Cape Realtor Wins Battle with Prostate Cancer

A simple blood test raised a red flag about Bob Herbst's health, but a visit to the urologist confirmed it: prostate cancer.

Herbst's friend and urologist J. Russell Felker, MD, told him that robotic-assisted surgery was the best option. On April 4, 2008, Dr. Felker and fellow urologist Gregg Hallman, MD, per­formed surgery at Southeast Missouri Hospital using the da Vinci® Surgical System. "They took out the prostate gland itself and two lymph nodes," Herbst says.

Herbst, a Cape Girardeau Realtor and former city councilman, was intrigued by the high-tech equipment. "When I got in that door and saw that machine, I was excited," he says.

With the da Vinci robotic system, the surgeon sits at a console several feet away from the patient and manipulates three robotic arms equipped with surgical instruments and an endoscope.

Flexible hand controls mimic a surgeon's move­ments but are so precise that the instruments can move in a very small, deep cavity such as the pel­vic region. Instruments can rapidly be changed to grasp, cut or suture. As a result, cancer can be removed in even the most confined spaces.

Southeast installed the da Vinci system in 2005 and was the first community hospital in Missouri to invest in the technology. Since then, more than 300 robotic-assisted prostatectomies have been performed.

Herbst says he felt good after his surgery, but admits he had some soreness. "The nurse couldn't believe I didn't need pain medicine," he says. "It was just a little tough bending over to tie my shoes."

After returning home, he took it easy. "For the first time in my life, I did what the doctor said," Herbst notes.

And recuperating wasn't hard. "I didn't look bad, and I didn't feel bad," he says. Five days after surgery, he drove himself to the doctor's office for a follow-up visit.

The robotic-assisted surgery is more patient-friendly than traditional prostate surgery, Dr. Felker explains. Patient benefits include a faster recovery, shorter hospital stay, less bleeding and lower risk of urinary incontinence.

"Initially I was skeptical, but it became obvious to me that it was the preferred technique," Dr. Felker says. "I was astounded at how well patients did." The technology allows the surgeon to see individual nerves while performing the surgery. "It is much more precise," he points out.

The surgery also leaves the patient in better shape physically to handle radiation treatments should they be needed, he says.

Dr. Felker's colleagues, William C. Collyer, MD, and Gregg S. Hallman, MD, of Cape Girardeau Urology Associates and the Southeast Missouri Hospital medical staff, specialize in robotic-assisted prostate surgery.

Performing robotic-assisted surgery requires physicians to rely on their sight while traditional surgery involves touch. "When you were doing traditional surgery, you really didn't see, you felt," explains Dr. Felker.

But even with its advantages, surgery alone can't always eliminate the cancer. "It's not magic," Dr. Felker says. Radiation treatments may be necessary after surgery, and that was the case with Herbst.

A post-surgery PSA (prostate-specific antigen) blood test a few weeks after surgery showed Herbst had a slightly elevated PSA level. On Dr. Felker's recommendation, Herbst made an appointment with Joseph P. Miller, MD, medical director of Radiation Oncology at Southeast Missouri Hospital.

Herbst's PSA was monitored over a period of months. In fall 2008, the PSA level increased, a sign that some cancer cells remained. So on Jan. 15, 2009, he began receiving a series of 40 radiation treatments, given five days a week for eight weeks. The last treatment was on March 11, 2009. Herbst says the radiation treatments worked, killing the remaining cancer cells.

"Intensity-modulated radiation therapy provides treatments that target the radiation to specific areas of the body where the cancer is located, minimizing the side effects of treatments," Dr. Miller explains.

Today, Herbst feels fine and is enjoying life. "I am a very fortunate person," he says. "I couldn't have been more comfortable putting this whole issue in the hands of Dr. Felker and Dr. Miller at Southeast Missouri Hospital."