Health Chats
Prostate Cancer Surgery
Friday May 15, 2009, 03:00PM - 04:00PM (EST)
242579?1252111171
Professor of Urology
Weill Cornell Institute of Prostate Cancer
Urology, NY, NY
Prostate cancer is the leading cancer in men with an incidence rate of .16%. It is rare in men under the age of 45 but becomes more common with advanced age. Surgery is often used to treat prostate cancer along with radiation therapy, chemotherapy, cryosurgery, hormonal therapy, or a combination of different treatments. Which option is best depends on the stage of the disease, the Gleason score, and the PSA level, as well as the man's age, his general health, and his feelings towards the treatments and side effects. Learn more about prostate cancer surgery - what happens during surgery, who is best suited for surgery, and possible side effects - in this hour long chat with prostate cancer surgeon Dr. Ash Tewari.<br><br> Ash Tewari, M.D., M.Ch. is the Director of Robotic Prostatectomy and Prostate Cancer-Urologic Oncology Outcomes at Brady Urology Institute at the Department of Urology and an Associate Professor of Urology; he is also an Associate Professor of Public Health and Outcomes in the Department of Public Health and Outcomes at The Weill Medical College of Cornell University. He is an Associate Attending at The New York Presbyterian Hospital and he directs a fellowship program in Robotic Prostatectomy and Prostate Cancer- Urologic Oncology outcomes in Cornell.<br><br> Dr. Tewari is an internationally acclaimed expert on Robotic Prostatectomy and other minimally invasive robotic surgeries. His clinical interest involves urologic oncology and care of patients with prostate, bladder and other urological cancers. He performs open, laparoscopic and robotic surgeries. He is also involved in diagnosing prostate cancer by using PSA and modern ultra sound guided biopsy techniques. Using a dataset of 7000 patients with abnormal PSA, he has developed simple predictive models to calculate the risk of prostate cancer.
Ash Tewari, MD:
for urinary continence around 90% of my patients return to continence by the first month after surgery. Sexual potency takes a little longer however 22 days to erections is NOT unheard of. In fact some of my patients reported erection and full intercourse as early as the first week after surgery
aneilljr:
Dr. Tewari, I am in a wheelchair (CP). Any kind of invasive procedure has resulted in difficult recoveries. That is why I am hesitating to do the biopsy.  Several courses of Cipro stabilized PSA readings. Dr. said we could wait another 6 months and recheck PSA but he preferred immediate biopsy. That is where I am at but all this has done is create more worry.  I'm hearing you suggest I get it done ASAP. Is that right?
Ash Tewari, MD:
Yes. Cipro treats urinary infections. A rise in the PSA could be secondary to an inflamation or infective process, however a biopsy is recommended to rule out
Ash Tewari, MD:
how old are you?
tlee6565:
Hi...recently got a prostate biopsy because my PSA was 4.2. I'm 54 years old. I literally just got the results in the last hour...my doctor is traveling so he had to call me. The results were 4 positive cores out of 12...2 @ 5% and 1 @15%. My doctor assured me that it's completely curable. I'm to meet with him in the next two weeks to talk about treatment. He said less than 1% chance that it has spread to lymph nodes and 0% that it has spread to bone. I'm doing ok..but would just appreciate any further info/advice you might have...
Ash Tewari, MD:
This is an early stage prostate cancer. Can be cured by surgery or other modalities like radiation.
aneilljr:
I am 63. Sorry.
Ash Tewari, MD:
For your age a biopsy is recommended. As I stated earlier cancer needs to be ruled out
rich77:

What is YOUR regimen for return to "normal" potency?  It's been 4 months since RPP, and I use 100mg sildenafil every other day with 800 mg of cimetadine, and have yet to have a spontaneous erection [one without tactile or visual stimulation.] Those I CAN produce are at best 75% hard of of dubious capcity for penetration. I had normal abilities before.  I must add that a casual attempt, out of curiosity, with Viagra did NOT A THING a few years before the surgery.    
Ash Tewari, MD:
Regimen as therapy?
MedHelp:
This will be the last question for today as we're out of time.
MedHelp:
Thank you all for coming today and a big thanks to Dr. Tewari for answering our members' questions. If you have more questions for Dr. Tewari, you can submit a question in his forum: http://www.medhelp.org/forums/Prostate-Cancer/show/127. And don't forget to sign up for our upcoming LASIK chat: http://www.medhelp.org/health_chats/list_upcoming.
Ash Tewari, MD:
We initially start with low dose viagra (i.e 50mg viagra everyday) and increase it to 100mg every alternate day after 6weeks
Ash Tewari, MD:
thank you all