This is an update on where I am concerning my prostate cancer.


I have scheduled prostate surgery at the West Marion Community Hospital in Ocala for Tuesday, November 16th.


What? Ocala? I know.


I researched my options. I spoke with several doctors at Shands and the Mayo Clinic as well. Everybody concurred, I'm too young for radiation. Surgery is the best option. Even the Mayo radiation oncologist agreed that surgery was the appropriate treatment.


I've found that everybody is a proponent for what they do. A member in the choir (who happens to be one of my regular doctors) mentioned a new robotic surgery. But, he didn't know anything about it. I had to get on the Internet to find it. Nobody in Jacksonville does it. None of the doctors I spoke to even mentioned it. The robotic surgery is performed using the Da Vinci system.


The advantages of this surgery over the traditional radical prostatectomy are less pain, less blood loss, quicker recovery, less complications with incontinence and impotence. Traditional surgery has a recovery time of 3-4 weeks, up to 6 weeks. This procedure has a recovery time of 10-12 days.


The main difference is this surgery is laproscopic. 5-6 small incisions are made instead of one 6-8 inch incision. The surgeon sits at a monitor that provides him with a 3-d picture as he manipulates the surgical instruments remotely.


The closest place to offer the Da Vinci system is in Ocala at the new West Marion Community Hospital. They are a part of the HCA system (Hospital Corporation of America). The procedure is about 3-4 years old. They've had the system for about a year and a half... about as old as the hospital, actually.


I went there last week. It looks nice. The doctor and nurses seem to be as competent as everybody else. The hospital is really nice and clean. I think that's a big plus. Plus, the people have a good old fashioned country hospitality about them.


If all goes according to plan I will go down the night before, be operated on on Tuesday, and be released on Wednesday. I'm supposed to hang around Ocala for a few days. Then, I am officially released and can go home.


To give me time to investigate all of the options my urologist gave me a shot of Lupron, on 9/7/04. It lasts 4 months and is designed to shrink the prostate and help prevent the cancer from spreading. Lupron raises the testosterone level, however. So, I am taking Casodex to counteract the affect of the Lupron. Go figure. An interesting site for that is: It also has the side affects of other drugs, including Casodex.


Talk about different opinions and different levels of competence.


My urologist recommended the Lupron. The Mayo urologist was against it. The urologist who is performing the surgery recommended it. Mayo said the Lupron causes the prostate to become fibrous and more difficult to remove. I can appreciate his comments. I have noticed some improvement after having the shot.


I liked the Shands doctors. I'd have to be unconscious to voluntarily go to Shands, though. The hospital is dirty and dreary. I would be concerned with the level of care I'd get there. They ran a blood test last week but, would not tell me the results (PSA) over the phone, nor would they mail them home. They wanted me to come in for a consultation. And, this was after calling me Claude... not Paul. I had a few words to say. I was nice.


Mayo is a nice 'resort-type' hospital. Wow. It looks really nice. The Rochester clinic actually does the Da Vinci procedure. Mayo is very organized. You get the distinct impression that everybody is on top of everything. I appreciated that. If they did the procedure in Jacksonville, then, I would've gone there.


I think the geek in me just said to go with the new procedure. So, that's my decision.