Jim Webb talks about his robotic prostatectomy
The words fell heavy upon me as I got the news that I had Prostate Cancer. It all seemed so impossible … but also very real.
My wife, June, had Breast Cancer when our smallest child was five years old and I remember how frightened we were then. Today the internet provides more information than the frightened human mind can process but I soon had files on all the possibilities. My wife and I consulted with my urologist – in fact, my daughter -who is a physician assistant- attended the session so we could all listen together.
I wanted treatment that would minimize the impact on my prostate and maximize the impact on the cancer. I had a real deep desire to hold on to my prostate in spite of the fact that the prostate had been messing with the quality of my life for years. For some time I had been struggling with an enlarged prostate with a weak stream and multiple interruptions of my sleep at night in attempts to empty my bladder. Because of the slow rate of flow I was also experiencing pooling of urine in the bladder with more than my share of bladder infections. For years I was taking prescription drugs to treat my enlarged prostate as well as antibiotics to treat those recurring bladder infections. It was becoming an expected ‘way of life’.
My wife offered great advice in the form of a question – “after your treatment of choice, what will be the effect on your quality of life? – if you still have the same size prostate. Will you continue to have the constant pre-disposition to bladder infections and will you still have difficulty urinating causing you to be up multiple times every night?” I heard her but I didn’t hear her. Sometimes husbands have selective hearing that does not always work for our good.
My primary urologist offered me an opportunity to consult with the new urologist in his office who performed robotic prostate surgery but I declined the invitation because I wanted to keep my prostate – pure and simple. I made the decision that I would journey down the “radioactive seed” road and made an appointment with the recommended radiologist to get set up for the seed planting procedure. During my first appointment with the radiologist it was discovered that, not only was my prostate enlarged, but it was extremely large. Too large for seeds at that time. So it was recommended that I take hormone therapy in order to reduce the size of my prostate and I was told that the hormone therapy would also place my cancer in remission. The hormone therapy would take about a year and then I would be ready for seeds. My wife again asked the question – “what will be the effect on Jim’s quality of life? The radiologist replied that we could “deal with that question later”.
In late August 2006 I took the hormone shot that would take me into the strange world of female menopause – I must say that I took the hormone shot without thinking through the impact of night sweats, hot flashes, loss of muscle mass, weight gain and changing from an always warm, “what do you mean it’s cold in here” to a shivering “where is my sweater” kind of guy. My wife remarked that if every woman talked about their hot flashes as much as I did, menopausal women would never talk about anything else. Just for the record, hormone therapy is not passive and needs to be weighed like any other solution offered.
In September 2006 I returned from our son’s wedding with what appeared to be another bladder infection. I called my urologist to get a prescription for an antibiotic but was asked to come into the office to see the doctor. My regular urologist was on vacation and I was told that I would see the new doctor in the office – Dr. Shah. I believe in “divine appointments” and truly believe my meeting with Dr. Nikhil Shah was far more than fortunate or coincidental.
Dr. Shah had reviewed my medical file and was eager to talk about my situation and the choice I had made. Dr. Shah helped me understand that the hormone therapy may not work as well as I thought because the amount of reduction expected from the hormones and the actual results may leave the prostate still too large to accommodate appropriate seeding. At the end of a year I may still have a prostate that was too large for placing radioactive seeds.
My wife still did not have answers to the questions she had been asking so she sent those questions, written in a note, with me to my appointment with Dr. Shah. Her questions read: “Will the seed radiation treatment eliminate a constant pre-deposition to bladder infections and his difficulty in urinating?” Dr. Shah took her note and wrote her his answer “It likely will make it WORSE!”
For the first time I began to ask the real question – “After I deal with the cancer, then what?” I found that I could talk directly with Dr. Shah – I was comfortable in his presence and he was comfortable with me and encouraged all my questions. I knew immediately that I liked this doctor and I had an intuitive sense that I could trust him. We set up another consult appointment where I invited my wife and my daughter to talk and to see what I had already discovered about this special man – he had a passion for his work, he had a passion for me as his patient and the quality of my life was important to him.
I had my surgery on Oct. 18, 2006. The very large prostate turned out to be even larger than anyone thought – my prostate was six times the normal size. Dr. Shah applied his considerable talent to the robotic surgical task with excellent results. Because of the size of my prostate, the bladder opening had to be redone so all the “plumbing” would connect.
The surgery was long, as Dr. Shah had anticipated, but by that night I was walking laps around the nursing station. I was released to go home the next afternoon. I kept my catheter for three weeks to allow the work done in the bladder opening to fully heal. I was sent home with a prescription for pain but never used it – not because I am so brave but because the minimally invasive surgery had been so kind to my body. I played my first round of golf five weeks after surgery – I have had better rounds but I was delighted to feel that I could swing, had strength, could walk, climb out of sand traps and enjoy the day.
The PSA results after surgery came back 0.0 – my body was free of cancer. It took me about six weeks after the surgery to feel that I was continent. Three months after surgery I still wear a Depends pad because I am more comfortable with the pad --- just in case I sneeze or sit on a bleacher seat watching my grandchildren’s teams play for too long at one time. Three months after surgery I think of myself as a ‘two-pad-a-day guy’. My quality of life is very good. I am up once per night on average and could change that if I would drink less fluids after 6 p.m.
My relationship with Dr. Nikhil Shah is quite incredible. When he walked into my hospital room at Saint Joseph’s I could feel his warmth as well as a genuine caring about me and my recovery. He was pleased with his surgery but he was more pleased that I was doing so well and had such a positive future. The Saint Joseph’s Hospital staff was great and I heartily recommend the Saint Joseph’s experience – it was superb.
I would love to talk to you directly but that may not be possible. However, I want this testimonial to speak to your head, your heart, and to wherever indecision lives. I want to encourage you to join up and communicate with your spouse. Listen to one another and grow closer to each other through this difficult time. I also want to share Dr. Nikhil Shah with as many as I can --- he is one gifted and brilliant doctor and he will care for you just as he has cared for me.
For more information about robotic surgery, call 1-866-SJ-ROBOT (1-866-757-6268).
