How much does prostate surgery cost in the US?

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KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/15/2010 10:12 AM (GMT -6)   
I am a 52 year-old American working in Japan, recently married, just diagnosed with prostate cancer. My PSA is 6, Gleason score is 6, pattern 3+3.

Two urologist surgeons in Japan told me that at my age, I should go back to the US if I want nerve-sparing surgery done. In Japan, it is still new. I am considering returning to the United States to have a da Vinci robotic, or laparascopic, prostatectomy done. I am wondering if I can afford it.

Question: Can anyone give me a general idea of how much either one of these surgeries might cost “out the door”, including all the hospital, doctor, and anesthesiologist’s fees? I need to get an idea if this is even remotely possible for me. I may get little, or no, reimbursement from my overseas medical insurance.

KJN

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1785
   Posted 1/15/2010 10:28 AM (GMT -6)   
KJN, sorry about your diagnosis and the fact that you're looking to fly back to the U.S. for surgery. My husband had robotic prostatectomy in March 2008 and we were indeed luck to have very good insurance. Our insurance company sent us statements on a regular basis about what bills had been submitted. The hospital portion was almost $26,000 - that included $17,000 for the use of the OR. My husband went into the hospital at noon on Tuesday and was discharged at noon on Thursday - 2 days. We never saw any charges for the surgeon or the anesthesiologist but I would imagine these two doctors added a good $15,000 or $20,000 to the bill. Considering the pre-op tests (my husband had to have a quick physical before surgery), the CT scans and other assorted tests, I would guesstimate that the final cost was around $50,000 (give or take). The only cost out of pocket for us was a co-pay for the hospital ($250), the co-payment for the physical ($20), and a co-pay for the initial consultation with the surgeon ($30) - that's $300 out of pocket.

As far as nerve-sparing surgery, that's usually not a decision that is made by the patient. The surgeon does not know until he or she "gets in there" whether or not the external nerve bundles can be spared. If the cancer has escaped the prostate capsule and is affecting the nerves, the surgeon will take one or both. The nerves that run through the prostate will be removed so there is still a risk of ED - if this is your concern.

Come back and let us know how you're doing.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24044
   Posted 1/15/2010 10:32 AM (GMT -6)   
Hello KJN

I had open surgery and spent 4 full days in the hospital, I think the "total" total including everyone and everything was close to 70,000 USD, for everything that was associated with the surgery and aftermath.

That figure does not include the Salvage Radiation I just completed.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 1798
   Posted 1/15/2010 10:58 AM (GMT -6)   
My insurance picked up most the cost. I think that the top robotic surgeon in Atlanta does not take insurance and was charging 8,500.00 per operation last year. I was only in the hospital one night but like the others say, you have numerous tests as well. Good luck and hope you find what you need.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


JStars
Regular Member


Date Joined Oct 2005
Total Posts : 451
   Posted 1/15/2010 11:08 AM (GMT -6)   
I just looked up the surgery costs in my On-Line Health Record -- very convenient. Not sure if everything is covered there but here are the charges for a routine open Surgery at a local regional hospital (not in Boston) -- in early 2009 (in USDollars).

Anesthesia: 1386 + 924
SemiPrivateRoom: 350+2250
Surgery (2 docs): 139+2659+315
Labs: 250+290
Total: 8563.

I will check the actual paper copies that I have at home and update if necessary.

But bottom line, a lot of people seem to be getting ripped off by super high charges!!
Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 11/2009).
04/01/09, 07/07/09, 10/01/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray no stones.
08/09 - started MUSE@1000mcg ... pump&plump - success(80-90%) (alpro ache).
09/09 @500mcg +pump&plump + 2 advil - success(80-90%) - (less Alpro ache).
10/09 TrimixGel (500/300/100mcg): 1st:60%, 2nd:(pump&plump) 60%, 3rd(added 500mcg muse):70-80% -- (no Alpro aches!) but none @ useful hardness!


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1785
   Posted 1/15/2010 12:20 PM (GMT -6)   
Jim, you may want to double check those figures as they may be what the insurance company paid vs. what the actual charges were. Our statement showed the full charges billed by the hospital vs. the negotiated rate paid by the insurance company. The amount I listed was what the hospital charged, not what the actual operation cost our insurance company.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24044
   Posted 1/15/2010 1:46 PM (GMT -6)   
Same here, Sephie, I put down the official 'list prices" that were charged.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2603
   Posted 1/15/2010 4:17 PM (GMT -6)   
Jim may be able to negotiate some better prices as well.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1821
   Posted 1/15/2010 4:28 PM (GMT -6)   
KJN,
Although you know the situation in Japan far better than I, it would be surprising that given the excellent medical care available there, that was the case so far as nerve sparing surgery went. You may have just struck a couple of docs who cannot do it. It is most certainly available in both Singapore and Thailand. It might be worthwhile investigating the expertise of other urologists in Japan. Although unaware of the cost for an uninsured patient in the U.S., in Sydney (Australia) for example nerve sparing robotic will set you back just over $20,000 for hospital stay and doctors fees (for non citizens with no insurance). But in these other places you are faced with additional costs as pre-consultations, accommodation and follow up care.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
PSA December 09 <0.01

My Journey: www.yananow.net/Mentors/BillM2.htm


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 596
   Posted 1/15/2010 7:11 PM (GMT -6)   
Mine was almost exactly $40,000.00 on the nose - Surgeon, hospital, everything.

I would say that is pretty typical for a large metropolitan area. Middle of the country or more removed from big cities might be cheaper.
Paul
www.franktalk.org ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 5184
   Posted 1/15/2010 7:14 PM (GMT -6)   

i BELIEVE it costs $64000 (that's what I was told by Dr. Menon's team).

I'm fortunate to have excellent insurance. It will cost me about $1200 for everything, including all consultations, pre-op, etc. Much of that is because of my 2010 deductible.

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.  
History of BPH/prostatitis. PCA-3 test: 75.9 (bad news, guaranteeing I have to do....): Biopsy on 11/30/09. Result of biopsy:

5 out of 12 cores positive. Gleason 4+3. More specifically: 2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C

REVISED BIOPSY REPORT: The previous was read by Umich. Slides were then sent to Dr. Menon at Ford Hospital. Here is their report (much better) -- changes in bold print below:

5 out of 12 cores positive. Gleason 3+4. More specifically: 2 cores were 3+3 (one 5% and the other 20%) on one side. On the other side, 3 cores were 3+4 (5%, 5%, 20%)

 Latest: Surgery with Dr. Menon at Ford Hospital, set for 1/25/10

 


Bedelia
New Member


Date Joined Nov 2009
Total Posts : 18
   Posted 1/15/2010 8:33 PM (GMT -6)   
My husband had robotic in December 09, and the cost was $52,000.  That did include the biopsy, and 3 consults (one at $500).  Luckily our insurance covered all except for $110.00 in copays so far.
 
 
Age 60, no symptoms
Hardness found in DRE during physical
PSA 1.84 (up from 1.5 last year)
Diagnosed 10/27/09
Left Mid and Apex: Adenocarcinoma, GS 3+3,
cancer in 2 of 10 cores occupying 40%
daVinci 12/11/09 Strong Memorial Hospital, Rochester NY
Path showed 3+3, Pca contained to prostate at 10%
Clear margins, lymph nodes clean
 
 


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/16/2010 12:31 PM (GMT -6)   
Thanks to all of you for the figures. Wow! Those prices are as bad as I had feared. Doing it in the US may not be possible for me. I'll keep looking around. I've heard that it may be possible to negotiate with some hospitals for the insurance company price. I'll see what I can come up with.

I had my biopsy done in Bangkok (my wife is Thai). They took 24 cores. The right lobe showed no cancer, and the left showed cancer in 9 out of 12, but I don't know the percentage in each. The slides just arrived at Johns Hopkins yesterday for a second opinion.

The urologist surgeon in Bangkok who did my biopsy does robotic assisted surgeries. He's done 180. He is supposed to have done the most in Thailand, and he says he's got more than the leader in Singapore. I'm hearing that over 250 is a better bet. When I read of surgeons doing 1800 in the US, it sounds much better to me.

Prostate cancer is less common among Asian men living in Asia. I talked with two urologists in Japan, both at university hospitals, in Kyoto and Osaka. I was told that laparascopic is what's used here, now, but that most patients are older and not so worried about ED. Both of them told me that at my age, I ought to go to the US where surgeons have much more experience with all types of prostatectomies. The guy in Osaka said he had done 150 laparascopic and he was one of the leaders in the Osaka area. He also said that robot assisted surgery is still experimental surgery here. This is not surprising to me. I have lived here 10 years. The medical care here varies from modern high tech to archaic and downright scary. Japan is known as the land of opposites.

That price of $20,000 in Australia - was that in US, or Australian, dollars?

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3220
   Posted 1/16/2010 3:03 PM (GMT -6)   
KJN,
Hajimemash ite. Kyu nen kan Yokohama ni sundeimash ita.
Anatano mondai wa taihen. Dakkedo shimpaishinaide, yo.
I now live in Rochester NY and had my surgery here. It cost about $20,000 after the insurance company dickered with the hospital. Everything, except about $150 was covered by insurance.

You might want to check out Colin45. He had his done in Thailand for about $10k and his results are so good, I think he's even fathered two kids by now. ;-) (He might chime in here.)

I agree with your comment about the "high tech to archaic" spread of the Japanese system. One minute you can be enjoying the warm spray and gentle drying breeze from a Toto washlet - and the next you pass a squat toilet in a train station.
Full of surprises.
Good luck.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next? See Uro 1/20/10
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day
1/11/10 6 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.

Post Edited (Worried Guy) : 1/16/2010 1:31:46 PM (GMT-7)


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1821
   Posted 1/16/2010 6:23 PM (GMT -6)   
KJN,
That cost in Australia was in Oz dollars (currently Au$1-00= US$92c). Then again, robotic is not as prominent here as it is in the U.S so experienced urologists will charge a premium for robotic surgery and open is quite a deal lower in cost. Although I had robotic I would not be too hung up on it. open surgery with a well experienced doc will deliver equivalent results as far as continence and nerve preservation are concerned.......it is most certainly not the second best choice. Many members here have had open surgery with great results........and there are some advantages to open. I am not a fan of straight out laproscopic surgery as all I've read suggested it takes quite a bit of skill (hand movements are the reverse of the instrument movement) with the field of view somewhat restricted. Given the complexity of a prostatectomy, who needs extra hurdles. As "Worried Guy" says, "if Colin45" from Bangkok is about ( he had similar stats to yourself) he may be able to give you details on his to date successful open surgery there.
Bill

Post Edited (BillyMac) : 1/16/2010 4:28:25 PM (GMT-7)


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 215
   Posted 1/16/2010 8:42 PM (GMT -6)   
KJN

I went thought my problems in Thailand and got quotes of 260000 to 280000 Baht for open (it cost me 320000B the extra was because I have a bleeding problem and had to stay in hospital 1 extra day) and 450000B for Robotic but that had to be done in a government hospital because at that time it was the only hospital in Bangkok that done Robotics The doctor that I used quoted me that he had a 95% rate for continence and a 50% for ED well I am continent (which I was after 1 week) except for the occasional stress dribble and have no ED problems at all although I lost one nerve bundle

I did not feel that the doctor I see about Robotic surgery had enough experiance he quoted me 250 operations and was far to pushy for me I felt like I was being sold something like if I was buying a car he did not even give me a DRE where the doctor that carried out my operation gave me all the information I needed or asked about and just left it to me very laid back about the whole thing if you need any more info please let me know but I might be a bit delayed in a response but I will reply Colin
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/16/2010 10:10 PM (GMT -6)   
Great info. Thanks again.

Ohio State: I’ll check out Dr. Bahn for overseas referrals.

Worried Guy: Hajimemacrape. Yoroshiku. What type of surgery did you have in Rochester? May I ask the names of the hospital and your surgeon? My sister lives in near NYC so NY is one of the easier states for me to visit for treatment. I’m looking at all of my options here. $20,000 after negotiations is doable. $50, 000 isn’t.

BillyMac: Thanks, US and Oz $ about the same. Again, $20,000 beats $50,000, though. I understand, too, going to a country I am not familiar with adds to the expense, and difficulty. I do have friends from Australia though, so I may run it by them.

Colin45: May I ask who the surgeons were in Bangkok? Which type of surgery did you have, and at what hospital? The guy who did my biopsy at Bumrungrad is usually at the government hospital and does robotic surgery there. Maybe the guy you talked to?

I actually have insurance in Thailand (BUPA), but it pays nothing for care in the US. As a general rule, here too, it seems like you may get what you pay for. It sounds like you got great results. How much experience did he have? It seems that I might get spectacular results from a low experience surgeon, but maybe not. That is what scares me and makes me want to bite the bullet, spend the money, and go for a more highly experienced surgeon in the US, or elsewhere.

Too much information, too many choices, too many decisions to be made.

Thanks again, all.

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 375
   Posted 1/16/2010 10:20 PM (GMT -6)   
The hospital/surgeon billed my hospital approx. $65,000 for my da Vinci procedure and hospital stay.  Blue Cross Blue Shield paid approx. $37,000, and the hospital/surgeon accepted that amount and didn't bill me for more.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0

 


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3220
   Posted 1/16/2010 11:21 PM (GMT -6)   
Hey KJN,
I went to Univ of Roch Medical Center and had DaVinci by Dr Jean Joseph. I've got all my bills and billing paperwork and do not mind opening my kimono if you need a peek. You've got my email through this site. I noticed someone else here had the same surgery, by the same doc , at the same hospital but at a much higher price. Clearly there is something whacked with the health care system - or at least the billing.
Ja, mo ii. Ano mondai wa shikattaganai.

(Oh, you probably noticed this site has an automatic profanity filter. It looks at character strings and converts them into less offensive words. It sure makes Japanese ridiculous. That's why I inserted spaces "incorrectly" in the Nihongo.)

By the way, given the chance to do it all again, I'd seriously be thinking about calling Colin. He's on the beach wearing a Speedo, while I'm in my kitchen wearing a pee pad.
You found a great site. Glad we can help.

Moshi shi_tsumon ga arimasu, zehi emairushi_te kudasai.
Ja mata
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next? See Uro 1/20/10
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day
1/11/10 6 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 215
   Posted 1/17/2010 4:36 AM (GMT -6)   
Hi KJN

The doctor that carried out my open surgery was Dr Chodchoy I also saw Dr Sitti**** both at the Bumrungrad but I think that Dr Sitti**** is mostly at the government hospital I had an appointment with Dr Sitti**** at the government hospital and did not like the idea that there was so few people that spoke English so I decided to go the open route which if I had to do again I would change nothing I had very little pain when I left hospital after 5 days I had a 90min car trip in a Honda Jazz which I was not looking forward to but it was no problem at all I did not at that time have any continence pads (and never brought any) and all I used was some toilet paper which I managed with I have had no ED problems from day 1

Jeff still no more children I just say that my operation was a very some expensive contraception
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/17/2010 5:08 AM (GMT -6)   
Hi Colin45

Thanks. Any idea how many open surgeries Dr. Chodchoy has done? Which hospital did you do your surgery at? Great news about your continence and no ED!

Yes, I had my biopsy done by Dr. Sittipawn. I figured that if I did do it with him, my wife would have to be my translator at the government hospital. But I also was concerned with the number of surgeries he has done with robotic assistance. He says he has done around 200 laparascopic, but only 180 robotic.

Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 215
   Posted 1/17/2010 7:22 AM (GMT -6)   
KJN

I cannot remember how many open surgeries Dr Chodchoy as done but it must be plenty otherwise I would not have had him do my surgery at Bumrungrad he seems to be the old school type of doctor although he would not say anything against Robotic surgery other than he likes to feel things with his hands which cannot be done with a robotics machine

It is not always easy to translate medical terms unless she has a medical background which is why I did not like the idea of my lady translating for me
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/17/2010 7:43 AM (GMT -6)   
Colin45

Thanks. I've found him on the net and will find out more about him.

Good point about translating the medical terms!

Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 215
   Posted 1/17/2010 8:13 AM (GMT -6)   
KJN

Best of luck with any decisions that you make
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/17/2010 11:14 AM (GMT -6)   
Colin45

Thanks.

You say in your bio that you lost one nerve bundle. Was that because of the location of the tumor? Did you have any idea that would be the case before you had the operation? That's great that you have no ED, regardless!
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