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Da Vinci Prostatectomy Allowed Mark to Get Back To His Athletic Lifestyle!

Mark tells his story of a prostatectomy and traveling the road to recovery with the team at Urology Associates


I want to give shout out to Urology Associates on the great care I received on my recent Prostate Cancer diagnosis and treatment.

Here is my story and a bit of background about myself for context – I am 61 years old, and retired in 2018.  I am very active. I road cycle year round ~5000 miles a year with ~400,000 ft of climbing and do 2-3 weight and stretching workouts a week to maintain my core strength and flexibility.  Also, I am a hiker, back country skier and peak bagger. I have a replaced left hip (2017); right rotator cuff repair (2017 – cycling accident), scoliosis and L4 nerve compression (steroid injection treatment in 2017), AFIB (only one incident – cardioversion after a century ride in 2017), and a left ACL repair (1996). I am 5’ 8’’ and weigh 150 lbs.

My PSA score had risen from 2.5 to 5.0 over 24 months, so at the suggestion of my primary care doctor (Thank you Celinde Strohl!) I got a prostate biopsy. Biopsy  (12 samples) showed >50% cancer (Gleason 3+4) in all 6 samples on the left side, and >20% cancer (Gleason 4+3) in 1 sample in the center on the right side. Left side was a tumor, and its increasing size was creating some issues with urinating, both frequency and flow rate.

My wife and I had a consultation with Dr. Cowan after he did the biopsy. Dr. Cowan did a great job of laying out the treatment options, explaining the pros and cons, and patiently answering all of our questions. We felt no pressure to pick a specific treatment (surgery or radiation), and were encouraged to do some research and meet with both radiation specialists and surgeons. After that meeting, and some follow-up research (my wife and I are both scientists by training), we felt educated, informed, and empowered enough to make our own decision about the best treatment option

Choosing Da Vinci Surgery with Dr Eigner

My advice – do your homework on the treatment; take advantage of the information and consultations that are offered by Urology Associates, certainly not one size fits all. In my decision, the downside of radiation was the combined hormone therapy. I need the Testosterone for muscle recovery, and core strength / back health, based on a bad experience with induced testosterone deficiency while using Diclofenac (anti-inflammatory) for back issues.  After a very honest and informative discussion with Dr. Eigner (surgeon), we landed on the Da Vinci robot assisted laparoscopic surgery at Sky Ridge with Dr. Eigner and his team. Sky Ridge is a Center of Excellence for this type of surgery, which his what is recommended by the Prostate Cancer Foundation.

Very happy with the surgery and the result. Nerves on the right side were spared, cancer had escaped the prostate capsule on the left side, so Dr. Eigner removed those nerves. No cancer in surrounding lymph nodes or other tissue outside the prostate based on pathology. I just had my post-surgery (9 week) high resolution PSA test and it is down to 0.014 (very low score), which means that I don’t need any more treatment at this time, but will need periodic testing to ensure the cancer is not spreading.

If you have had surgery, you know that a lot of your treatment, pre-operative, and post-operative care is not only tied to your surgeon but to the larger medical team, both in the hospital and in the specialty practice. I continue to be very impressed with the PAs, nurses and staff at Urology Associates, and particularly Dr. Eigner’s team. My care at Sky Ridge was excellent. Liz Kelly answered my questions and gave me some good advice and tips prior to my discharge. Anna Willis has been a great advisor and coach in my overall recovery, and is very responsive to my questions, concerns, and suggestions.

My recovery has gone very well, and at 8 weeks, I am back to doing everything I was doing pre-surgery, including bike riding, weight lifting, and core exercises (though February weather has not been very outdoor cycling friendly). I am house cleaning with my wife again (no excuses), and gearing up for some spring home improvement projects!

Also, often after surgery, you never really see the surgery or specialty practice again. I can tell that Urology Associates is in it with me for the long haul on my recovery. From the start, it has felt like real partnership with a reciprocal commitment to my treatment. They are very honest and open about the ED issues that take awhile to work through after prostate surgery (nerve related) and have a treatment plan in place to help me monitor and improve this in my long-term recovery. They are surprisingly easy to talk to about post-operative ED and treatment options.

Weighing the Positives and Negatives of Surgery

Again encourage you to talk to the folks at Urology Associates and let them help you figure out the best cancer treatment option for you!

Pluses

  • Surgery seems to have gotten rid of the cancer, and unless there is some change in my PSA going forward, my treatment is done!
  • Surgery was minimally invasive, fast recovery with minimal side effects. Stopped wearing pads after 4 weeks (incontinence ended – except for stress events)
  • Was able to stay active and see real progress in recovery. Could exercise (walk) immediately, do pelvic floor / core rehab exercises after 2 weeks, do 50% effort weights, core and cardio workouts after 4 weeks, and bike riding (30 miles – 2 hours) after 6 weeks. After 8 weeks back to full effort on core, strength and cardio, and relatively normal bike riding (can’t be  100% sure due to winter weather restrictions).
  • Urination post surgery is amazing, I can empty my full bladder in <20 seconds, which prior to surgery was often a 2 minute long dribble fest.
  • I did not have to do the hormone therapy (associated with radiation) which based on my previous experience with drugs that suppressed my testosterone was not good for me with respect to building and maintaining strength in my back and cardiovascular fitness.
  • Most surprising, I can still have an orgasm (yes, I AM going to talk about this), even though I cannot yet have an erection. I spoke with Anna about this and did some reading and ejaculation, erection, and orgasm, while related are actually independent. Obviously, also requires a partner willing to try some different approaches to sexual intimacy. Reminding yourself and your partner that you were not killed by cancer sort of puts things in the right perspective!

Minuses

  • Surgery is well, surgery. You have to spend time in the hospital, you have to get general anesthesia and be intubated. There are risks of complications like bleeding and infections. You have to have a catheter for 10 days, and put up with the exercise restrictions, incontinence, and erectile dysfunction, which is a longer-term effect; however, considering the complexity of this surgery and all the detailed “re-plumbing and re-wiring” that gets done, the recovery is amazingly fast, and in my case, the results are outstanding!

Could not be happier with the quality of care I am receiving from Urology Associates!

 

– Mark S.