a writeup. I didn’t, which led to a number of calls to my urologist’s long-suffering nurse that could have been avoided.
As for details, I’m going to spoiler them rather than just flopping them out (as it were) because they’re a tad TMI-ish:
[SPOILER]By far the worst part of the early recovery is having a catheter. It’s obviously necessary — part of the urethra is removed with the prostate and the point where the two ends are grafted together needs to heal — but that doesn’t make it fun. For one thing, you’ve got this fairly inconvenient bag that you have to tote around (I had two: a larger bag for nighttime use and a smaller one that strapped to my leg). For another, you . . . dribble, and the less said about that, the better. Finally, any pressure in the area, such as a bowel movement, is likely to cause bleeding from the urethra (normal, but disconcerting as hell).
In my case, the strain-relief gizmo which anchored the catheter to my leg was defective and detached during the first night, resulting in the bag falling off the bed and dragging everything off to one side. I may have experienced more exquisite pain in my life, but if so, I’m glad I don’t remember it. Fortunately, that’s anything but a normal occurrence.[/SPOILER]The other piece of advice, which I’ve given three times now, is to plan a “birthday” celebration for the day the catheter is removed. It’s not the end of the road (the body has to relearn continence, so there is a transition period of diapers and/or guards), but IMHO it really is akin to being reborn.
Thanks, Igrapeape. The whole family is old school computer people, so he’ll get a kick out of being referred to that way.
My take on the samples - they take pieces from various regions of the prostate, to get a representative sample. In his case, only a small bit of one area showed cancer. Unfortunately, it showed a fairly aggressive form, which means we’re lucky to have caught it early.
Hmm. Dad thrashes around quite a bit in his sleep. I hope this doesn’t cause problems. I guess Mom will have to deal with that. She’s a pro at dialing 911…
I love the “birthday” idea. How long did you have the cath in?
-D/a
Ten days — surgery was on Friday and the catheter came out the second Monday after. Disclaimer: my surgery was robotic, and traditional may have a different timeline (the only point of comparison I have is my BIL, and I believe his was two weeks). I only realized how much it mattered on Sunday, when I found myself counting down the hours, then the minutes. then the seconds.
They took him back around 7:45. I’m in the cafeteria having coffee with Mom.
it turns out they are doing it robotically…laproscopically.
First step is to remove some lymph nodes and check them. If they are clean, they proceed with the rest. If not, they close him up and we replan.
The doctor thinks he’ll be done around noon or 1. I hope we don’t here from him until then.
-D/a
Good luck!
Best of luck. I sure hope it goes well.
The reason they excise and check the lymph nodes first is to determine whether the cancer has metastasized — if it has, that changes the approach radically and it’s time to step back and regroup. But you probably knew that.
(As a side note, one of the few advantages of being overweight is that there may well be a layer of fatty tissue between the prostate and the local lymph nodes which acts as a barrier. At least that was the case for me.)
Don’t be surprised if he complains about his head hurting afterwards: for robotic prostate surgery they kind of stand the patient on his head so that gravity holds the surrounding organs out of the way, eliminating the need for retractors. This keeps the incisions small.
As others have said, good luck.
Fly-by update. Dad got out of surgery at 3pm. LONG procedure.
Because of his past surgeries and injuries, there was a lot of fibrosis.
In fact, the doctor said there was basically no differentiation from the prostate to the surrounding tissue.
The doctor opted not to remove any lymph nodes - he was worried that they were too close to major arteries. He said they were not inflamed at all, and it is likely they would have been clean. We’ll get the prostate biopsy back in about a week to see if the cancer was contained.
He also had a hard time sewing him back up, because my Dad’s pelvis is rotated a bit…but he got it done.
Now, on to recovery, and hoping the biopsy comes out clean.
And I’m on my way out of town…I’ll check in on Thursday when I get back.
-D/a
Back in town. I stopped by the parents’ condo on the way home. Dad looks tired, but is doing well. A few mishaps with the cath bag…oops.
Apparently the doctor said because of all the fibrosis, and therefore cutting he had to do, Dad bled as much as any patient he’s had. So he’s probably weak from that.
Next milestone is next Wednesday, when he is scheduled to have his catheter removed, and we should get biopsy results.
**OttoDaFe **- you were absolutely right about his head. I didn’t get to see him, but Mom said he was so swollen!
-D/a
Three month post-surgery update.
Dad had a follow-up with his urologist today. We found out his PSA is elevated. Before the surgery, he was at 4.8. Afterwards, he was at 0.1. Now he’s at 0.4.
Since he doesn’t technically have a prostate at this point…this is concerning. From what I’ve read online today, a reading over 0.2 after having the prostate removed normally triggers additional treatment.
He had an ADT injection today - androgen deprivation therapy. Androgens, produced mainly in the testicles, stimulate prostate cancer cells to grow. Lowering androgen levels often makes prostate cancers shrink or grow more slowly.
He has a consultation scheduled for Wednesday with a radiation oncologist. His urologist thinks he should do both ADT and radiation.
The urologist indicated that this is manageable, and he should get through this ok.
The literature I’ve read so far seems to agree…but I’m not comfortable with “should.”
I have a lot of reading to do this weekend, and I’m anxious to hear what the oncologist has to say on Wednesday.
So…dopers…anyone have any experience/advice at this point? I’m interested in side effects of the radiation treatment and the ADT treatment, as well as any other information anyone has.
Thanks…
-D/a
My father was diagnosed with prostate cancer shortly after my mother died. Because of his age at diagnosis (75), his urologist recommended chemotherapy alone. He said it was a “quality of life” issue.
Daddy’s PSA went down almost immediately after beginning the chemotherapy. His only real complaint was from the hot flashes.
He died ten years later, from a bowel blockage. There was no indication of any kind of a recurrence of his prostate cancer. The chemo gave us ten more years with Daddy, and we were very, very grateful.
~VOW
Yeah…Dad’s not in good overall health. My sister has been worried about it for a few years. I’m not sure how many more years he has. Honestly, I hope it’s years.
Dad always gives us the impression that he’s going to live his life his way, and then let it go. I think he’s got more fight in him than he admits, though.
I have a good friend who is younger than me, and lost his father almost 10 years ago. I’m going to lunch with him tomorrow, and I’m sure this will come up in conversation. It helps me keep perspective, sometimes.
I’m going to value whatever time I can get with him. And if the treatment extends that, all the better.
Thanks.
-D/a