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Patients speak about prostate cancer and laparoscopic radical prostatectomy

Ron Savage, Ontario, Canada

Reading these testimonials is part of the research each man must do when confronted by prostate cancer. When I debated with Dr. Krongrad the value of these stories I emphasized how much I had learned from the experiences of others who had gone before me; he said he felt the real value was in each man seeing that he was not alone with this disease and that thousands of other men were facing the same challenges each day. We are probably both right. As you read each of these testimonials be assured you are not alone; we have all faced the same fears you now face; we have all faced varying degrees of challenges during our rehabilitations and in the end we have all gained a new appreciation of life and all it has to offer.

I'm 58 years old and have always been an active person. I worked for Bell Canada for 39 years as an installation/repair technician. I have been active in my non-working hours with the love of my life working with other volunteers constructing an 850 km trail network from Niagara Falls to Tobermory. I'm the trail director for a 125 km. section which my volunteers and I maintain. Needless to say I get a lot of exercise and stay quite healthy. I retired from Bell 4 months ago and was looking forward to spending my hours hiking and building new trails.

At my annual physical my doctor, as usual, asked for me to get a PSA test done. The results were high 7.3 but since I had an enlarged prostate and the PSA was increasing each year I wasn't worried. She asked me to see a urologist to be sure.

The urologist was concerned that the readings had more than doubled in the last year but again said it was probably due to the size of the prostate. He suggested a biopsy to be sure. Again I thought: nothing to worry about. At the follow up meeting with my urologist the next week, he gave me the results of the biopsy. Five negative cores but a sixth one with cancerous cells and a Gleason score of 6. Now I was worried.

Only one of us who has sat in a doctor's office receiving this news can relate to the feeling. The world seems to suddenly go into slow motion; in a fog and from far away I could hear the doctor's voice talking about options and giving my wife and I literature and pamphlets to read. He was going to schedule the staging tests to see if the cancer had spread. If the test returned with negative results he would schedule the prostate cancer surgery in 6-8 weeks. I walked out of his office in disbelief. I had cancer at 58 - I thought that this only happened to people in their 70s and later. My whole world had suddenly come apart.

The books and pamphlets outlined my options - none looked really great. All described lengthy hospital stays, severe pain, and a long period of recuperation. I then found one of the Canadian prostate cancer support groups right in my hometown. After meeting with several members, who were more than willing to share their stories with me, I ruled out radiation as an option. The seed implant and cryotherapy treatment was also ruled out - in my case I had decided I wanted the cancer completely out of my body and not to continue to worry that all of the cancer had been killed. This left open radical surgery with its long recovery period as my only option until I came across the web site of Dr. Arnon Krongrad. There was more information about laparoscopic radical prostatectomy on this website and links than you could ever want. The testimonials and descriptions of the procedure were clear and concise. I quickly discovered how wrong I was about ones age in relation to contracting prostate cancer.

Within a few days I was an expert on the latest technology that was available. All I had to do was find someone in Canada to do a LRP. I quickly discovered that there are only about a dozen doctors in all of Canada that have started using this procedure and only in the last few months. I tried contacting the office of some of the doctors but was quickly turned away with the phrase "you must be referred by your urologist to have an appointment with the doctor". I didn't want an appointment. I wanted to know how successful his operations were, how long they took and how long the waiting period was to be scheduled for an operation. "Sorry, you must be referred."

With nothing to lose I sent a note off to Dr. Krongrad and was amazed that within an hour I received a reply. Yes, he would be interested in talking to me. Yes, he had done surgery on patients from all over the world, including Canada.

I soon was talking to the best professional office personnel one could ever hope to deal with. Hope and Ruth were patient with the questions they have probably heard a thousand times. Their answers were friendly and helpful and I wasn't even a patient but I was determined to become one. They helped me schedule in Canada the entire required tests that I would need before surgery, which was booked for three weeks away. Talking to representatives of the Ontario Health Insurance Plan they told me that if I was determined to go outside the country for a medical option that was available inside the country, I was on my own. I had made up my mind; I was going to Miami. My son decided to take some time off work to help with the driving.

The meeting in Doctor Krongrad's office was like a reunion with old friends. We had talked for so long on the telephone we knew a lot about each other. Dr. Krongrad has a wonderful personality that immediately puts you at ease and you can quickly feel the confidence he has in his abilities as a surgeon. My wife and son were equally impressed.

The day of surgery I arrived at the Aventura Hospital at 6:00 AM. Surgery was scheduled for 7:30 but the staff was quickly getting me ready as Dr. Krongrad quite often arrived early, which he did for me, too. By 10:30 A.M. I was out of surgery, on no pain medication and talking to the recovery room nurses. By the afternoon I had a room of my own and met with Dr. Krongrad who said around 9:00 P.M. he wanted me to go for an escorted walk done the hall to the nurses station. With my son at my side, I made it that far but gas pains soon started to well up in me so that was the end of my first walk. It seems that the anesthesia paralyzes your bowels and gives cause for Dr. Krongrad's warning "do not eat solid food before passing gas" (my bowels took more than 30 hours to wake up).

The next day after a visit from Dr. Krongrad I was released from the hospital. Gas pains were a continuing problem but I was able to do a few laps around the hotel parking lot. It wasn't until evening that I was able to give a royal toot on the horn. Everything started to improve from that point on.

The 2nd day after getting out of the hospital I had my post surgery consultation with Dr. K. The pathology results showed an encapsulated cancer, which had not reached the walls of the prostate. Dr. K. declared as far as he was concerned I was cancer free. But should follow-up with some PSA tests in a few months. After news like that there were lots of smiling faces all around. Saying goodbye to Dr. K. and his staff was like parting with good friends.

The 3rd day after surgery my family and I left Miami on our 3-day drive back to Canada. I felt well enough to trade driving responsibilities with my son every 2 hours - after walking a lap around each rest area parking lot.

At one point, the catheter was really becoming a pain. If I tried to walk any distance it hurt. I was so angry at the overnight bag that I just dragged it down the hall to the bathroom not realizing that I had hit it on a door jam. When I got to the bathroom and lifted it to empty it I was shocked to see the bag empty- it was full when I had left the bedroom. A quick look back into the hallway confirmed my worst fear. I had emptied the bag all the way across the bedroom floor and down the hallway on our rug floor. That was the final straw. I used the standing in the shower method to remove the catheter myself without much of a problem. For the first time since surgery my body was not tied to something foreign. It felt good but still sore.

The 12th day I hiked 3 km. and on the 13th I met with some friends in a work party who were opening up a new section of trail. I tagged along and completed about 12km. of trail. One of my friends commented to another that it was just amazing to see someone who had just had major surgery 3 weeks ago hiking with the same stamina as them. I had to remind him it was less than 2 weeks since my surgery.

Incontinence is a problem but each day I am better able to anticipate when I have to go and to hold on for a few minutes longer. Perineum and urethra pain has become a constant companion. An e-mail to Dr. Krongrad confirmed that indeed some prostate surgery patients experience this discomfort but fortunately it will diminish over time.

By my 4th week I was back to most of my old routine of hiking and working in the woods. I even surprised my volleyball club by showing up for a game. Incontinence definitely became a small problem playing volleyball but it was great to be getting back to an active life.

By my 10th week incontinence was vastly improving in fact becoming very close to normal. At my 12th week I had a PSA test done with a 0 result. Thank you Dr. Krongrad! And I am finally completely rid of all perineum and urethra discomfort.

I have been asked, looking back now with the option of free (in Canada) open radical prostate surgery as opposed to expensive out of country surgery, would I change my decision on LRP. My answer is an emphatic no!

My research, when first diagnosed, proved to be valuable input to my decision. The professionalism, information and kindness of Ruth and Hope at Dr. Krongrad's office helped to confirm my decision. The results from the surgical skills and friendliness of Dr. Arnon Krongrad were everything that I had hoped for. My decision resulted in an amazingly quick recovery time with minimal pain from what I find hard to describe as major surgery.

The words "cancer of the prostate" send chills down every man's back. With surgeons such as Arnon Krongrad these chills are not long lasting.

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A Canadian with an enlarged prostate and rising PSA uses prostate cancer support groups and other methods and finds laparoscopic prostate cancer surgery.