Finding the right surgeon

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

milestogo
New Member


Date Joined Jun 2008
Total Posts : 4
   Posted 7/7/2008 11:45 AM (GMT -7)   
Hello to all,
 
I'm new here and have been lurking up to now.  I appreciate the honest discussions and openess about the many sensitive issues regarding prostate cancer.  My best wishes to all.
 
I live in a medium sized town with a good hospital, but it's not a major medical center.  The only urologist here who does prostate surgery says he's done fewer than a hundred total and so far this year has done "eight or ten."  I want to find someone with more experience.  I got a couple of recommendations from a local PCa support group, but I don't know if there's a way to get some kind of rating on doctor's online.  Is there such a site?  One or two satisfied customers doesn't necessarily mean this is the best surgeon I'm going to find.  I also want to try to avoid a drive of three hundred miles to get to a major medical center.  The town of Medford, Oregon is about an hour's drive and has more experienced urologists, but which one to choose?
 
I haven't added a signature line yet, so I'll mention here that I'm sixty years old, have a PSA of 5.03 and rising, and a gleason score of 3+3=6.  My father died of prostate cancer.
 
Thanks in advance.
 
Miles

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 7/7/2008 1:07 PM (GMT -7)   
 Hello, Miles, someone will be along shortly with some info in your geographical area, I bet.  In the meantime, here's a big ole' HW Welcome.
 
 
tongue    Hi ~Miles and Loved Ones,

 

Welcome   to  ~ HealingWell ~

 

and

 

A   Special Warm Welcome  to  You !

 

Knowledge gives us POWER.  POWER takes away the fear.

 

~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~

 

 Click  on  link  below for important information that will help you ~ help us!!

 

  >>  Welcome New Members ~ to HealingWell

 

The information (link) listed above is to help you get around the forum! 

 

This is a journey best traveled with friends. 

 

Welcome ~ New Friend from all the members here... on HealingWell.com

 

 

Forum Moderators

v      IdahoSurvivor ~  Moderator for Prostate Cancer Forum

http://farm2.static.flickr.com/1160/1313099593_9f819e3ff8.jpg

 

v      TC-LasVegas ~  Moderator for Prostate Cancer Forum

 

v      Doting Daughter ~  Moderator for Prostate Cancer Forum

 

v      James C ~  Moderator for Prostate Cancer Forum


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 7/7/2008 1:11 PM (GMT -7)   
Hi Miles! Welcome to HealingWelll. I hope that you discover what an incredible forum this is and share your story. My father is actually from Southern Oregon and I am pretty familiar with the treatment centers down there. We actually made the decision to have his surgery done in Seattle, rather than down there. I know Portland is probably quite a drive, but there are some great surgeons there too. I know the distance is a big deal, but I would recommend going with a more experienced surgeon if possible. Hopefully, you will get a few recommendations on here. I tried to find out as much as I could about the local doctors and found a site that would give a little information, but didn't have number of surgeries etc.
My father is continuing treatment through the Spears Center down there. He unfortunately needed radiation and hormone therapy and has been receiving the therapy through them. My dad didn't want to stay in Seattle for 8 weeks. He has been happy with the treatment and facility. A few of the doctors received their training from Loma Linda, which I was happy about. :) Anyhow, keep us posted and welcome again!!

P.S. I am attaching the instructions for a signature.

Doting

Signature Line (Single spaced in profile ~ please)
(10 line minimum not in effect for Prostate Forum)

** Using…Reply Post: Signature appears at the end of each of your postings automatically
v If you wish for signature not to appear on a specific posting
Click the check mark off in the options
(Include signature) just above submit button
** Using…Quick Post: Signature appears at the end of each of your postings automatically
Log In
Click on Control Panel (top left)
Click on Edit Profile
Scroll down to Signature
Type specific information that you wish to share…
** optional (I use WORD and then copy & paste directions are available see #4)
I find this works better if I want to move around or add something later
Scroll down to the bottom of the page
Click on Submit button
Page will process and you will see a statement
Your profile has been updated…
Click on HOME top right next to calendar/chat/search/members/help
This brings you back to the Main Page for HealingWell.com Forum
Click on Prostate Cancer
And you’re back with us!!!
Now ~ the next posting that you create…. Your signature will automatically show up at the bottom !!! Check the first time to make sure all information is exactly as you want it!

Example:
Name and State you live in
Date and Treatment (be specific) Age at time of diagnosis/treatment
PSA, Gleason, Tumor Stage, Margins
Any and all information that gives a clear picture of “Your Journey”
Date 1st PSA
Date 2nd PSA
[color=#000fe0>DX]Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 3, 08 PSA .02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 7/7/2008 2:13 PM (GMT -7)   
Selmer is correct. Dr. Barrows does do the surgeries and he is one that we considered. However, when we spoke to him a year ago, he hadn't done very many. My father really liked him though.
[color=#000fe0>DX]Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 3, 08 PSA .02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Dirtmover
Regular Member


Date Joined Apr 2008
Total Posts : 158
   Posted 7/7/2008 3:52 PM (GMT -7)   
hello there miles and welcome to the site with most of the support you will ever need no judges here just good people they were here for me and we will be here  for you.now this is only my opinion so take it for what it is worth . i interveiwed several docs for my proceedure, i live 30 miles east of sacramento , so you would think mmmmm, sac is big no problem , one of the most qualified surgeons here had 125 divincis done ,im sure he was a very good doc , however there was a study done on the learning curve of the divinci, it concluded somewhere between 450-500 surgerys were needed for optimum results my surgeon had 2100 and pioneered the divinci on the west coast, while going to a cancer center which specializes in doing several of these  a week should produce even better results .I AM NOT SAYING THIS IS THE ONLY WAY TO HAVE SUCESSFULL RESULTS , there are very good surgeons in smaller cities which produce good results, they are just harder to find . you only get one shot at this my attitude was i would do whatever necessary to achieve good results its your life and the after results can ruin your life if not performed correctly, i hopped a plane and flew 500 miles away for my proceedure, i stayed all week in l.a. and im thrilled  with my results ,keep in mind this was 5 1/2 weeks ago please take the time you need to make  the decision that suits  you best you get one chance my brother so please reconsider is during this whole trying time in your life which i will pray will only last a year or two if you are early stage  if travel is really a big deal . lots of these men have traveled for good outcomes  your gonna do fine miles cause your already asking the real questions when you need us we will be here,remember all i said is only my opinion,  however i would do it the excact same way again................................dirt



Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night

Post Edited (Dirtmover) : 7/7/2008 5:28:05 PM (GMT-6)


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2268
   Posted 7/7/2008 4:13 PM (GMT -7)   

Miles--Welcome to the forum.  The more I read the more I am convinced that the number of prostatectomies a surgeon performs (open/daVinci) the better the results are likely to be.  That said, there are some high-numbers surgeons who are not as good as others. 

If you are willing to travel outside southern Oregon to a bigger city, I would ask the surgeon about his numbers, ask to talk to patients who have had this surgeon perform their prostatectomies, and see if you can talk to other health care folks in the area for their two cents about the surgeon. 

When I discussed the option of DaVinci with my urologist, he told me of a high-numbers surgeon who had a less-than-great reputation for his surgical outcomes.  This kind of information, while anecdotal, can be  helpful.  I ended up getting an open prostatectomy not a robotic.

Many of the posters here know of great surgeons in many different areas of the U.S., including the West Coast.  Research  as extensively as you can before making your decision and read some of the standard books on  prostate cancer listed on this forum. According to most here who have travelled elsewhere  for surgery, it wasn't too difficult to accommodate.

You will not regret making an informed, well-researched decision, rather than a hasty, ill-considered one.


Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 2006 
Organ confined pT2a  Gleason 5   
Cancer-free for 2 years  PSA's undetectable 


milestogo
New Member


Date Joined Jun 2008
Total Posts : 4
   Posted 7/7/2008 4:44 PM (GMT -7)   
Thanks to all for your replies so far.
 
Barrows is the surgeon in Medford who was recommended by a local man.  I don't know how many robotic surgeries he's performed, but I'm taking my medical records over tomorrow.  Not sure if I'll make an appointment or not.  The local guy's niece is a surgical nurse in Medford, and she said Barrows was the guy to go with there.
 
I'm also thinking about UC Davis, which my local urologist recommended.  But how do you finally decide?  In the end, can I really compare one surgeon to another?  I agree this is the biggest decision I've ever made so far in my life, and I've had to make a few big decisions, but I don't know that I have the knowledge to make the right pick.
 
Mostly, I've been handling the emotional side of this very well, but as it gets close to the time to act, I'm starting to feel like a deer in the headlights.

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 7/7/2008 5:05 PM (GMT -7)   
Miles-

By now you've got some doctors in mind and some hospitals. The first thing I do when I get a doctor's name is check him/her out on Google. Find out what schools he attended, what hospitals he's worked in and whether he's a Diplomate of the American Board of whatever specialty - in this case urology.

Also Google the hospitals you're considering. They usually list the professionals in each department. Google each of the docs as above. It's very important to do what I call "due diligence". It's much better to get it right the first time, than to have regrets and try to undo what's been done.

Liking the doctor is also a big part of it. If you have insurance, ask how many 2nd opinions they'll pay for. And ask several times - you'll get different answers from different people. I had 5 "2nd opinions". The first person I asked at my insurance company said they wouldn't pay for any 2nd opinions. Horse hockey!!!

And, yes, it's scary as hell. But you'll find out that it's not nearly as bad as you've imagined.

Good luck.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - Finally got results from doc. A number of lung nodules have grown, but, more important to him, is the fact that the malignant lesion on my pelvis seems to have flared up and he wants me to start chemo. He said I could wait a few months, but I told him I want to start now. He to get me signed up for a clinical trial in nearby NY.

Post Edited (Gordy) : 7/7/2008 7:39:42 PM (GMT-6)


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 7/7/2008 6:36 PM (GMT -7)   

Hi

Welcome to a great forum.  You have some good infromation here and especially the things that Gordy has said.  One other thing I might suggest is to check your states Medical Board to see if the Dr has had any problems with his license.  I guess it's the cop in me.  Take care and let us know how you are doing. 

Mika

attempted to edit out dead space at bottom of post- failed miserably...lol  James C.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


Post Edited By Moderator (James C.) : 7/13/2008 7:29:09 AM (GMT-6)


Dirtmover
Regular Member


Date Joined Apr 2008
Total Posts : 158
   Posted 7/7/2008 7:10 PM (GMT -7)   
miles . which u.c. davis are you considering ? also consider the hospital C.O.H. is  the 19th leading hospital in the u.s. in urology but it was the doc  that impessed me. most docs are errogant when you consult them ,they have to be , if you can get past that and recognize there actual achievements your on the right  road , your gonna be asleep anyways. type in the docs name i had or any for that matter and you will see the difference you dont wantt a good advertizer you want to see thee results are they willing to let you talk to there patients  mine was and they all had similar results .im not saying a certain doc has never had a bad out come   ,if they tell you that ,turn around and run , but compare the percentages , i considered .u.c. davis  chris evans is cheif of urology and not only a great doc but just plain nice guy but the numbers just werent there for  me and it was only an hour drive which would have been much more conveinent take your time if you would like to contact me i can give you the  email of a professor in ohio whom researches top docs all over the world  ..     dirtmoverz@comcast.net  your gonna do fine just take your time hell im just thrilled you caught it in time . :-) ...........dirt

p.s. whats more gordy is absolutly correct its not as bad as your mind makes it out to be .


Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night

Post Edited (Dirtmover) : 7/7/2008 8:13:25 PM (GMT-6)


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 7/12/2008 12:43 PM (GMT -7)   
My two cents: I was told that 300 robotic surgeries is sort of the majic number. The surgeon is not going get dramatically better after that. But - more experience is always better.

kcragman
Age: 52
March 2006: PSA 2.5
Dec 2007:   PSA taken for insurance application. I did not see the results until late Jan '08 - after I was rejected. Their lab said PSA 4.5. PSA again in Feb '08: 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were cancerous and the 6th did not look good.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.
Post op: Gleason 9 (4+5). 15% of prostate involved. Negative margins. Lymph nodes and associated glands all appear to be cancer free.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/12/2008 11:01 PM (GMT -7)   
Miles I'm a COH guy too. That have two of the very best PC surgeons on the west coast and clearly from what I read, the world. Their program is awesome.

A word about avoiding travel. My Coh visit could have been done in three days. I stayed in the area for 13 days as I had family in the area, but I could have come home on the third day and had local support to remove the catheter and follow up care. I guess I should mention that I live where my screen name indicates. We are NOT a small town and I have heard about bad surgeries here and at this site. Don't skimp this part and get to a major center at least for that all important second opinion, and likely surgery. Quantity has nothing to do with selecting a surgeon. The program that the center has is far more important. Once you've been to a major center, you will see what I mean.

West Coast centers I considered:
UCI,
UCLA
USC
COH
USF
Mayo Clinic
MD Anderson (technically not west coast)
Huntsman

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 7/13/2008 8:20 AM (GMT -7)   

 

Hey Dirtmover

Give Sacramento a little more respect.  Dr Brian Naftulin of the Sutter system is one of the most experienced and best respected DaVinci surgeons on the west coast.

Yea, he did my surgery.  30 miles east too...

lifeguyd


biopsy 10/16/06
T2A,  PSA 4.7
Gleason  4+4=8  right side
DaVinci Surgery  1/16/07
Post op confirms gleason 4+4=8
no extension or invasion found
no continence problems
PSA 90 day -.01  , 6 month -.01 , 9 month +.02 , 1 year +.02
Ed problems continue
Now using Bi-mix
 
 


Nasha
Regular Member


Date Joined Dec 2007
Total Posts : 42
   Posted 7/17/2008 5:22 AM (GMT -7)   
milestogo,
My husband and I faced the same issue 2 years ago. We're in the Tampa area. My husband was adament, as you are about getting the absolute best in the field since this is a one shot deal. After meeting with several of the leading candidates here, he just didn't feel right about any of them.

We chose Dr. Mani Menon at the Henry Ford Institute in Detroit who pioneered the DaVinci method. The appointment with Dr. Menon and his associates was the most timely, (it was for 11:00, and they actually called us up right on time) orchestrated, informative, professional for any type of appointment I've ever experienced.

We sayed at the residents' dorm which is steps away from the hospital (and a wonderful, very inexpensive cafeteria). For about $30.00/night, we had a clean, quiet sparsely furnished apartment.

My husband had the DaVinci, nerve sparing procedure. After the surgery, Dr. Menon explained that my husband's was a "textbook case", clear margins, everything great. However, it took him 11 months to achieve a usable erection (with Viagra). It has been improving ever since. Prior to that, he tried the pump and injections, along with Viagra. (No problems with ED prior to surgery).

Everyone is different, nerves take time to heal.

The best of luck to you.
fibro, PTSD, depression/anxiety, mitral valve prolapse, high blood pressure,
peripheral neuroma (3 surgeries on right wrist)
 
 
accupril, xanax, percocet, wellbutriun


Dirtmover
Regular Member


Date Joined Apr 2008
Total Posts : 158
   Posted 7/18/2008 9:28 PM (GMT -7)   
 i in no way wanted to dissrespect sac , i grew up there brian naftulin was my second choice and i did consult with him, however at 125 divincis (which is very little experience) and those were his numbers that isnt close enough for me the article written by one off the foremost experts on the divinci at city of hope clearly states a min of 500 to be a good  ,im sure he did a great job and really is a nice guy, , at least till you cancel surgery with him (wheres the respect there)  hey he does have a nice office in folsom ,hope you didnt take my post wrong , im here to help not offend ,the same way these people helped me...................dirt



Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night

Post Edited (Dirtmover) : 7/18/2008 10:35:56 PM (GMT-6)

New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, February 18, 2018 5:26 PM (GMT -7)
There are a total of 2,930,647 posts in 321,557 threads.
View Active Threads


Who's Online
This forum has 160296 registered members. Please welcome our newest member, Dillon White.
376 Guest(s), 8 Registered Member(s) are currently online.  Details
JayMot, Froggy88, 81GyGuy, XX222, lazyminimoo, Wilderness, Saipan Paradise, leo77