Hank Mielke - In the Nick of Time: a Lifesaving Robotic Prostate

When bank executive Hank Mielke turned 60, that milestone birthday motivated him to take his fitness routine to the next level and spend more time at the gym. Hank was already exceptionally active and spent his spare time golfing, hunting, surfing, fishing – and his favorite activity of all, paddle boarding in Richardson Bay with the family yorkie on board! Hank was in such good shape that he almost skipped his yearly physical. Fortunately, good sense prevailed, because that annual checkup saved Hank’s life.

Although Hank’s PSA numbers were low, Dr. J. David Andrew, his primary care physician, found a suspicious lump while examining Hank’s prostate. He referred Hank to Dr. Harry Neuwirth, a MarinHealth urologist who ordered a biopsy. The news was not good. Hank had a prostate tumor so rare, it’s only seen once every three or four years. The tumor type is exceptionally aggressive and doubles in size every 90 days.

Hank underwent a battery of tests to determine whether the cancer had metastasized. After this type of tumor breaks free of its surgical margins, it’s considered inoperable. (The margins refer to the amount of normal tissue between the tumor and the area to be removed). To Hank’s great relief, the cancer had not yet spread. Once they knew what they were dealing with, Dr. Neuwirth introduced Hank to urologist and robotic surgery specialist Dr. R. James Yu of MarinHealth Urology | A UCSF Health Clinic. Hank gratefully refers to Dr. Yu as, “the Edward Scissorhands of the da Vinci Robot.” Dr. Yu explained that the robot is the ideal tool for delicate, precise surgeries like prostatectomies. The technology allows the surgeon to operate through five tiny incisions, resulting in less scarring and bleeding, reduced pain, and a swifter recovery.

Five weeks after receiving his biopsy results, Hank had his surgery at MarinHealth Medical Center (formerly Marin General Hospital). He knew exactly what to expect, as Dr. Yu had explained the procedure in detail. Dr. Yu removed the cancerous prostate and surrounding lymph nodes. He was able to leave a crucial layer of nerves intact: With an expert robotic surgeon like Dr. Yu at the controls, the robotic surgery system allows for enough precision to preserve continence and sexual function. The surgery took place just in time, as the tumor’s margins were less than a millimeter. Hank was amazed that he could return to work just two weeks later. His physical therapist helped him develop a gentler exercise routine that got Hank back in the gym just a month after surgery.

Next, Hank’s treatment plan called for hormone therapy, to reduce testosterone production, followed by full external radiation with MarinHealth radiation oncologist Dr. Lloyd Miyawaki. The radiation treatment was especially delicate because even the most minor error could result in damage to Hank’s bowels or bladder. Dr. Neuwirth implanted a marker in the surgical area before the radiotherapy treatment, to help Dr. Miyawaki target the tumor as accurately as possible. 

After he finished radiation, Hank was in remission. He was able to go on a summer vacation. He has since resumed his high intensity workouts and still plays all of in his favorite outdoor sports. For now, Hank has to come in every three months for a blood test. If he remains cancer-free, the frequency of blood tests will be gradually reduced. He is deeply grateful to the collaborative team at MarinHealth Medical Center for saving his life. “Everyone,” Hank declares, “worked so well together. It was fantastic. The doctors, the nurses, the navigator, the technicians. It was first class treatment all the way.

This story was first published in Summer, 2015.