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Patients speak about prostate cancer and laparoscopic radical prostatectomy

John Schmertmann, Gainesville, Florida

My prostate PSA test had gradually climbed from 1.1 in 1994 to 3.6 in 2001 and then increased to 5.3 in Nov. 02. My Gainesville urologist did a prostate biopsy on Dec. 6th, and the results came in with a Gleason 6 on one side. I got a second opinion 10 days later - same but Gleason score 7. Subsequent Jan 2nd bone and soft tissue scans showed the cancer had not spread. On Jan 10th my urologist laid out alternatives for prostate cancer treatment for the elderly, including his willingness to do a radical prostatectomy on my 74-year old prostate. I'm in good shape, except for a TURP procedure in 1995, and have had no other surgeries in the area.

But, he failed to mention the possibility of laparoscopic radical prostatectomy, which I discovered on Dr. Krongrad's website while searching the Internet for decision information. I then found out that there were some 5-10 locations around the USA with varying experience with LRP. But, this did not include Gainesville, despite our having 4 hospitals, including the University of Florida Shands research hospital. The closest, and the man with the most experience, appeared to be Dr. Krongrad. He answered my email immediately and I called Ruth and found out I could get an evaluation appointment on Jan 22nd, and if accepted, a surgery date in mid-Feb. This was good news because I wanted it out and the sooner the better. The Cleveland Clinic (my 2nd choice) would have had me waiting until at least mid-April. It was also a lot less personal.

I went to Dr. Krongrad's Aventura office with my son on the 22nd and spent an hour with the doctor, passed his inspection, and Ruth's, liked what I saw and heard, and made an appointment for LRP surgery for Feb 12th. And that's the way it happened.

My wife and I drove to Miami on Monday the 10th, stayed at the Bay Harbor Inn, and on Tuesday morning registered for surgery at the North Shore Medical Center. On Wednesday the 12th we were there at 6AM, I was prepped by 7 and in surgery at 8. Out at 12 and then in the recovery room for 2 hrs -- the 1st of which was rather woozy. By 3 PM I was in my own first floor private room.

My hospital stay was fairly routine for LRP - Dr. Krongrad checked on me and I walked around that evening, had lots of nurse/attendant interruptions during the night, my wife stayed in the room with me on a recliner, and because I was still on a liquid diet I couldn't enjoy the hospital food.

They let me out Thursday around noon and we drove to the Inn where we stayed one more night. That afternoon Dr. Krongrad called the hotel only to find out that I was out walking by myself and looking for a lost hat in a nearby restaurant where I had left it an hour before on another walk. He wrote "That's as good as it gets!"

The next morning I drove to Dr. Krongrad's office, had a drain removed, passed his inspection which included having first passed gas the previous midnight (a big event!), and he gave me a present of 12 annotated photos of the internal progress of my LRP. I then drove the first 150mi + 50 more by my wife towards Gainesville. The next morning I drove the final 150. Dr. Krongrad reported later that I was his "oldest driver." That's my main claim to LRP distinction, but I also have a minor claim concerning the catheter. Of course, all the above driving included having a catheter and a "leg bag."

According to my log I had the first clear urine (no blood) on Feb 16th, that same day got the all-clear post-op pathology report, on the 17th I had my first walk outside the house and my first BM, and on the 18th I went to my office for the 1st time. Monday the 24th was a big day -I removed the catheter in my shower - no problem, but my wife hovered around ready to take me to the emergency room. That same day it happened - my minor claim - I found I had urinary control and I really didn't need any of the $50+ we had spent on diapers and pads. Great news, and unexpected.

My only complaint so far, and I'm writing this 10 weeks after the LRP, is that I'm in the unlucky approx. 10% in that I still have considerable perineal and penile soreness and pain - enough to be annoying, sometimes very. It keeps me off my bicycle, but not from other normal activities, and I do not use much pain medication. Dr. Krongrad assures me it will eventually go away.

Of course, I'm pleased I went the LRP route. Overall, the results have been better than I expected. Dr. Krongrad and Ruth have been very available by phone and email and I think I have benefited from their very personal attention both before and after surgery.
prostate cancer treatment for the elderly