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Godfather
Regular Member


Date Joined Jan 2009
Total Posts : 64
   Posted 2/11/2009 7:56 PM (GMT -6)   
Hi all.  Today I had my appointment with Dr Patel in Orlando.  For those who are considering him, he is top shelf.  The operation there at Celebration Health is state of the art and very professional.  He has done over 2500 robotic prostate surgeries.
 
Now the bad news.  Due to some ambiguity in my pathology reports, he decided to do another DRE, my third in less than 30 days.  He was shocked at the size of the tumor and said it wasn't described accurately in the earlier reports.  He feels it my be a T3 and that any surgery should not be nerve sparing on the right side and he would have to "go wide" on that side.  He counseled me not to wait beyond the 8 weeks post biopsy to have it done.
 
I explained to him that if I decided on open surgery, I was going to have it done by James Eastham at Sloan Kettering.  He asked if I'd been to NY or was Dr Eastham going by the records.  Eastham hasn't examined me so Dr Patel gave me his card and said to have Dr Eastham call him.
 
This thing keeps getting worse so I'm going to stop updating my signature until I finally have something concrete.
 
Tony
Age at diagnosis 61  5'8" 260 lbs.
Resides in SW Florida
12/07 PSA 2.6  12/08 PSA 4.0
Biopsy 1/09 - 6 of 8 nodes positive 
Left - 2 of 4 positive, 2% involved, 4+3=7 Gleason
Right - 4 of 4 positive, 40% involved, 4+3=7 Gleason
Perineual invasion is present 
DRE small nodule on right - Prostate 22.6 cc's
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 2/11/2009 8:05 PM (GMT -6)   
Sorry to hear the news Tony, please keep us informed as to any new develops. We kinda all fall in love with each other on this site and care about each others well being. I will be following your condition.

peace and love
dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .06
Testosterone keeps rising, the current number is 156, up from 57 in May
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/11/2009 8:06 PM (GMT -6)   
Tony, I know it seems to keep getting worse, but you are closer still to getting on with your treatment choice, with what this dr. told you, I would heed his advice about not delaying beyond the 8 week. Was he comfortable about doing a robotic with what you know now, or did he think you would be better off with the open surgery? Hoping for the best for you brother, can't wait till you have that thing out of you and you are on the recovery side.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Godfather
Regular Member


Date Joined Jan 2009
Total Posts : 64
   Posted 2/11/2009 8:15 PM (GMT -6)   
David:

Dr Patel still thinks the robotic surgery gives me "a shot at a cure", in his words. If not, we still have radiation to fall back on. Thanks to you and Dale for the notes.

Tony
Age at diagnosis 61  5'8" 260 lbs.
Resides in SW Florida
12/07 PSA 2.6  12/08 PSA 4.0
Biopsy 1/09 - 6 of 8 nodes positive 
Left - 2 of 4 positive, 2% involved, 4+3=7 Gleason
Right - 4 of 4 positive, 40% involved, 4+3=7 Gleason
Perineual invasion is present 
DRE small nodule on right - Prostate 22.6 cc's
 


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 2/11/2009 8:26 PM (GMT -6)   
Tony, In my heart of hearts, I think I would listen to Dr. Patel...Diane
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Forging ahead to health!


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/11/2009 8:40 PM (GMT -6)   
Sorry to hear the bad news. Keep your head up and proceed with the appropriate treatment. We are all fighting PC and as long as we are fighting we can win. Stay positive. We are all behind you.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/11/2009 9:00 PM (GMT -6)   
Tony, the important part isnt the robotic vs open argument, its which surgeon do you put the most stock in, and you are right, having radiation as a back up is a good card up the sleeve. With your T3 situation, I think so even more. We got your back covered, brother, whatever you decide, we are here for you.

David
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


spisam
Regular Member


Date Joined Jan 2009
Total Posts : 47
   Posted 2/11/2009 9:55 PM (GMT -6)   

I'm sorry to read your report to us. I used Dr. Patel and I swear by him. I was treated royally by a true professional. Based on your comments you were also treated with the utmost care and consideration.

Sam

 

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