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Thread: 2 days out from RALP

  1. #1
    Regular User
    Join Date
    Jul 2016
    Posts
    38

    2 days out from RALP

    I had my RALP on Thursday, everything went as planned and I came home yesterday. The pain isnít as bad as I expected and Iíve been able to control it with ibuprofen.
    What did you guys do about the gas? Thereís a lot of gas working itís way around in there that I canít quite get out
    DOB 4/11/1969
    PSA: 5/12: 3.46, 3/13: 2.38, 3/14: 3.49 6/15: 3.10 7/16: 3.19 12/17: 3.5 04/18: 3.8 12/18 4.1 4/19 4.5 6/19 4.8
    Nodule found during DRE 7/2016
    Biopsy: 7/22/2016
    RMB: adenocarcinoma, Gleason score 3+3=6
    Total surface area 5% involved
    perineural invasion present
    Biopsy: 7/19/2017
    Gleason score 3+3=6
    Total surface area 30% involved

    RALP 8/15/2019 United Hospital, Dr Sershon
    Path report: gleason 3+3, grade group 1 of 2, pT2 (organ confined), margins: positive (limited, left apical), prostate weight: 53 grams.

  2. #2
    Congrats on your surgery, wbigs! Walking (without overdoing it) is great for recovery in general and for moving gas out, too. Shorter, more frequent is better than longer, less often at first.

    Djin
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg., then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day check)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015
    08-28-19 (2 yr. ) 0.016
    Avg. = 0.013

  3. #3
    Senior User
    Join Date
    Nov 2016
    Posts
    297
    I agree with Djin, walk, walk, walk. Glad you're mostly pain free. Dont let lack of pain convince you to lift more than allowed...
    Age at Dx 57
    PCa History: Father, Uncles, Grandfathers

    Oct 2016 Biopsy 12 core: Adenocarcinoma, Gleason 4+3=7 Grade Group 3) w/PNI
    Left Lateral Base: Suspicious
    Left Lateral Mid: PIN
    Left Base: 4+3=7 (60% pattern 4) Core involvement 30% (5mm)
    Right Base: Suspicious
    Right Apex: 3+3=6 Core involvement 60% (7mm) discontinous
    Right Lateral Mid: 3+3=6 Core involvement 10% (1mm)
    Right Lateral Apex: 3+3=6 Core involvement 10% (1mm)

    Jan 2017 DaVinci - Dr. Grant Taylor - Path = pT2c pNX pMX; Gleason 4+3=7; Weight: 42g

    Jun 2019 AMS800 installed - Dr. David Rapp - Jul 2019 activated

    ED: Light to moderate

    (Note: All PSA tests prior to Jun19 were done by LabCore)
    PSA_TESTS

    Apr 2016=5.1
    Jul 2016=4.7
    Aug 2016=5.13

    ----Surgery----

    Mar17<0.01
    Jul17<0.01
    Oct17<0.01
    Jan18<0.01
    May18<0.01
    Nov18<0.01
    Jan19<0.01
    Jun19<0.02

  4. #4
    Quote Originally Posted by wbigs View Post
    I had my RALP on Thursday, everything went as planned and I came home yesterday. The pain isnít as bad as I expected and Iíve been able to control it with ibuprofen.
    What did you guys do about the gas? Thereís a lot of gas working itís way around in there that I canít quite get out
    Honestly, I think my surgeon blew me up like the Goodyear blimp. Took 2 weeks to get rid of the gas.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    ADT - 6/19 - 6/21
    ART - 78Gy 8/19 - 9/19

  5. #5
    Hi wbigs! Welcome to "The Good side of RP!" As your fellow FBs have suggested, Lots of walking will help nearly everything. Nothing strenuous until cleared by your surgeon. Follow all of the post RP instructions exactly.

    Keep in mind that each day is better than the previous.

    Once you are liberated from the catheter, you will have a new view of the world!

    Best wishes for a clean Path Report.

    MF
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3a pNO pMX pRO c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml
    uPSA remains "stable" at 84 Months Post Op: Mean = 0.021 (20x uPSAs: Range 0.017 - 0.026) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  6. #6
    Experienced User
    Join Date
    Oct 2018
    Posts
    95
    Congrats, brother. Hope it's smooth sailing from here.
    Born 1953. All care at Kaiser in LA.

    10/11/18: 2 pos G6 cores of 12. Pros vol 33g.
    12/6/18: MRI finds 15.5mm diameter mass, labeled PI-RADS 5.
    1/4/19: G6 tumor 10% in 1 of 6 cores; uro recs treatment
    2/27/19: Dr. Epstein - G6 on that single guided core; 20%
    3/26/19: Color Doppler with Dr. Bahn; recs AS.
    5/6/19: 2nd Kaiser uro recs AS.
    6/7/19: Dr. Clayton Lau at City of Hope recs AS.
    7/8/19: 3rd Kaiser uro: AS.
    7/15/19: Dr. Leonard Marks at UCLA: AS. UCLA rad finds nothing abnormal in MRI.
    8/23/19: Another Kaiser rad finds nothing abnormal.
    Changing docs to 3rd uro.

    PSA
    8/2/18: 1.2
    3/26/19: 1.8
    6/14/19: 2.2

  7. #7
    Regular User
    Join Date
    Jul 2016
    Posts
    38
    Thanks for the well wishes, honestly the worst part is the catheter and that’s tolerable. I’ll check in on Friday when I get the pathology report and can hopefully call myself cancer free.
    DOB 4/11/1969
    PSA: 5/12: 3.46, 3/13: 2.38, 3/14: 3.49 6/15: 3.10 7/16: 3.19 12/17: 3.5 04/18: 3.8 12/18 4.1 4/19 4.5 6/19 4.8
    Nodule found during DRE 7/2016
    Biopsy: 7/22/2016
    RMB: adenocarcinoma, Gleason score 3+3=6
    Total surface area 5% involved
    perineural invasion present
    Biopsy: 7/19/2017
    Gleason score 3+3=6
    Total surface area 30% involved

    RALP 8/15/2019 United Hospital, Dr Sershon
    Path report: gleason 3+3, grade group 1 of 2, pT2 (organ confined), margins: positive (limited, left apical), prostate weight: 53 grams.

  8. #8
    bigs...best wishes for a clean path report. Welcome back and best of luck. MM
    DOB:Feb 1958
    PSA: 9/15: 5.9
    DRE: Negative
    Biopsy: 10/1/15. Second Opinion University of Chicago. +9 of 12 cores. G6: 5 cores, G7 ( 4+3) 4 cores
    10/12/15: -CT scan/BS
    Clinical Staging: 10/28/15 T2c
    ( RALP) UC 12/29/15

    Final Pathology Report; Jan. 6 2016

    -15 lymph nodes
    G9 ( 4+5)
    +EPE
    +LVI
    +Right SV -Left SV and vasa deferentia,
    PI present
    PM
    pT3bNO
    uPSA 2/9/16 0.05
    uPSA 3/23/16 0.11
    Casodex 4/1/16-8/5/16
    Lupron 4/15/16-5/15/18
    SRT 6/14/16...8/5/16 38Tx
    uPSA 8/10/16---8/22/19 <0.05
    Feb. 2017 Loyola Chicago
    11/15/2018 AUS 800 Implanted
    12/18/18...T Levels...Free T 42.8...Total T...262

  9. #9
    Senior User
    Join Date
    Feb 2019
    Posts
    194
    Good to hear sir.

    And, as others have said ... walk, walk, walk. To coin the phrase, "this too shall pass".

    After a week time the gas will start to become a distant memory.
    Age DX 63 dob 1955
    8/11/16 CT scan (blood/sand in urine). Prostate norm w/cent calcification.
    11/6/18 GP freq urine/retro ejact. PSA 7.1 (RX Proscar/Flomax)
    12/18 PSA 4.1 14.8% Free Proscar? MRI Lesion 1.6cm. Lymph nodes sim to 2016 CT, prostate norm size. Stage 3. PIRADS 4
    1/19 Biopsy 2/5/19 DX
    2/19 Bone/CT scans: No evid met chest/abd/pelvis
    3/2019 RALP Cath out/post-op path rpt week later:
    G9 (4+5) (65-70% + 15-20%)
    Dominant tumor: 4.3 cm apex to base, bilat.
    LNI+ (4 of 12 on R, largest 4mm, 1 of 8 on L, 9 mm)
    EPE+ (right lat., post. and L lat. aspects apex to base and at ant. mid aspect)
    Intaraductal component+, BNI-, SVI+, LVI+
    SM+ (carcinoma unifocally extends to ant. mid margin area of EPE (2mm)
    Prostate fat: neg. pT3b pN1
    5/2019 Casodex 2-weeks. uPSA 0.11
    5/24 uPSA 0.11 Lupron injection
    6/19 uPSA .02
    8/7 began 39 sessions RT.
    8/23 uPSA .01 Lupron injection

 

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