Nancy Hintz talks about her husband's robotic prostatectomy
Our experience with prostate cancer all started on a normal Thursday afternoon the beginning of July, 2006 when I opened a letter from First Colony Life Insurance Co. addressed to my husband. He had recently applied for some term Life Insurance and I figured it was just a routine follow-up letter saying that his application was being processed. However, I was wrong.
The letter read “We regret to inform you that your application for life insurance has been denied.” I’ll never forget reading those words. John was a perfectly healthy 50 year-old man in good physical condition who had never been sick a day in his life.
However, the results of the blood test which the insurance company had done showed a PSA reading of 13.0. This was John’s first PSA test and quite frankly neither one of us knew much about it. Two years ago, at age 48, he had gone for a routine physical and for whatever reason, they never checked his PSA. He thought that was unusual at the time, but the doctor assured him that he didn’t need it checked until he was 50 since he had no family history or any other condition that would put him at high risk.
Up to this time, basically John had only minor symptoms of any prostate problem which included more frequent urination and stronger urges and less volume and pressure, but nothing that he couldn’t live with. Now, with a PSA of 13.0 something needed to be done. He immediately went to our family doctor who did a prostate exam and said that his prostate was “globally enlarged.” However, he was convinced it was just an infection and put him on an antibiotic. He said that because of his age it was very unlikely that it was cancer.
The next three months were filled with taking antibiotics, more PSA tests and prostate exams, but there was no change. In fact, his PSA was creeping up and his symptoms were the same or possibly getting a little worse. Another doctor said he suspected it might be cancer since the antibiotics were not helping, and he referred us to an urologist to have a biopsy. After three days, which seemed like three years, of waiting for the results of the biopsy, we got the phone call from the urologist saying that it definitely was cancer and he needed to see us right away.
The next day, we found out that not only did John have cancer, which in itself was difficult enough to deal with, but it was aggressive cancer. His Gleason score was 9, which he said was highly unusual, especially in someone as young as John. The urologist gave us a book to read on prostate cancer. He scheduled a bone scan and CT scan because he feared it had spread to his bones and/or lymph nodes. We were more scared at that moment than we had ever been in our life.
The next week was filled with tests, talking to more doctors and waiting for results so a decision could be made of what to do. We heard everything from he needs surgery ASAP to his cancer was inoperable. We were also told that radiation might not even be on option because of the extent and aggressiveness of the cancer and that hormone therapy would be his only hope to try to control it. If they were unable to control the cancer with the hormone therapy, he probably only had 2 to 3 years to live.
We were devastated. We were so ignorant about medical problems and we were just at the mercy of doing whatever the doctors would recommend. We went from thinking that prostate cancer is a very slow growing cancer that is easily cured to realizing that it is the second most common type of cancer in men and only lung cancer is responsible for more cancer deaths among men.
Fortunately, the bone scan and CT scan both were negative and there was finally a glimmer of hope. The urologist suggested a radical prostatectomy as soon as possible, followed by six to eight weeks of radiation. He said there was a good chance of him needing hormone therapy after that.
John was very scared of the surgery and I had read enough about the surgery to know that it was not going to be easy. John had never had surgery before. In fact, he had never even been in the hospital. He couldn’t imagine the week in the hospital followed by the six to eight weeks of recovery and the chance of being impotent and/or incontinent, but we knew we had to get the rid of the cancer one way or the other.
We went to a radiologist group who suggested seeds and external beam radiation, but again, because of the aggressiveness of his cancer they would need to use very high doses of radiation which have another whole set of side effects and complications, and they would follow up after the radiation with hormone therapy. We even went to a doctor at a cancer clinic in the Bahamas where they do some alternative medicine not available in the U.S., but even that doctor highly recommended letting our urologist do the radical prostatectomy and get the cancer out of his body.
I was on the internet day and night researching every site on prostate cancer I could find. John was too upset to read about it at all. He let me do all the research and I would tell him “edited” versions of what I read so he wouldn’t be any more scared than he already was. The words “incontinent” and “impotent” kept coming up and I couldn’t even imagine either happening to John. I read the book that the urologist had given us cover to cover twice, mostly in the middle of the night. We couldn’t sleep or eat. Thank God for our supportive family and friends who helped us get through this difficult time.
In less than a month since we had found out that John had prostate cancer, we had been to five different doctors and had done extensive amounts of research, but we still were confused and scared. John told me to stop researching because no matter what new information I might find, he was not going to one more doctor. We were both mentally and emotionally exhausted. His PSA was now up to 14.8 and that coupled with the Gleason score of 9, it was time to make a decision. He decided to have the surgery.
It was a Monday morning and I put a call in to the urologist to schedule the radical prostatectomy. While I was waiting for the urologist’s office to call back, I got an e-mail from our daughter-in-law saying that she had found a news bulletin on the internet about Saint Joseph’s Hospital in Atlanta appointing Dr. Nikhil Shah to be director of their urologic robotic surgery program. I almost didn’t even open the e-mail or the attachments, but am I glad I did! Dr. Shah came from the Henry Ford Medical Center in Detroit with very impressive credentials and extensive experience with robotic radical prostatectomy surgery.
Related articles explained the benefits of the new robotic-assisted surgery available for prostate cancer patients. Benefits included minimal bleeding, shorter hospital stay, less pain during recovery and lower risk of side effects such as impotence and incontinence. I was afraid to even hope that John might be a candidate for this less invasive surgery. I knew John had told me to stop looking for new ideas, but this one sounded too good to pass up.
The contact person at Saint Joseph’s was Erin Popescu, Robotic Program Manager, so I e-mailed her and explained John’s situation. She passed my e-mail along to Dr. Shah and about three hours later, I had a phone call from Dr. Shah who said he wanted to talk with me further. I explained everything that had happened over the past few months and he said that he had handled cases with high PSA and Gleason scores before and he could help us as well. He assured me that John was a candidate for the robotic surgery and that John would have two or three more decades to live, not the two or three more years as we had heard just two weeks before. Dr. Shah said he would meet us later in the week and he would do the surgery the following week. I started to cry. I could not believe that we had finally met a doctor who was optimistic that he could cure John’s cancer.
Our respect and admiration for Dr. Shah started with that phone call and has only grown as we have worked with him over the past several months. He is an exceptional person as well as a skilled and experienced surgeon. He is kind and compassionate which made it easy for us to place all our confidence in him. Our first meeting in his office went very well. He took time to explain the procedure and what to expect in a clear, direct and honest manner. The more we talked with him and the more we heard about the robotic-assisted surgery, the more we knew that we had found the right man for the job.
John’s surgery was the next Wednesday, Nov. 1, 2006 at 2:00 pm. We had a wonderful experience at Saint Joseph's. Everyone there was kind and supportive. The surgery lasted about 3-1/2 hours, a little longer that I was anticipating and I was getting worried, but everything had gone well. When Dr. Shah came out to the waiting room to speak with me after the surgery, he was excited. He was confident that John would have a full recovery including full urinary continence. He had been able to spare his nerves and in time he feels confident that he will regain male potency as well. I was so relieved. He gave me a hug and once again I started to cry.
John got to his room that night about 7:00 pm following a couple hours in recovery. I was able to spend the night in the hospital room with him which was great. He was “uncomfortable”, but not in any real pain. The next morning he was up walking around the hallway with me. He never even had to take a pain pill. The only sign of the surgery were six small incisions across his abdomen. It was remarkable. He was released from the hospital less than 48 hours after we had checked in for the surgery. He was back to work a few days later. The catheter came out the following week which was a big relief. Now his true recovery could begin.
The full pathology report from the prostate itself, seminal vesicles and lymph nodes which were removed during the surgery showed that although the cancer had spread to the right seminal vesicle, the lymph nodes were clear as was the tissue surrounding the prostate. Also, the pathologist recalculated the Gleason score to be a 7 rather than a 9 as originally thought, all very positive news.
John’s follow-up visits have been just a continuation of the supportive care we have received since the first day we met Dr. Shah. One month after the catheter was removed, he had his first PSA test with a reading of 0.00. Dr. Shah was almost as excited about the results as we were. In John’s case, there is still a 40% chance of recurrence in the next 10 years so he will continue to have his PSA checked every 3 months, but as long as the results continue to be undetectable, Dr. Shah is not recommending any radiation treatments or hormone therapy. My most recent PSA test, 4-1/2 months after the surgery, still showed 0.00.
We feel that hearing about Dr. Shah and the robotic prostatectomy available at Saint Joseph’s Hospital was truly a miracle and we are very blessed to have been able to take advantage of this amazing procedure to treat and cure John’s cancer. We will be eternally grateful to Dr. Shah and the staff at Saint Joseph’s for all they did to help us get through this scary and difficult time.
Read this story from her husband, John Hintz' perspective.
For more information about robotic surgery, call 1-866-SJ-ROBOT (1-866-757-6268).
