Robotic prostatectomy for prostate cancer: Paul Jenkins’s story

Paul's symptoms and journey to diagnosis

Paul Jenkins is a 42-year-old delivery driver from Forest Town, a village on the outskirts of Mansfield in Nottinghamshire.

In early December 2020, Paul began experiencing abnormal urinary symptoms, which made going to the toilet uncomfortable. He didn't feel the urge to go to the toilet often, and when he did, he produced very little urine (this is known as urinary retention).

Paul initially put this down to holding in his bladder when working long hours on the road in his van. It was his wife, Rebekah, who encouraged him to book a GP appointment and discuss his symptoms with a professional. "I'm so grateful to my wife for encouraging me to visit the GP." he says, "I wouldn't have gone otherwise, but it was absolutely the best decision for me."

Paul's GP found small spots of blood in his urine, so they booked him in for an MRI (Magnetic Resonance Imagining) scan for further testing. An MRI scan can diagnose prostate cancer in some instances. It uses magnets to produce a detailed picture of your prostate and its surrounding tissues. In this instance, an MRI scan alone was not enough to diagnose Paul, as his PSA (prostate specific antigen) levels were on the cusp of the level needed to confirm a diagnosis.

What is PSA (prostate-specific antigen)?

PSA is a protein produced by cancerous and noncancerous cells in your prostate. It is normal to have a small amount of PSA in your blood, and the amount rises as you age. A raised PSA level may suggest you have a problem with your prostate, which can sometimes be prostate cancer.

"Initially, the Consultant was unclear whether I had prostate cancer judging by my PSA level, so a biopsy was needed to confirm it," explains Paul. "I wouldn't describe it as a pleasant experience, but it needed to be done."

Paul’s treatment with Mr Ben Sherwood

Paul's biopsy confirmed he had prostate cancer. He quickly met with Mr Ben Sherwood, Consultant Urological Surgeon at The Park Hospital in Nottingham, who told him about robotic prostatectomy surgery, a type of keyhole surgery to remove the prostate that is performed with the help of a robotic system. This would be the treatment plan they decided on.

Paul describes his early conversations regarding his diagnosis and treatment options with Ben as "like meeting with an old friend." He says:

"He is utterly brilliant. He always made a point to see me for appointments in person. He is kind but direct when it comes to advice and information about treatment. I have so much respect for him, and within five minutes of us meeting, I felt comfortable talking to him about topics as personal as my prostate, my sex life, and my general feelings about my cancer diagnosis."

After discussing other potential treatment options such as chemotherapy and radiotherapy, Paul and Ben decided it was best for him to have a robotic prostatectomy to remove his prostate and eliminate his prostate cancer.

What is a robotic prostatectomy?

A robotic prostatectomy, which might also be called a robotic radical prostatectomy, or a robotic-assisted laparoscopic radical prostatectomy, is a type of keyhole surgery performed with the help of a robotic system. Its main benefits are that it helps your Consultant be as precise and controlled as possible, significantly reducing the risk of side effects after surgery.

The procedure is still performed by your Consultant Urological Surgeon. The robotic element is simply a technical surgical platform that your Consultant uses to be as precise as possible. In an operation such as prostatectomy, precision is of the utmost importance. The more precise your Consultant can be, the better your chances of a full recovery and the lower the risk of side effects

Robotic prostatectomy at The Park Hospital in Nottingham

Our specialists use a robot called the da Vinci X surgical system to perform a robotic prostatectomy. This is a cutting-edge machine designed to make prostate surgery as successful as possible. The robot consists of a series of mechanical arms, which are linked to a console controlled by your Consultant.

The system translates their hand movements in real time, so that the robotic arms move in the same way. Your Consultant can watch everything that's happening via a high-definition, 3D real-time image. They can use the da Vinci robotic system to make smaller and more accurate movements than possible with their own hands.

What happened during Paul’s prostate surgery?

Due to some scarring around Paul's prostate caused by the biopsy he had to diagnose his cancer, the procedure took slightly longer than usual (four and a half hours, compared with the usual two). The scarring had healed, but Mr Sherwood had to cut around it, which took some time.

Paul felt that Ben showed great compassion, even while performing complex surgery. He made a point to call Paul's mother-in-law and his wife to assure them that, although the procedure was taking longer than usual, it was nothing to worry about, and that Paul was okay. "He was just amazing, keeping them in the loop like that. They really appreciated it," says Paul.

It wasn't just Mr Sherwood who helped make Paul's experience that little bit less daunting. Paul had a team of nurses that supported him throughout the five days he spent in hospital recovering after surgery. He says: "They were so kind and helpful. It felt odd discussing such intimate things about myself with the team at first, but they made me feel so comfortable and open."

For many people, a robotic prostatectomy is a day case procedure, meaning they can return home on the same day as surgery. However, due to a pre-existing health condition that puts him at higher risk of developing an infection, Paul had to stay in hospital for a few days after surgery to recover. He was monitored closely and cared for around the clock by a team of nurses. Paul was extremely impressed by the quality of care he received at The Park Hospital, as well as his room and the facilities, particularly the food menu.

"The room was comfortable and spacious. The food menu was brilliant! I had no idea there would be so many options, it was like being in a hotel with a three-course food menu at my fingertips. I'm upset I didn't have the stomach to order everything after surgery..."

Paul’s recovery: Back to normal life

Paul's recovery at home has been steady. His scarring is healing naturally over time, and he's been given some ointment to speed up this process. He had a follow-up appointment with Mr Sherwood six weeks after surgery to test his PSA levels, which were normal.

For a while they had a follow-up appointment every six weeks, and now it's every six months. These regular check-ups help reassure Paul that the surgery was a success and that his health remains stable.

Paul took eight weeks off work to rest and recover. This was mostly because his job requires heavy lifting. Every person's recovery journey looks different, but many people can be back at their desk job within four to six weeks of having prostate surgery. Paul is now back at work full-time, golfing regularly, and enjoying being with his family as much as possible. The one negative side effect of the surgery that has affected Paul is erectile dysfunction.

Erectile dysfunction after robotic prostatectomy

Erectile dysfunction is common following prostatectomy, because nerve tissue and blood vessels vital for getting an erection can be easily damaged during prostate surgery, no matter how precise your Consultant is.

Problems getting an erection are not always permanent. Regaining erectile function after prostate removal surgery often takes months. Within one year, around 40 to 50% of men will have returned to their pre-treatment function.

Treatment for erectile dysfunction

There are many treatment options available for erectile dysfunction, including injectable medications that can induce an erection, as well as mechanical devices that create an erection mechanically by forcing blood into your penis using a vacuum seal.

These options have not worked for Paul, but he has noticed a gradual change in his ability to experience an erection. "It has affected me mentally more than I anticipated, "he says. "You don't realise how much of a big deal it is being able to have it until you can't. But I have noticed slow improvements, which I was told would happen after some time. And of course, it's worth it for my health."

Checking your prostate at home

Prostate cancer is the most common type of cancer among men in the UK, and the second most common cancer in men worldwide. Prostate cancer will affect 1 in 9 men in their lifetime.

Symptoms of prostate cancer do not normally appear until your prostate is large enough to affect the urethra (the tube that carries urine from your bladder out of your penis). This can make it difficult to detect early. However, detecting prostate cancer early can mean the difference between life and death, which is why regular self-checks at home are important.

Paul urges every person to check their prostate as regularly as they can to maintain their prostate health. He says: "It doesn't need to be done obsessively, but knowing how to self-check and when to self-check is important."

Global charity Movember has amazing resources on its website that can help anyone who is worried about prostate cancer, or just wants to know how to check themselves. 

Facing life cancer-free

Robotic prostate surgery eliminated Paul's prostate cancer.

He is now an avid golfer at his local club, even using his hobby to raise money for charity, golfing as many courses as possible in one day in aid of prostate cancer research. Paul spends as much time as possible with his close-knit family, particularly his two kids, who he "finds pretty much anything to laugh about with these days."

"Golf is one way of blowing away the cobwebs. Another is spending quality time with my beautiful family. I'm a real family man, even more so now after everything. I keep getting little wins back in life, like being able to go away golfing for the weekend with my best mate, or sit with the guys at work and talk about our health in a meaningful way. It feels really good."

He is overjoyed to have his life back, and urges anyone suffering with prostate cancer to have a robotic prostatectomy.

If you would like to find out more about robotic prostatectomy, our kind and knowledgeable advisory team is here to answer any answer any questions you might have. You can also give them a call.