Question:
I have scheduled my robotic LRP for April. My doctor called me today to
ask if I had any questions about the surgery or his results and I asked
him if he removes the lymph nodes or not since I am stage T1c,G6,PSA 7.4,
age 60. He said he always removes the nodes since it not only assures him
that he has removed any cancer,but is also uncomplicates the surgery. My
question is: Is it standard practice to remove the nodes and is there any
risk or complication in him doing so? He did say that if a patient asks
him to not remove the lymph that he wouldn't. Looking at the Partin
tables it looks that the chances ,at my stage and PSA scores and Gleason
scores, of the cancer being present in the lymph nodes are 0%. Do they
remove the nodes in the open RRP? He also said that he has a priority
list of 7 things when he operated on a patient. #1 thru #5 was get rid of
the cancer, #6 was continency, and # 7 was potency. I suppose most of the
surgeons that operate on PCa feel this way, as they should. Any comments
would be appreciated since #6 and #7 are always on your mind when you
think of surgery. Yelnats
Answer:
doing the LRP - that is the one big drawback of having that particular
type of surgery and that is how this particular surgeon is insuring that
he's not leaving anything behind. it is like an overkill in the sense
that it may not have to be done, but he can't take that chance due to
the LRP.
on the RRP, the surgeon has the opportunity to physical touch and feel
for cancer in the lymph nodes, but it takes longer to heal.
so, there you are. the good and the bad. chances of incontinence and
impotence are about the same for either.
