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Patients speak about prostate cancer and laparoscopic radical prostatectomy

John Luce, Venice, Florida

My story, like most of those diagnosed with prostate cancer, began a few years ago when my prostate-specific antigen, PSA, began to rise. I was 53 at the time and based on my urologist's recommendation, I had a prostate biopsy performed in his office with no medication. Needless to say, this was a very uncomfortable experience, but at least the results were negative.

A couple of years later, in August of 2001, as part of my annual physical I had my PSA checked. The results showed a reading of 7.2 ng/ml and I was scheduled for another biopsy. This time I was sedated and felt no discomfort and the results were once again negative.

In October of 2003, after seeing my PSA drop to 4.9 ng/ml and then rise to 6.0 ng/ml, my urologist suggest another biopsy, this time the results came back positive with a small area of adenocarcinoma in the right prostate. I was now 57 years old and diagnosed with prostate cancer.

Over the course of the next few weeks I read everything I could find about this disease and treatments. I learned about Gleason scores and staging and what I could expect as a result of the various treatments. I was told by my urologist that I essentially had all of my treatment options open, radical prostatectomy, cryotherapy, external beam radiation, and radioactive seeds.

My urologist recommended the cryotherapy. I read more about this procedure on the internet and began to have my doubts. Then I spoke to a radiation oncologists and he was adamantly opposed to cryotherapy. Interestingly enough, he convinced me to strongly consider a radical prostatectomy based on my age and medical data. He was at least 10 years younger than myself but indicated this would be his choice if in my position. I now ruled out cyrotherapy and external beam radiation, but was still interested in radioactive seeds, which appeared to be minimally invasive and yet effective. However the more I read the more I became concerned about the lack of long-term studies and the fact that if the cancer was not totally eradicated my future options may be limited.

I finally decided to have surgery and hopefully be done with the problem. I also liked the fact that the entire gland could be studied by a pathologist to determine if the cancer was contained in the prostate. Now it was time to find a surgeon, if not my original urologist.

In my extensive searches, I happened to find Dr Krongrad and became very interested after reading the benefits of the laparoscopic technique. I was also impressed by Dr Krongrad's academic and professional credentials and experience, not the least of which was the number of these procedures he has done. I read with great interest all of the patient stories and felt like I wanted to be one of those satisfied people. I searched for more information about the surgical procedure and found that it is only being performed by a few doctors, primarily because it is relatively new and also because is requires a different skill than a traditional radical prostatectomy.
I made my decision and scheduled an appointment with Dr. Krongrad. I met with him the day before surgery and then completed all of the paper work at Aventura hospital. The next morning I checked in and had my LRP.

From what I could tell the procedure took less than three hours and Dr Krongrad was able to spare both nerves. I woke up with no pain and five very small band aids covering the incisions. When I got back to my room, I was walking the corridor in no time and was discharged the next morning accompanied by a Foley catheter.

The following day after a brief conversation with Dr. Krongrad, during which he gave the pathology results that indicated that the cancer was organ confined, I returned home and never had a single problem and did not take so much as an aspirin for pain.

I tell my friends that perhaps the worst part of my recovery was that I felt so good that I had to remind myself that I just had major surgery and had to limit certain strenuous activities. I recently received my first post-op PSA results and was happy to hear the term "undetectable."

If you have to have a radical prostatectomy, then LRP is the way to go and Dr. Krongrad and his staff are the greatest. He will answer all of your questions and spend as much time with you as necessary; this is a doctor who never forgets his patients. Thanks, AK, for what you have done for me and so many others.
John Luce - Florida