Hi Brenclan and welcome to the Cancer Chat community.

Hopefully some of our prostate cancer members will offer their support and advice soon but whilst you wait I just wanted to let you know about the information we have on our website about prostate cancer. It has a section about treatment options, including robotic surgery, which I hope will help clear up any confusion but you're more than welcome to have a chat with our cancer nurses about this once they return from their Christmas break. They will be available again from the 27th onwards (except New Year's Day) on 0808 800 4040. Their phone lines will be open between 9a.m - 5p.m.

You may find Prostate Cancer UK quite helpful and informative at this time as well.

Kind regards,

Steph, Cancer Chat Moderator

Hi Steph, many thanks for your response to my post, I was beginning to think I had not completed the posting correctly as there was no response as I am not very good with this modern hi tech! Given the time of year it is understandable of course!

I do hope over the next couple of weeks some kind people who have had the same issues will able to give some advise/ recommendations with regard to pros and cons of different types of surgery prior to me meeting with my team !

many thanks and a very Merry Christmas Brenclan

Hi Brenclan. Welcome to the Prostate Cancer club, although no one ever really wants to join it!

I had a robotic radical prostatectomy way back in 2010.  I was confidently continent within 6 months, but because I could only have one-sided nerve sparing, my erections never recovered.  Nevertheless, I have no regrets.  I'd probably be in much worse state now if I hadn't had the operation. 

You are right that the robot is controlled by a surgeon, but the robot is able to move far more precisely than a typical human hand. The surgeon requires special training to use the device and then lots of practice.  However, the same is true of all surgery, no matter how it's done. 

You can ask who will be doing the surgery and how many RPs they've done in the last year.  If it's over 100 or so then who should be in good hands, but don't forget that in any teaching hospital, less experienced surgeons (under the guidance of the chief surgeon) will be doing part of the work.  

Personally, if surgery is an option I wouldn't go the radiotherapy route. It can affect the bowel, sometimes years later, and once you've had radiotherapy, normally you can't have the operation if the RT hasn't worked.  

Also, once you've had treatment, you need to be monitored for recurrence, which is a PSA test every 3 months.  With surgery, your PSA should drop to < 0.1  ("less than 0.1" or "undetectable") within 6 weeks, and then stay there for life.  If ever it creeps up then you've got plenty of warning and you can have radiotherapy to salvage the situation. But if radiotherapy is your main treatment then the PSA never drops to a similarly low figure, and it can vary from reading to reading, going up and then down.  I'm not sure I'd want to live the next 10 years with that level of uncertainty.  Furthermore, you may not be able to further radiotherapy in the region.  

I hope you've find this helpful. 

Many thanks for your response Raymondo, your experience and telling of the same is most appreciated. It seems that I am going to be a candidate for impotence because I have been told that the cancer is on the front left of the prostate directly where one of the two banks of nerves are situated and the likelihood is they will have to remove the nerves around the tumour. I have made the decision to have surgery with all its challenges because I don't believe I would be a very good candidate for the other options. My decision is whether to have laprioscopy or wait a little longer for the robotics? Of course either op would only be as good as the persons expertise carrying out the procedure?

kind regards Brenclan

Hi Brenclan.

If your PSA before biopsy was low (say less than 10) then I don't think a delay will cause any problems.

Mine was 5.6 before I had my biopsy in July 2010.  I had more tests and a review in August and I was scheduled for surgery in September but that fell through because my blood pressure was too high.  Then the robot was out of action for a few weeks due to some incident during another operation where it got contaminated and needed a special deep clean.  So I finally got my operation 21st December 2010 (9 years almost to the day).  I asked my GP about the delay and she said that I probably could have waited for a year without any untoward issues. 

BTW. Even if you can't get an erection, you can still orgasm so with a bit of imagination sex isn't out of the question.  

First Telemando, I apologise for the renaming to Raymondo, I obviously had the feeling you were MAGIC! My PSA has risen from 14.5 in June this year to 15.1 in October. Sounds a bit worrying about the robot requiring a deep clean due to contamination but I guess all equipment has to undergo essential deep cleaning! I am suffering with lower back pain and a dull ache in one testicul but I have been assured that this is not related and the cancer is confined to the prostate! I am pleased to hear that there is sex of sorts after?

kind regards Brenclan 

Hi Brenclan.

As I understand it, the robot was being used for surgery and hit an infested cyst.  Pus and nasty stuff went flying everywhere.  Sounds a complete mess, but a very rare event.  They couldn't use the robot until they were 100% sure it was sterile.