MY CONDITION: Prostate Cancer

TYPE OF PROCEDURE I HAD: da Vinci Radical prostatectomy

DATE OF PROCEDURE: May 3, 2007

MY SURGEON: Dr. Chris Teigland

HOSPITAL WHERE MY PROCEDURE WAS PERFORMED: Carolinas Medical Center

OTHER TREATMENTS I CONSIDERED BEFORE DA VINCI SURGERY:
Briefly considered watchful waiting, radiation therapy and open prostatectomy

THE BIGGEST CONCERNS I HAD ABOUT TREATMENT:
Wanted to maximize chances of preserving normal urinary and sexual functions

WHY I CHOSE DA VINCI SURGERY:
Less invasive; quicker healing time; good success with nerve-sparing procedures

HOW LONG I WAS IN THE HOSPITAL:
two days

MY PAIN AND/OR DISCOMFORT LEVEL:
no discomfort at all from surgery; the catheter was uncomfortable and the bladders spasms were very discomforting

ABOUT MY RECOVERY TIME:
I had the catheter out in two weeks. I exercised as much as possible each day and walked around the block within a couple days

WHEN I RETURNED TO NORMAL ACTIVITIES:
I was off from work for nine weeks

ABOUT MY SURGEON AND/OR FACILITY STAFF:
The surgeon did a great job and the hospital staff were attentive and competent

HOW DA VINCI SURGERY COMPARED TO MY PREVIOUS EXPERIENCES OR PRECONCEPTIONS OF SURGERY:
I was expecting more post surgical pain etc. I was able to start walking more quickly than anticipated

I WOULD RECOMMEND DA VINCI SURGERY TO MY FRIENDS OR FAMILY MEMBERS!

Reflections on Prostate Cancer

By Raymond C. Jones

Excerpt from an article orginally published in The Charlotte Observer, September 2007
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My encounter with prostate cancer began simply enough, as the result of a routine blood test. I knew something was amiss when the doctor tracked me down by phone. When the news is good, they never call. He reported that my PSA was high, and that he wanted to do a repeat test to verify the reading.

At the time, this information came more as an annoyance than a threat, because I didn't really know much about PSA. I learned soon enough that the initials stood for "prostate specific antigen." The PSA test measures a substance in the body that increases in direct proportion to abnormalities in the prostate gland.

If one is lucky, a high PSA score might signify the routine effects of aging or a simple infection. If not, a high PSA means abnormal cell growth, which is to say, "cancer."

It took several additional tests to confirm the presence of cancer, tests which - suffice it to say - are not designed to preserve male dignity. Indeed, while submitting to the necessary poking and prodding, I learned two things about the prostate gland. One is that it's hard to reach. Two is that it's hard to remove without doing collateral damage.

Later on, while reading about prostate cancer in greater depth, I was amused by an irreverent comment from one physician who was explaining the particular challenges of prostate surgery. He said, "I'm surprised that God put the prostate gland where He did, because no self-respecting civil engineer would have ever have committed such a design flaw."

I must admit that I retreated into denial as soon as I received my diagnosis. The urologist patiently explained that the most widely accepted treatment options include a couple types of surgery (regular or laparoscopic) and a couple types of radiation (internal seed implants or external beam therapy).

There is actually a fifth menu selection -- euphemistically called "watchful waiting" -- which held great attraction for me because it was so much less messy and precluded the need for an immediate decision. The problem was that the urology staff simply didn't have any enthusiasm for it. As one said, "If you go down that road you're probably just postponing the inevitable, and in the meantime the cancer will simply keep growing."

I personally liked the surgical option because it seemed more precise. Also, the physician explained that side effects tend to show up right away after surgery, at which point they can be evaluated and dealt with. With radiation, the side-effects are sometimes minimized in the short run, but less predictable in the long run.

By the time my surgical date arrived I had stopped fixating on the possible side-effects of surgery. And I had resigned myself to the discomforts of the recovery process, not the least of which would be a 14-day "meaningful relationship" with a urinary catheter. My focus was on getting rid of cancerous tissue so that I could return to a normal life.

By the time I entered the hospital I felt like I had assembled the best team of cheerleaders in the world. This sense of teamwork made a difference as I continued to focus my energy on my family physician's suggestions regarding the power of positive thinking.

As for the surgery itself, I don't remember a thing about it, which is a testimonial to the skill of the anesthesiologists. Nonetheless, when I regained consciousness my drainage tubes, intravenous lines, and abdominal bruising removed any lingering doubts about whether or not the prostate gland had been designed for easy removal.

Fortunately, my prospects for a quicker recovery were enhanced by the utilization of a da Vinci Robot for surgery. The da Vinci is an imposing device that looks like a prop from a Star Wars movie.

Ironically, I had written a news release announcing the acquisition of this very machine when it was first installed at Carolinas Medical Center. At the time, my task of explaining the da Vinci's capabilities was facilitated by descriptive copy I found in a promotional packet. Thank goodness for that press kit, because at the time I barely knew what a "laparoscopic radical prostatectomy" was.

It's poetic justice, I guess, that I am now so well positioned to do personal testimonials.

The da Vinci is a wondrous machine in the hands of a skilled surgical team, and thanks to a virtuoso performance by my team I was home in just 48 hours. The first two weeks of recovery were a blur, literally and figuratively, but during week three I experienced a burst of energy. I was able to turn NPR off and start reading again, while taking nightly two-mile walks.

If I have any regrets looking back, one would be my prior level of ignorance about prostate cancer.

There's an expression in the medical field that many more people die with prostate cancer than of prostate cancer. This is because it is typically slow-growing. Nonetheless, my newfound calling is to caution others against a false sense of security.

Prostate cancer is the second most common type among males, behind skin cancer. It is the second most common source of cancer fatalities among men, behind lung cancer. Nearly one in five adult males will receive a prostate diagnosis at some point in his life. Clearly, as one doctor commented, "there's a lot of it out there."

The best defense is regular PSA testing, and I am hoping that in my own limited way I can do for the PSA test what Katie Couric did for the colonoscopy.

Looking back, I also have a lot of respect for the medical team that treated me. I suppose they relish the occasional phone call when they get to tell someone "the biopsy was negative." But basically they spend their days sharing bad news with people who don't want to hear it. They administer tests that no one wants. And they perform a type of surgery which requires as much skill and dexterity as almost anything in medicine. They earn their money.

With the aid of hindsight, it now appears also that my fears of the dreaded side-effects of prostate surgery were somewhat exaggerated. I've been pleased so far with the pace of progress in getting my "male plumbing issues" back under control.

For patients who are lucky enough to have a successful outcome with the so-called nerve-sparing surgical technique, the textbook average on returning to normal (or near-normal) continence is three to six months. The average on sexual function is 12 to 18 months.

One thing cancer patients have in common is a lingering fear about any cure being 100% permanent, and I am no exception. Nonetheless, my diagnosis was one of the better ones available in the world of cancer. I feel lucky to have had such an outstanding level of care. Nothing like it is available in most parts of the world. Indeed, many people in the United States have to travel long distances to have access to the quality of care I had right in my backyard. I don't know why the Lord brought me to this particular place at this particular time in my life, but I am grateful.