The C Word “When the doctor told me I had cancer, I just glazed over,” Jack recalled. “He was telling about my options for treatment, but I didn’t hear much after he said the ‘C’ word. That word just kept going over and over in my mind.”
Jack Floegel was 62 when an elevated PSA score was discovered during an annual exam. Six months later his score was checked again, and it was higher. Jack’s physician referred him to an urologist who performed a needle biopsy on his prostate. That’s when it was confirmed he had cancer.
Jack was now among the 200,000 American men every year diagnosed with prostate cancer. And like the others, he needed to make a tough decision on a course of action. He didn’t want to join the other group, the 32,000 fatalities annually from that disease.
Ugly Options
An engineer by profession, Jack attacked the situation with research. He wanted to learn all he could about his disease and his options for treatment, or even if treatment was needed. “I went to the internet first, which is the worst place to get information, unless you want to read horror stories,” Jack said. “The library provided much better information.”
An engineer by profession, Jack attacked the situation with research. He wanted to learn all he could about his disease and his options for treatment, or even if treatment was needed. “I went to the internet first, which is the worst place to get information, unless you want to read horror stories,” Jack said. “The library provided much better information.”
His research showed that some men choose to do nothing, hoping the cancer doesn’t spread beyond the prostate. “The the course my father-in-law took, and he died at 60,” Jack said. “I’m not going there.” Then there is the option for radiation treatment or radioactive seed implants. “I want the cancer out,” Jack stated firmly. “And that that meant surgery.” The best change to get rid of all the cancer would be to have the entire prostate removed - a prostatectomy.
There were several surgical options consider, including a couple of variations of the standard open surgery. The invasive nature of the open procedures could mean a significant loss of blood and the potential for substantial side effects. Like most men of Jack’s age, he wasn’t ready for long period of incontinence, or to permanently sacrifice sexual function.
Engineering a Plan
His research also uncovered a surgical option new to him, minimally invasive robotic surgery. Testimonials from da Vinci patients painted a more hopeful picture. Side effects were less and recovery time was typically quicker. “I use robots in my work and I know that robots can do things that you can’t do with your hand,” Jack remarked. “So the idea of using robots in surgery made sense to me.”
His research also uncovered a surgical option new to him, minimally invasive robotic surgery. Testimonials from da Vinci patients painted a more hopeful picture. Side effects were less and recovery time was typically quicker. “I use robots in my work and I know that robots can do things that you can’t do with your hand,” Jack remarked. “So the idea of using robots in surgery made sense to me.”
But in 2006, the da Vinci system was not available everywhere. “At that time it was still relatively new,” said Jack. He located hospitals in Salt Lake City and Portland where the da Vinci was being used. He then learned that da Vinci prostate surgeries were being performed at Saint Alphonsus Medical Center in Boise.
da Vinci
The da Vinci® Surgical System is a proprietary robotic platform for minimally invasive surgery. The da Vinci consists of a control console placed several feet from the patient. While seated at the consol, the surgeon maneuvers up to four electromechanical arms attached the remote robotic cart, one arm holding a 3-D video camera. With a magnified 3-D video display of the surgical area, the surgeon uses hand and finger controls to manipulate micro-instruments mounted on the robotic arms. The micro instruments are introduced into the patient's body through minute incisions. The surgeon’s movements are filtered by the robot and scaled as he remains comfortably seated throughout the procedure.
The da Vinci® Surgical System is a proprietary robotic platform for minimally invasive surgery. The da Vinci consists of a control console placed several feet from the patient. While seated at the consol, the surgeon maneuvers up to four electromechanical arms attached the remote robotic cart, one arm holding a 3-D video camera. With a magnified 3-D video display of the surgical area, the surgeon uses hand and finger controls to manipulate micro-instruments mounted on the robotic arms. The micro instruments are introduced into the patient's body through minute incisions. The surgeon’s movements are filtered by the robot and scaled as he remains comfortably seated throughout the procedure.
Validation
Jack was leaning toward the minimally invasive da Vinci procedure, but still wanted confirmation on his research. So he returned to his urologist. “I asked him what he would do if he were in my position,” said Jack. “That urologist performs the standard open surgery, but he recommended the da Vinci procedure.” The urologist then recommended Todd M. Waldmann, M.D. with Idaho Urologic Institute. Dr. Waldmann began performing his da Vinci surgeries at Saint Alphonsus in 2003. Jack had the confirmation he needed, and now had his action plan.
Jack was leaning toward the minimally invasive da Vinci procedure, but still wanted confirmation on his research. So he returned to his urologist. “I asked him what he would do if he were in my position,” said Jack. “That urologist performs the standard open surgery, but he recommended the da Vinci procedure.” The urologist then recommended Todd M. Waldmann, M.D. with Idaho Urologic Institute. Dr. Waldmann began performing his da Vinci surgeries at Saint Alphonsus in 2003. Jack had the confirmation he needed, and now had his action plan.
Jack met with Dr. Waldmann and the surgery was scheduled at Saint Alphonsus. “Dr. Waldmann made sure I had considered all options,” Jack said. “And he warned me about possible side effects of incontinence and impaired sexual function. To my surprise, I had neither.”
Jack was also surprised at his lack of pain following the procedure and the brief hospital stay. “I was walking five hours after surgery and out of the hospital in 36 hours.” Jack worked from home the following week without pain medication. “I was shocked at how good I felt,” remembered Jack. Recovery can continue for up to two years, but Jack’s sexual functions returned after six weeks and incontinence was resolved even sooner.
Back to Zero
“I have friends who had standard prostate surgery,” Jack stated. “They have side effects I don’t think they’d have with a da Vinci surgery...I wish I could have told them about the da Vinci.”
“I have friends who had standard prostate surgery,” Jack stated. “They have side effects I don’t think they’d have with a da Vinci surgery...I wish I could have told them about the da Vinci.”
Jack still has annual exams. His last PSA score was zero. “Zero is a very good number,” said Jack. “I’m delighted with the care that I received at Saint Alphonsus and from Dr. Waldmann’s office,” complimented Jack. “It’s always nice when the people you work with are nice, and they all bent over backwards to make me comfortable...and then there’s that PSA number of ZERO!”
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