ASSOCIATE PROFESSOR HAREWOOD
SPECIALISING IN ROBOTIC
OR "DA VINCI PROSTATECTOMY"
Company with My Prostate - “The Robotic Way”.
by Bruce Ricketts
The purpose of this paper is to share my experience and thoughts
with others who suspect they may have a prostate problem or
have been diagnosed with prostate cancer, and considering
The important thing to remember is you are not alone. More
of us at a younger age are being diagnosed with prostate problems,
including prostate cancer, so I guess it is up to men to be
more aware of the situation, and act early.
If you are worried about what to do, I hope the following
is of help in alleviating concerns and in helping you make
This month I celebrated my 60th Birthday, minus my prostate
and I am pleased to say that unless they knew of my operation,
nobody was aware it had gone.
I am a retired IT professional, who keeps fit and loves the
outdoor, especially walking, fishing and golf. I have been
very lucky to date and enjoyed excellent health all my life.
I have a wonderful wife of 38 years, who is my sole mate.
We have two wonderful adult children, a daughter aged 33 and
son 36. We are a very close family, which has been an enormous
help for me, in discussing and dealing with this health “hiccup”.
Two other people have played vital roles - my Melbourne Urologist
(Mr. Laurence Harewood), who specializes in Cancer of the
Prostate, raised PSA and Robotic Radical Prostatectomy and
my GP on the Gold Coast (Dr Graham Exelby).
Whilst we are Melbourne based, we spend many months at the
Gold Coast each year, and my GP at Mermaid Beach has provided
what I describe as complete “health management”
services, rather than just “incident” consultations.
For that I thank him. More GP’s should operate that
way. Whilst I have been forthcoming in managing my health,
you do need a GP who is pro-active, and shows a personal interest.
Most importantly, I have complete confidence and trust in
both men, which made any decisions much easier.
Early Detection is important:
Since retiring, six years ago, I decided I had more time to
look after my health and that I should have regular medical
checkups, including (Prostate Specific Antigen) PSA tests.
I went back over my records and found a PSA reading of 0.9
in January 1994 and 2.0 in April 1998. My first retirement
reading in January 2002 was 3.8, which did get my attention.
Early Detection is important (Contd):
During the following years, it increased slowly (and there
were some decreases) peaking at 4.4 in 2003, remained the
same in 2004, and by October 2005 it was 5.3. It peaked at
5.5 in March 2006. My free PSA was low, at a 5%-7% reading.
I had no symptoms of anything being wrong.
After consulting with my urologist, in 2003 I underwent a
Trans Rectal Ultrasound & Biopsy. The biopsy results were
clear. As a result of the rising PSA, these were repeated
in December 2005, (1 biopsy out of 10 was suspect), and March
2006 – the latter results confirmed prostate cancer
with a Gleason score of 7, (3+4).
My urologist recommended a chest x-ray and bone scans. Thank
goodness, the results of which were both fine.
I have never felt any need to question any advice I have received
from either my GP or my urologist, so when my urologist, with
my wife (who was with me on all visits to him) and I sat down
to discuss the facts and the options, it was more a case of
absorbing his recommendations.
I left his rooms feeling informed, aware of all the risks
and options, but also fully confident and felt very fortunate
that I had met this specialist - urologist, Mr. Laurence Harewood.
Given the stage of the cancer, my age, level of fitness, and
general health to date, my urologist recommended radical prostatectomy.
All other options were discussed to make me aware of solutions,
but given my circumstances, in particular we discussed radical
prostatectomy - the open and robot assisted laparoscopic procedures.
He recommended the robotic radical prostatectomy - because
of its advantages over the open method.
I spent time with my urologist’s male nurse who took
me through the process of the operation, hospitalisation,
after surgery, and discharge. I was also given instructions
on going home with the urinary catheter, and “do’s
& donot’s” during recovery. All the information
was first class. At my request I also made contact with a
past patient who had recently undergone the robotic procedure.
I felt ready.
This was March 2006, and my wife and I had booked and planned
a 21 day tour of Canada/Alaska for May-June 2006 so we were
in two minds over timings etc – should we take the trip
or postpone? However, once again after discussing with my
urologist we decided to take our overseas trip and lock in
the robotic radical prostatectomy for 20th June 2006.
Coming to terms with the issue and decision:
This is not easy and everybody deals with it, in their own
way I suppose.
In my case, given my IT background, and my desire to understand
things in detail, I had done lots of reading up to this stage
to gain an understanding of prostate cancer, at least to satisfy
my mind. Now, having found out that I really do have prostate
cancer, my reading and research had new meaning and focus.
Men’s health magazines, research papers, the internet
web-sites, and reference books all played helpful roles in
satisfying my questions. I know I drove my wife mad with research,
and she often suggested I was in “data overload”,
but I needed to do it to get clarity of what I was about to
However, you do need to be careful, as whilst the internet
search engines are wonderful in providing feedback, some of
the data is questionable and a bit scary. Once again, my urologist
gave me a list of quality web-sites to reference, which were
Having satisfied myself that I understand what I had, and
what the surgery would do, one still has those questions of
success or otherwise, incontinence and impotence, and how
will it affect me?
I must admit, that whilst I thought of all the consequences,
I have always had a positive attitude, so I did not dwell
on any negatives. It was a matter that my wife and I had discussed
and we agreed that getting rid of the cancer was the number
one objective, then, if we need, we would deal with any side
The date of the operation soon arrived:
Our trip to Canada/Alaska was tremendous and I did not let
my impending surgery affect our trip. I had made my decision
and I had no need to change it. In fact, as we made more new
friends on our trip we heard of more men affected by prostate
problems, so it actually made more sense to “get on
My robotic radical prostatectomy was carried out in Melbourne’s
new Epworth Eastern Hospital in Box Hill.
I have only praise for the hospital and its staff, they were
The operation took something like 5 hours, and went extremely
well, thanks to my urologist again, and his support team of
professionals. After being wheeled to the surgical ward at
lunchtime and I have never been so happy to see a digital
clock that read “17.57.00”. I knew I had come
through the operation…step one achieved.
The immediate visible outcome of the robotic
radical prostatectomy from my perspective were six small incisions
in my abdomen, and that dreadful catheter. I felt well, and
spent several hours in the intensive care unit overnight,
as part of normal procedures.
When my urologist visited, he was happy with how the surgery
had gone, and a day and a half later I was on my way home,
(after the obligatory bowel movement in hospital). Not long
afterwards I received a call from my urologist with the pathology
results – which were “best possible outcome”.
The results were that the tumour was organ confined with no
extra capsular extension and the margins were negative.
Laurence Harewood did a marvelous job and I am forever grateful.
Recovery at home:
It’s not fun having a catheter inserted, but its only
for a few days so stop complaining…that was my approach.
Bowel movements were also difficult at first. Recovery went
extremely well, the catheter came out on day nine and the
plumbing then started to reposition itself. Considering just
days earlier I had undergone major surgery, the body was healing
I listened to what my urologist and urology nurse had said
about recovery - what to do and what not to do, and decided
I would conform. I walked whenever I could, drank litres of
water and got things moving whenever possible. I did not drive
the car for 3 weeks.
Two months after the operation:
The first month is the “tender” stage, and I was
very conscious of not doing too much, not straining or lifting
Two months later I am pleased to say I feel great, both physically
and mentally. It’s good to have the operation behind
My small scars have healed, I am walking 6 klms each day with
my wife, and am back playing 18 holes of golf weekly.
From an incontinence perspective I am affected by stress incontinence
– coughing, sneezing, twisting, walking distances etc,
and it is improving daily. “Tena for men” works
wonders and nobody knows. I have twice sought the services
of a expect continence physiotherapist and have been fairly
regimented in doing my pelvic floor exercises. Based on daily
improvements, I am hopeful all gets back to normal in the
My erections have not returned yet, and they are eagerly awaited.
A bottle of Penfolds Grange is ready.
I have just had my PSA rechecked, and the result was fantastic
(undetectable - less than 0.1). I have a re-check in four
So looking back on this experience, would I make the same
decisions, and the answer is -
I have no hesitation in recommending robotic radical prostatectomy
if you are faced with a similar challenge as I was. It gives
you the peace of mind that at least you have removed the cancer,
and with the aid of the new robotic techniques, with little
stress on the body and the benefit of a rapid recovery.
An excellent reference site for robotic radical prostatectomy
For the readers of this article, what are the
• Manage your health, have regular checkups, and don’t
ignore your PSA and DRE tests,
• Persist with tests if things don’t look right
( I was told by one medical GP not to worry about my PSA until
it was over 10, then we would know I have a problem),
• Find a GP and Urologist you are confident in and trust,
• If you are so inclined, read until it hurts, but don’t
believe every web site article,
• In consultation with your Urologist, make your decision
and stick with it,
• Don’t waste time, the sooner you act, the sooner
you part company with your diseased prostate, and hopefully
gain peace of mind.
Good luck with your health.
30th August 2006