For many cancer survivors, the path to healing is like a marathon: a grueling but enlightening journey requiring endless patience, stamina and support.
But for one local survivor, the result of his diagnosis and treatment was a marathon. Literally.
“I’ve always been a bicyclist, but never a runner — until after my cancer surgery, when I couldn’t ride a bike, of course,” said JB Balmut, 55, who was diagnosed with prostate cancer in April 2009. “So
I started walking during my recovery. I just started going longer and longer distances, mostly around my block.”
His surgery — a radical prostatectomy with the help of the da Vinci Robotic Surgical System — took place in May 2009.
“I just completed my fi rst marathon,” the native Nevadan said of the Rockin’ River Marathon, 26.2 miles along Reno’s Truckee River, conquered just one year after his surgery.
“I took third in my age group,” he laughed. “Of course, I never asked how many were in my age group; could have been three, for all I know!”
Balmut wears his marathon fi nish like a medal symbolizing his victory over cancer. His diagnosis may have a familiar ring to many local men: He and his doctor had been watching his PSA levels for a few years. They started out “well within the normal range,” he said. But every year, they’d rise a little more.
“Then in 2009, the PSA was a little above fi ve, which is when they start talking to you about cancer,” he said. “So I had a biopsy, then I came in for my little talk with Dr. McCormack.”
Urologist Matthew McCormack, MD, counseled him on his options.
“I had no idea there were so many options for treatment,” Balmut recalled. “I defi nitely was leaning toward the ‘watchful waiting’ approach, but the prospect of an annual biopsy scared the bejesus out of me.”
After talking through the process of a radical prostatectomy using da Vinci Surgery, Balmut said he found his answer.
“It all made perfect sense to me,” he said. “The technology is safe, and the doctor still does the real fi nesse work. Once I made the decision, we scheduled the operation. And it went off without a hitch.”
Dr. McCormack, one of only three surgeons in the region performing radical prostatectomies with da Vinci technology, describes the procedure as an “extension of the laparoscopic prostatectomy.” “Da Vinci is a state-of-the-art tool that allows us to remove the prostate in a less invasive manner while adhering to the principles of cancer surgery,” he said.
A minimally invasive procedure has great advantages to an open procedure. Some of the direct benefits of da Vinci procedures may include:
• Reduced trauma to the body, resulting in faster recovery times that enable patients to return to their daily activities sooner;
• Smaller incisions, with less scarring and faster recovery times;
• Less post-surgery pain and discomfort;
• Reduced duration of hospital stay;
• Significantly reduced blood loss and reduced need for blood transfusions.
And in terms of a radical prostatectomy, the advantages are even greater. “This technology offers a unique ability to see the different anatomical structures and spaces in magnified form, enabling maneuvers a surgeon is unable to perform in traditional open surgery,” Dr. McCormack said.
He added that Renown is the only hospital in the region to utilize highly skilled and designated teams trained specifically for each da Vinci procedure.
“Motions are smooth and precise,” he said. “The robotic ‘wrist,’ for example, has greater degrees of motion than a human wrist, allowing for improved mobility and maneuverability.”
Specific to a radical prostatectomy, the potential for side effects inspires concern for many men. Erectile dysfunction and incontinence are among the most feared, as the surgeon is working in a space that houses surrounding structures critical to these functions.
“However, by utilizing the da Vinci technology, we’re able to be more precise, and in my opinion this reduces the chance of affecting surrounding structures, which can result in fewer side effects,” Dr. McCormack continued.
Perhaps the only resulting side effect for Balmut, the patient admits, was self-imposed. “Apparently I didn’t listen as well as I should, because I missed a critical order,” he said, remembering the day he was laying outside and relaxing as ordered, listening to the birds chirping — and decided to rebuild a brick wall.
“Clearly, I needed the stress management I got from working out, but I couldn’t do the physical exertion, and I definitely couldn’t do the gym,” he said, describing his typical visits to Gold’s Gym spanning a couple of hours. “So I started walking.” The walks opened new doors to him. He met neighbors he didn’t know before. He cleared his head and managed his stress. He even walked with Doc Holiday.
“That’s my toy poodle,” he said. “Even at 10 pounds, he was tugging at me to go faster. We had to practice, because he loves to be the leader. But he learned quickly.”
Walking led to running. Running led to cycling again. And just a week before the interview for this story, he completed his first Century race in Petaluma, Calif.
“James is a very athletic individual,” Dr. McCormack said. “I knew it was important for him to get back in the saddle as soon as possible.” And he says that was largely accomplished because of da Vinci Surgery. “He was able to resume his activities ahead of the curve,” Dr. McCormack said.
Dr. McCormack says that as technology progresses, more and more patients come to him savvy to the surgical options, including da Vinci Surgery. But he said that one prevalent misconception often rears its head.
“Patients sometimes unnecessarily fear that the robot is performing the surgery,” he said. “But that couldn’t be further from the truth. The surgeon is at the controls the entire time. The technology enhances magnification, creates a greater smoothness of motion and provides exceptional perspective, which is three-dimensional. It allows us to have 3-D view into a space that we typically can’t access visually.”
Balmut agrees that the technology inspired a smoother healing process.
“My experience was really phenomenal,” he said. “da Vinci Surgery was the way to go for me. I mean, there were five teeny holes, the largest of which is where they pulled the prostate out. But when I compare my story to the story of some of my buddies who had a regular surgery, I know I had it easy.”
For Balmut, a quick recovery is allowing him to accomplish his goals and return to his routine. “I think it was Lincoln who said, ‘People are only as happy as they make up their minds to be,’” he said. “That’s my philosophy, and I’ve made up my mind to be very, very happy.”
With health on the immediate horizon, Balmut already is planning his next challenge. “I’m going to complete my first mini-triathlon this summer,” he said. “I’m taking it easy right now with easy rides, and I’m practicing swimming a lot so I don’t drown.”
“But with cancer in my past, I’m now focusing on the future,” he continued. “I’ve always said I’d rather wear out that rust out — and that’s my plan.”
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