First of all, a disclaimer: We are at the very beginning of this process. My husband hasn't even gotten the details of the pathology results, only news that "Yes, it's cancer. It's an early stage and I don't think it has spread outside the prostate." I fully realize I'm jumping the gun on a LOT of questions.
My biggest concern at this point is about how my husband's past surgical procedures will affect his treatment going forward. He's had an open appendectomy, gall bladder removal (laparascopic, but just barely), an open sigmoid resection, and two open surgical hernia repairs relating to the resection. The most recent hernia repair was just last October, and it was actually three hernias. He has also had lithotripsy for kidney stones.
The surgeon told me that my husband was so full of scarring and adhesions and surgical mesh, it would be best to hope that he never required surgery again.
I was worried about him just having the biopsy. Now, based on all I've read about surgical approaches to prostate cancer, it appears he will not be a candidate for any kind of minimally invasive procedure. (this also excludes him from any clinical trials that involve surgery)
Yes, yes, yes - I know there are a dozen other approaches and that surgery might not even be on the table. But even with the other options, I can't help but wonder if he is at greater risk of negative side effects and/or aftereffects because of his medical history.
For anyone who has had OPEN RP surgery -- What did your doctor/surgeon tell you about needing the open procedure? Was it because of scarring from other surgeries? Were other treatment options excluded because of your surgical history? How long were you in the hospital after surgery? How long did you have the drain tube and the catheter? And how long were you out of work?
So far my husband is terrified and deeply depressed and mostly not wanting to talk about any of this. In fact, I have not even said anything to him about the surgery part because 1) I'm not a medical professional and 2) I can't bear to give him more bad news. He was talking just last night about how hopeful he was about the possibilty of robotic surgery and it just broke my heart.
His father and two paternal uncles died of prostate cancer. His father lived for many years with the cancer, but not always comfortably and the last six months were bad. There is also a history of many other family deaths due to other types of cancers.
My husband also had a close friend at work diagnosed with cancer (not prostate) last year, who died about three months after finding out.
His PSA was barely over 4, but it had gone up more than a point in a year, so his PCP recommended seeing the urologist. Because of the October surgery and the holidays and, to be honest, just the fact that he was procrastinating because he feared bad news, he waited five months. During that time the PSA dropped a bit, which I understand signifies degradation of the cancer cells, which in turn relates to progression of the disease? There was no mass palpable during the DRE, which I also know should be encouraging.
By nature, my husband tends to go into a kind of depressive shock with anything bad - shuts down for hours or days or even weeks at a time. He's only been to work two days in the past two weeks, some days working from home and some days just calling in sick. He usually doesn't want to know too much of the medical stuff because it causes him too much anxiety. I'm the one who takes comfort in asking a million questions. (doctors find me really annoying - ha).
We are also both VERY concerned about the financial aspect of this whole process.
I've read many of the posts. I understand that this is not the time to be freaking out, especially when we don't know ANYTHING yet. We live in a large, metropolitan area and I am grateful we will have care options. We also have health insurance at the moment, something I am also grateful for and that I hope we can hold on to. And, so far, with past medical issues, his employer has been pretty flexible about letting him work from home. Without that option he would have certainly been out of a job before now.
I'm open to all advice and suggestions, but would particularly appreciate hearing from anyone with similar experiences of treatment options being impacted by surgical history.
I know this has been mostly wild rambling with a few too-early-to-ask questions thrown in.
In advance, thanks to all.
The following user gives a hug of support to flower919: jackie607 (03-07-2012)
Flower 919, I had the robotic surgery back on December first... My psa was a 6.5 with a Gleason 8 (4+4) and T1c. I had my appendix removed back in 1991 leaving a big scar, think my doctor back then was on an exploration based on the size of the incision. Almost 1 year to the day before my prostate surgery I had an open hernia operation with mesh. My surgeon didn't seem to think there would be any issues with the scars left from those two surgeries. After the robotic surgery I met with the surgeon and he said everything went as planned but did say working around the scar tissue and mesh added time to the surgery but didn't affect the outcome.
Flower-- I was Gleason 7 (3+4) with 4.7 PSA which had been trending up. The biopsy came back with 1 sample of 20 showing cancerous cells. I had robotic surgery 1 month ago. If you have the option and decide to go with surgery, I would definitely recommend going that route. It was abt a 3 hour procedure. I was in my room at 5 Wed and walking around Thursday morning. Discharged Thursday abt 1. I had a cathether which was removed a week later. the doc said it was all enclosed in prostate and he expected no further treatment would be necessary.
I was very much doom and gloom before the surgery. None of the treatments are very appealing and the after effects on quality of life can be dramatic. The 3 main issues are bowel, continence and sexual function. Surgery seemed to lessen bowel issues and there was something appealing abt getting the cancer out. That swayed my decision. When they removed the catheter, I had complete bladder control. No bowel issues and (pardon me) but the sexual part is working ok as well. I know I am not the normal case. But it does show there can be good results. I have had 2 friends who did not know of the cancer. One delayed treatment for a year and a half after it was found and by then it had spread and he died. The other friend is now at the end because his had spread before he knew abt it.
Everyone I talked to emphasized geting rid of the cancer, getting cured. Then you can deal with the treatment effects.
I found out on Nov 30, 2011 that I had cancer. My doc told me on Feb 1, 2012 that he got it all. That is the best case you can imagine!!!!
Best of luck to you both. Having a caring partner is very important and he seems to have that!!
@Flower919 - sorry to hear about your husband's recent diagnosis. I chose robotic surgery in 2008 with an experience surgeon. I had a hernia repair with mesh when I was in my 20s.
With previous surgeries the concern is adhesions. For me that meant extra time for a general surgeon to clear the way to the prostate site. Of course there is a risk of being under anesthesia for an extended period of time. I was told the entire procedure took about 3 hours.
I didn't have any complications and didn't need a blood transfusion.
I had a right orchidectomy for Testicular cancer 25 years or so before being diagnosed with PC. Surgery was not an option for me but at the time I was told it was because of the radiation's effect from the earlier post surgery treatment. I was quite pleased to have surgery ruled out as I wanted brachytherapy anyway. Good luck.
Peter, Brachytherapy in Guildford, England March 2008