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Sunday, 26 October 2008
Intuitive Surgical (ISRG) "A Personal Experience with Prostate Cancer"

Hello Friends!  Thanks so much for stopping by and visiting my blog, Stock Picks Bob's Advice!  As always, please remember that I am an amateur investor, so please remember to consult with your professional investment advisers prior to making any investment decisions based on information on this website.

I haven't been blogging for a few days.  I haven't even been paying attention to my portfolio.  In fact, I have even missed sale points for some of my own stocks (especially Covance (CVD)) which passed a sale point on the downside.  I can attend to that next week.

But what I want to share with you this afternoon is not about investing in any particular fashion, but rather my own personal journey with cancer, in particular Prostate Cancer that has entered my life and is an issue that I am now confronting and dealing with.  As with my financial advice, my thoughts on prostate cancer should be considered my own reflections and not medical advice for you.  Please consult with your medical professionals for that advice and information.

Back on April 30, 2004, more than four years ago, I wrote up an entry about Intuitive Surgical (ISRG), a stock pick which turned out to be a great pick for this blog.  I do not own any shares of ISRG at this time, nor do I own any options.

But last week, I became a customer of Intuitive Surgical (ISRG), undergoing a robotic prostatectomy at St. Mary's Hospital affiliated with Mayo Clinic in Rochester, Minnesota.

I will not offer an opinion on the investment opportunity that Intuitive presents.  In the rocky environment of this stock market, any investment is suspect, and in our difficult economic times of more people possibly losing jobs, and losing their healthcare insurance, there will be increasing pressures on hospitals that may be looking to forego expensive equipmnent purchases regardless of the value of these purchases to patient care

I am lucky that I have access to as amazing an institution as Mayo.

This year I became part of an frightening statistic.  In the United States, 186,320 cases are estimated to be diagnosed in 2008, and 28,660 men will die of this disease.

Two years ago, at the age of 52, I had a PSA test (generally recommended to be a routine part of the examination after the age of 50), which was slightly elevated at over 3.0.   Repeat testing this year came in at 5.3 and it wasn't as much as the absolute level (which was important), but what is referred to as the PSA velocity which raised some alarms in my own physician.  My digital examination was normal, I was essentially asymptomatic, but the laboratory screening test raised concerns that needed to be addressed.

An appointment was made with my Urologist, and the decison was made, as it is made each day in so many doctor's offices, to obtain an ultrasound exam with biopsy to obtain some actual prostate tissue to determine whether I had prostate cancer or not. 

Needless to say THAT wasn't much fun.  But it wasn't that bad either.  A total of 12 biopsies were taken that afternoon back three months ago.  A few days later, my Urologist met with me to let me know that two of the twelve had come back positive.  In other words, I had cancer of the prostate.  

It appeared that it had been discovered relatively early, with only 10% of the two positive biopsies showing cancerous changes.  Technically, I was told it was a Gleason 3+3=6, as the pathologist reported. 

Faced with a diagnosis of Prostate Cancer, a patient has three basic options.  For older patients, watchful waiting may be suggested.   Since prostate cancer is a relatively slow-growing cancer (as I undertand it), patients in their 70's or 80's may choose to simply do nothing or even skip routine testing.

Treatment is essentially divided into two basic approaches:  radiation treatment and surgery.  Each of these is also broken down into different strategies:  radiation treatment through either external beam or by implantation of radioactive particles;  likewise surgery can be broken down into open radical prostatectomy and the newer robotic surgery on the Intuitive Surgical (ISRG) machine.

The best I could tell there is no definitive 'winner' between the two treatment modalities.  The figure I was given was an '85% chance of being cancer-free' at ten years with either approach.  Complications were somewhat different.

I chose surgery.  There wasn't really a right or wrong decision.  However, at my younger age for prostate cancer (54), my life expectancy was greater than a 70 year old patient, and I intended to be around to at least see some of my current stock investments recover :).  My own tumor was confined to the prostate gland and the margins were clear.  The grade was upped to 4+3=7 so it was a bit more serious than the biopsy suggested.  All lymph nodes checked were negative.  So things were as good as could possibly be expected.

Fortunately I had access to the robotic surgery with the Intuitive Surgical unit at Mayo.  I do not know if the results overall will provide me with longer longevity and success but the morbidity of the operation with the laparascopic robotic procedure is less with reduced bleeding and quicker recovery reported. 

My own surgery was on Wednesday, just four days ago.  I am sitting on my couch in my own home blogging this entry that I felt important to write.  My catheter should come out this Wednesday.  I am staying off work for the month but hope to gradually continue to up my activity.  The pain was worse than I expected with all of the hype about robotic surgery but I expect that my ill effects would have been greater if I had chosen the open radical approach.

Wish me well.  I shall try to keep you all posted of my continued progress.  

For once I have been focusing on something other than the Dow or the Nasdaq. If you are over 50 or know any men 50 or older, please make sure they get their PSA tested.  It might just save their lives.  I hope it saved mine.

I shall get back to talking about stocks soon.  I have missed some sale points, my performance is dropping back to the mean, but it just doesn't seem to matter that much anyhow. 

If you have any comments or questions, please feel free to leave them on the blog or email me at bobsadviceforstocks@lycos.com.  

Yours in investing,

 

Bob 


Posted by bobsadviceforstocks at 5:41 PM CDT | Post Comment | View Comments (1) | Permalink
Updated: Sunday, 26 October 2008 9:57 PM CDT

Wednesday, 3 December 2008 - 11:24 PM CST

Name: "Mark"

Hi Bob  -- Just noticed this post from October about your recent medical story, and wanted to wish you well.

I'll check your more recent posts to see if you've given any further follow-up.

Hope all will be well!!!!!! 

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