Overcoming Aggressive Cancer with Prostate Surgery

One in eight men will be diagnosed with prostate cancer in their lifetime. It’s a concerning statistic, especially for a type of cancer that typically shows no symptoms. That’s why prostate cancer screenings are so important.

It was a blood screening test that led to Ray’s prostate cancer diagnosis in 2024. The cancer had been growing, even though he experienced no symptoms.

Ray’s Concerning PSA Levels

A PSA test assesses the level of a protein made by the prostate gland called PSA (prostate-specific antigen). Elevated levels can indicate prostate cancer or other prostate conditions.

As part of his annual doctor’s visit and screenings, Ray had his PSA level checked in April 2024. The result was abnormal, above the normal range of 4.0ng/mL. That was when he was introduced to Sarah Simmons, MD, with ProMedica Physicians Genito-Urinary Surgeons. After performing a digital rectal exam and re-checking his PSA, an MRI of the prostate was ordered followed by a biopsy.

Ray’s biopsy came back positive for prostate cancer, and some findings on his biopsy were concerning for rather aggressive disease.

Dr. Simmons talked with Ray about his treatment options. Based on his biopsy, he had options to treat with surgery or radiation, but he and Dr. Simmons agreed surgery was the best treatment for him.

Treatment Options for Prostate Cancer

Not all prostate cancer requires surgery. For slow-growing cancers, doctors may recommend “active surveillance” – routinely checking PSA and performing digital rectal exams to ensure a tumor isn’t becoming more aggressive.

“Treatment is very individualized to the patient and to their exact findings on biopsy and imaging,” says Dr. Simmons. “When cancers are localized but more aggressive, and we think that it would impact a person’s quality or length of life, we have the option of radiation therapy or surgery.”

Radiation therapy uses high doses of targeted radiation to kill cancer cells. Surgery physically removes the prostate containing the tumor. This surgery is called a radical prostatectomy.

Ray had his prostate removed on January 3, 2025, by Dr. Simmons, who performed robotic-assisted surgery.

“I woke up from anesthesia feeling great. I felt like I could have walked to my car and drove myself home,” he said. “I had to wear a catheter for 11 days, but it wasn’t life-altering. I could go for a walk or drive somewhere.”

By the end of February, he passed the seven-week recovery mark and was able to join in an annual golf trip in South Carolina.

Robotic Surgery for Prostate Cancer Surgery

To remove Ray’s prostate, Dr. Simmons performed a single-port robotic-assisted surgery. This minimally invasive surgery is called “single-port” because there is only one incision through which all robotic instruments are inserted.

Single-port robotic surgery allows surgeons to perform precise surgery on otherwise hard-to-reach areas.

Dr. Simmons explains, “For many urologic procedures, single-port robotic surgery allows us to do the entire surgery without entering the peritoneum. The peritoneum is the abdominal cavity where the intestines and other vital organs reside. Avoiding that compartment decreases the risk of injury and scarring, and is easier for the patient to tolerate.”

Because the prostate is very deep in the pelvis, it’s hard to reach. The single-port robot allows access to the prostate through the space in front of the bladder, which makes both the anesthesia and the surgery itself easier on the patient. During surgery, Dr. Simmons controls the robot the entire time from a console close to the operating bed. She has an extremely detailed 3D view of the area.

Multi-port robotic surgery is still appropriate for some patients, for example, if they’ve had a history of surgery to their urinary tract or if they have an extremely large prostate.

Life After a Prostate Removal Surgery

After Ray’s surgery, the pathology report showed that the surgery had successfully removed all the cancer. Weeks later, a PSA test confirmed he was cancer-free. His PSA level was undetectable. 

“There are two main side effects that can occur when you’ve had your prostate removed: urinary incontinence and erectile dysfunction,” explains Dr. Simmons. “For many people, the incontinence will improve and often completely resolves. There are treatments available for both urinary incontinence and erectile dysfunction if the problem persists.”

Oral medication and injections can help men who have had a prostatectomy have erections. If needed, surgery can even be performed to implant a prosthesis. Pelvic floor physical therapy can help regain coordination and control of the pelvic floor muscles after surgery, which improves continence.

In Dr. Simmons’ field, the hope is to one day be able to treat prostate cancer without having to treat the whole prostate gland. In other words, use surgery on a portion of the gland rather than remove the whole prostate.

“There’s been a lot of research, but we haven’t found any reliable solutions yet. The single-port robotic is the biggest advancement in terms of surgical technology and prostate cancer treatment,” says Dr. Simmons.

Ray’s Message to Other Men

At age 40, men should start talking with their doctor about their prostate cancer risk. For males with average risk, the American Cancer Society recommends beginning screening at age 50, while the American Urological Society recommends beginning at age 55. Those with a higher risk or family history may be offered screening sooner.

Ray says he has his own PSA (public service announcement) about PSA (prostate-specific antigen) screenings.

“What I’d like to say to men over 50 is if you aren’t getting your blood work done every year or if you don’t know if your doctor is checking your PSA, you need to know, because you need to be doing it,” he says. “I didn’t have any symptoms, so I would not have known that I had prostate cancer if PSA levels weren’t one of the markers my doctor was checking.”

Having prostate cancer and undergoing treatment can be a difficult topic to talk about. However, Ray had made the personal decision to share his story to raise awareness. He tells others not only to get screened but to be active in tracking their levels over time.

“If you don’t have the MyChart app on your phone, get it. You can see your lab results and urinalysis results and trends,” Ray shares. “I study that stuff. I can see the trends over the years, even with my own PSA.”

Lastly, Ray would like to thank Dr. Simmons.

“I can’t give her enough credit. She was awesome, and I’m so impressed,” he remarks. “When I saw the robot machine and knew she would be at the controls making it do all these tiny movements – it blows my mind that we have that capability.”