Discussion around Robotic Prostatectomy

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See that there have been few relevant recent posts to this forum, and someone doing research might interpret this to mean that Dr. Patel, his staff and Florida Hospital may not be a viable alternative for Prostate Cancer. Let me just state that, if you have been diagnosed with Prostate Cancer and removal is an option, you must consider GRI(Dr. Patel) for Surgery. There are a lot of opinions out there, but this is truly a case where knowledge and experience are a major determinant of the outcome. I am not going to give you a blow by blow of my Cancer, diagnosis and treatment however, I am a businessman, 61 years old and had psa score of 5.6, Gleason 7 but with ~80% cancerous. Cancer probably developed over 10 years ago. Dr Patel, his staff and Florida Hospital(Celebration) are first class and top notch. We tend to seek treatment from those we trust. My Urologist in NC does not do robotics and cited statistics indicating conventional surgery by a top notch surgeon, in many cases, yields better results than Robotic surgery,with respect to incontinence and sexual function. Probably true on average, but I consulted my former Urologist in NY, who performs Robotic and conventional surgery at Rochester General Hospital (they now have 2 Davinci's) and was preparing to go there for Robotic Surgery. However, I was not impressed with the incontinence and sexual function outcomes to date so I asked if he heard of GRI and DR Patel, citing the more favorable outcomes, stated that he had taken seminars by Dr Patel, that he is the "Real Deal" and that is where he would go. It has been 4 weeks since the Surgery. For me, incontinence has not been issue from the beginning, no diapers.. Sexual function is returning-even though I was instructed to "ignore" for at least six weeks. You owe it to yourself to investigate this option, regardless of what others are telling you. A really great pilot with years of experience, a clear understanding of the physics of flying and his plane can land a jetliner without power on the Hudson without incident... and probably repeat the feat. Most everyone else will likely crash. Regards, Bill Gates(No, the original), NC, USA

Hi! I'm on line reading for info for my mysyoulf and my husband, he was just diagnosed with prostate cancer, his psa is 29 and all 12 of the biopsies came back positive he is a seven. His bone scan and cat scan came back good. It appears to be contained in the prostate although they have let us know he has a large tumor. We have our first visit with the surgeon for robotic prostatectomy on Tues June 2nd. I am trying to get an idea of what we are in for. Thank You for your comments they have been helpful.

My husbund has diagnostic Prostate Cancer. He would like to talk with a patient that has had robotic surgery with Dr Vitul Patel. Please let us know how to contact some one on the 63 with a gleason 7

Let me start by saying that the treatment and care my family and I received from the Florida Hospital and Dr. Vip Patel's staff was top notch. They are the experts at taking something devastating like "prostate cancer" and focusing on the desired prognosis rather than the current diagnosis. I have never met such a humble, kind, gentle and sincere person as Dr. Vip Patel. On Dec 3, 2008 my cell phone rang, my urologist, hey Doc, are you serious? Diagnosis Prostate Cancer at 41, the big “C.” At that instant all of a sudden the unimaginable become reality, how could someone as physically fit and health conscious as me have an “old man’s disease?” Second opinion? Confirmed! So I was now faced with how to deal with my cancer, as a death sentence or as a gift. Being that I am a man of faith, God loving and believing in His providence the journey began. I set off to compete in the biggest endurance event of my entire life, embraced my diagnosis and became my own advocate. Hebrews 12:1 states; Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us. So the race began before I knew it….. On September 21, 2008, I raced for the cure with AFAC TRI at Walt Disney World, FL. While I joined in the fight raising over $1700.00 for the Prostate Cacner Foundation, little did I know, that I, too, had a cancer growing within me. A cancer that does not discriminate based on age, race, health or religion. I was diagnosed with prostate cancer on December 3, 2008, at 41 years old. Due to family history, I had been proactive in my health and started screening early at age 39. This consisted of determination of baseline PSA (1.6 which for under 40 was already suspect), colonoscopy and annual physicals. In late November, lab reports indicated a PSA of 2.0 (up from 1.2 six months prior). My urologist, and personal friend, explained that a biopsy was necessary due to the increase in PSA. On December 1st twelve core samples were taken. Two days later the pathology report indicated one of the twelve positive for cancer and two were atypical. A second opinion from John Hopkins confirmed prostate cancer, stage 1, Gleason score of 6. Next, we followed up with a bone scan, a pelvic and abdominal CT which both showed that the cancer was contained within the prostate. Our research began into what type of treatment would be best based on my age, health, and diagnosis. After a consultation New Year’s Eve with surgeon Vipul Patel of the Global Robotics Institute at Celebration Hospital, FL, my wife and I decided that a robotic prostatectomy would be our course of treatment. Surgery was then scheduled for April 6, 2009. I spent the next four months training spiritually and physically for my biggest race ever, the race against cancer. I made a commitment to go into surgery as physically prepared as possible by being in the best shape I have ever been. A cloud of prayer warriors, friends, family and those who had been before me surrounded me. The race clock had started. So I was off to prepare for the big day – April 6. When “race day” finally arrived I was indeed in the best physical shape I had ever been. Since the surgery was the live case for the World Robotic Urological Symposium hosted by Dr. Vipul Patel, my local urologist/friend was also in attendance. The procedure took just over an hour and, as I am told, was executed with total perfection. By the afternoon of surgery day, I was up and walking around – a bit wobbly at first, but nonetheless, I was on my feet. A mere 23 hours after arrival in my hospital room, I was discharged. It would then be an additional 4 days before I could leave the Orlando area. The results of the biopsy showed that the prostate was 15% involved by tumor, the stage was pT2c, Gleason Grade 3+3 (score 6) and the margins clear. The prostatectomy was the correct choice of treatment. Today, 5 months from diagnosis, 6 weeks after surgery, I am cancer-free and have been cleared from light duty. I received my first post-op PSA results, 0.00, confirming cancer free. I have returned to physical training. The recovery has been challenging, both spiritually and physically, without the strength of God, the wisdom of His son and the guidance of the Holy Spirit we would have struggled through this trial. We were able to embrace the cancer, learn from it and prayerfully use it as “megaphone” to help those too come. I will be raising funds with a group of triathletes, team proCURE for the 2009 AFAC TRI in Orlando. I hope to complete this story with an IRONMAN FL finish (Nov 7, 09) and my 42nd birthday (Nov 8, 09.) In closing, the bottom line is that when the trials come find strength in the Lord, take advocacy into your own hands, find a physician and a urologist that will take a general interest in your health, test early. Ask the questions; find the correct treatment and build relationships that will help you get through. I cannot tell you how important my newfound friendships with Dr. Vipul Patel (and Staff) and Athletes for a Cure make the difference; these are people who genuinely care. And lastly “NEVER GIVE IN.” If your interested you can follow my journey and recovery on my blog; www.bretttroia.blogspot.com Please follow the link below to donate to my cause, visit my personal web page and help me in my efforts to raise funds and awareness to change the face of prostate cancer. http://athletes.kintera.org/2009triathlon/bretttroia?faf=1&e=2422136044

As one of Dr. Patel's most recent patients (3/20/09), I couldn't be more pleased about my decision to have him perform the Robotic Prostatectomy. My urinary continence has returned to 99% within 5 days of catheter removal. Erectile dysfunction does not apply, I am just as I was before the surgery. True, I won't know the total experience until April 20th (min. 4 weeks after surgery for any sex per doctors orders for healing time), but I have 100% confidence things will go perfect. According to Dr. Patel, my tumor was huge for someone my age (56). Turns out, I only had 1mm left before the tumor grew through the capsule wall and then it would have been too late. Sure, I'm one of the lucky ones. It almost didn't turn out that way. I had a previous doctor that only cared about the "size" of the prostate. He never even scheduled me for a blood test. It took a lapsed life insurance policy and a 4.41 PSA score on the insurance company's blood test to get me started on my quest for better health. Thanks go out to my new primary Doctor Elaine Huffman of Hamlet, NC and Dr. W. Vaught of Florence, SC the local urologist, but most of all to the miracle man, Dr. V. Patel and his staff. No, I'm not being compensated for this testimonial. Whatever the operation cost, it doesn't matter. It's my life that was saved and I want every man over the age of 48 to know about PSA scores and the risks of Prostate Cancer. It only costs about $35 to get a PSA blood test. Please tell your friends and loved ones about the importance of knowing your PSA score. I am a statistic, but the RIGHT statistic, I'm a survivor. I could have been, and came very close to being, that 1 in 35 man that dies at an early age from advanced prostate cancer and/or other cancers that come from it. Thanks again, Dr. Patel and Staff. You gave me a new lease on a long life!! Brad

Hi My PSA went high then down from 4.5 to 4.1, biopsies were done 12 out 12 were positive and Gleason score was 8, with all the biopsies positive does that mean my cancer is advanced and does it mean the lympnodes and margins can be positive? My CT abd and pelvis and bone scan all neg.

My PSA begin to rise after surgery and I have had three lupron shots. The PSA remained low but has now began to rise. Do I have to take the shots the rest of my life? I am concerned about the effects of the low male hormones caused by the shots.

Are their any more answers to the questions already asked?

Does Dr. Patel use the Veil Nerve sparing technique when performing the robotic surgery?

Do you need a referral for insurance coverage?

hola soy ivanna necesito saber si hay una operacion para un tumor cardiovascular

hola soy ivanna de argentina tengo una hermana de 17 años que tiene un tumor cardiovascular y en argentina no hubo una operacion similar ayudenme

We typically leave the catheter in for 4-7 days post surgery. Continence rates 92% at 3 months.

What settings do you use for the PK dissector? Thanks

1] How long does a Foley catheter have to remain in place post surgery? 2] How long is the patient incontinent post Foley removal? 3] How successful is examination of local lymph nodes for possible spread of disease during procedure? 4] How often does PSA need to be checked? 5] What is cost of procedure? 6] What is incidence of impotence post surgery ? Thank you, Sincerely, Gershom Mailman M.D. ABA