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huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 7/13/2009 10:55 AM (GMT -6)   
Hi,
 
This is my first day on the site and I was diagnosed June 2 with a 3+3=6 Gleason and a t2a stage. Psa is 2.04. I'm thinking about robotic surgery with Dr. Mani Manon at Henry Ford  Hospital. Can anyone give me some feedback about their results using Dr. Manon. I know he is highly recommended but I would like to hear from you if you have had this surgery.
Is there anyone that feels they made a mistake going for surgery instead of other treatment options?
Thanks
 
Huey confused

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/13/2009 11:11 AM (GMT -6)   
Hi Huey,
Welcome to HealingWell...Dr. Menon was the pioneer for robotic surgery of the prostate. He has been around quite a long time and has done thousands of surgeries. In my two and a half years on the PCa scene, I have seen a few of his patients come through HW. If you are choosing surgery via the robot, he is well accomplished. You left out your age, and also on your pathology report there should be some mention of how many cores had cancer. For example I had 4 of 8 cores positive for cancer. These things could change any advice our team could let you have. With a PSA of 2.04, it would seem like your disease is very early. If so, take your time to find the treatment that is right for you. And if you are still at surgery, Menon is a good choice...

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/13/2009 11:12 AM (GMT -6)   
Go over to yananow.net and do a search for "Menon." Lots of stories.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


JoeyG
Regular Member


Date Joined Jul 2009
Total Posts : 162
   Posted 7/13/2009 11:13 AM (GMT -6)   
Huey,
 
I couldn't tell you about Dr Manon but the reason I'm replying is this:
 
You mentioned---"Is there anyone that feels they made a mistake going for surgery instead of other treatment options?"
 
If you do your research and decide on something, never look back, regardless of the outcome. Its like when you were back in school taking a multiple choice exam.....your first answer is usually the correct answer. When you finish the test, the best thing to do is to hand it in! That being said, I'm sure you will find few who will have thought they made a mistake unless the mistake was waiting too long (as in watchful waiting).
 
The best point I can give you and it sounds like your're doing it....get all the info you can, weigh it and make a decision.
 
Best of luck!
 
Joey
 
 
Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined
Cryoablation 4/06 Allegheny Hosp-Dr Ralph Miller (Cohen/Miller)
Post Cryo Nadir 8/06 0.2
Rising steadily to 0.7 4/09 :-(
Looking to take next steps soon
Hoping to qualify for salvage cryo or radiation


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/13/2009 12:07 PM (GMT -6)   
Let me just add that Henry Ford Hospital also has a good reputation
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 7/13/2009 12:11 PM (GMT -6)   

Greetings, Huey.  Welcome to the forum - you have found a place where people are in very similar circumstances to yours and have had to face the same questions you are now facing.  I don't know anything about the particular surgeon you are asking about, but given what others have said he sounds like a very experienced surgeon which is often a key factor to consider. 

Regarding second thoughts, I agree with Joey - take your time, gather lots and lots of information and make your decision and then never look back.  I had surgery and I believe for me it was the best decision.  Others here have had other treatment decisions and for them, it was the right choice and they should never look back. 

You are among friends - please feel free to ask questions and let us help as you go through this information gathering phase of your treatment.  David


Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/13/2009 12:12 PM (GMT -6)   

Dr. Mani Menon  (not Manon) at Henry Ford Hospital Detroit, has a very good reputation. Now since his name is mentioned he is the 2nd surgeon("B") I saw in my quest to treat this dragon of PCa. Now if you heard my story herein before, doc "A" another surgeon (but w/o robotic in 2002~but said he could do lapro method) is the infamous doc whom wrote down 'curative and 1% of incontinence' on paper and handed it to me.

 The next day I had already scheduled an appointment to see Dr. Menon at H. Ford of which lead to seeing two other docs(there) first for their input. I had to come back again to see Dr. Menon but finally after getting to talk with him, he flat out said I will not do surgery on you  (my numbers were that bad). I was ready to sign up then in 2002 (probably patient #20 or so in the USA, would have been the plan). Sooooo, I would say this is an honest man I had the money and/or insurance to pay for this and he would not do it for the money!!! He knew I would fail the curative realm of surgery, righteous man in my book. (although not what I wanted know about my PCa case, truth is what I ultimately wish to know, always even if it is painful to hear).

I met the 1st DaVinci patient in the USA, there while waiting for Dr. Menon. So, talked to him and he was please with the surgery, although he had come back in for checkup and mentioned perhaps some kind of bladder neck sewing/healing issue. (but he was #1 for this too) He was a younger guy in his 40's and was playing golf a few days later, he says.
 
Also, if you are very much overweight it is an issue for being on this machine, I saw another patient there who wanted to do this method so bad, he lost 70 lbs., so that the doc would accept him as a patient for this machinery.

huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 7/13/2009 12:39 PM (GMT -6)   
Hi all,

Thanks for your input. I appreciate it very much.

My age: I will turn 64 this week.
Twelve samples were taken and 1 out of 12 were positive with 20% cancer. Does this make a difference if I should have surgery or not?

huey

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 202
   Posted 7/13/2009 12:54 PM (GMT -6)   
Hi Huey,
 
Dr Manon performed Davinci surgery on me in September 2006.  Aside from being satisfied with the skill of the surgeon, Henry Ford Hospital has an incredible system in place.  Very organized and timely with their appointments. 
 
At times I felt I was on a bit of an assembly line, but it wasn't a negative feeling.  Dr. Manon's department is set up to do robotic prostatectamies.  They do a lot of them and they know what they're doing.
 
I don't regret my decision.  And that was my guiding agenda in trying to reach a treatment decision.  I didn't want to have any regrets following treatment.
 
Good luck in deciding upon your treatment.  Looking back, the period between diagnosis and treatment was the most difficult for me. 
 
Dave
Age:54
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/13/2009 2:03 PM (GMT -6)   
It might, Huey,
You can monitor it for a little bit and see how fast the PSA changes. At 64, with 1 in 12 cores positive, and Gleason 6, you are a potential active survellience patient. By that I mean diligent watching and waiting. Prostate cancer tends to be very slow in going. If you don't like the thought of waiting, then you need to do what you think is best. Surgery is a solid option, but there is no need to rush with your numbers. Out of curiousity, do you know what your family life expectancy is? If the males typically live into their 80's or more I would probably opt for surgery regardless with your numbers.

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 7/13/2009 3:41 PM (GMT -6)   
Huey,
with a G6 and only one core positive and nothing felt on a DRE, low psa and 64 years old, Active Survelience is the recommended treatment by the Prostate Cancer Research Institute. Their web site has a section on active survelience and many papers written by the top minds in the PC world.

You have over a 75% chance of no progression and if eventually treated a 1% chance of dying. At worse you can delay treatments and their side affects for years. Get a doctor that is experienced in AS, a prostate oncologist would be the best.

If you have surgery there is a 40% chance of failure (Sardino's numbers at Slone Kettering) defined as no cure, permanet side affects, or major complications. You will be incontinent for a period of time and have ED for a period of time if everything goes well. There are other effects of surgery rarely mentioned such as urinating during sex. If you do decide on surgery there is a 90% or better cure rate with your stats. (the same goes for radiation or seeds)

If you were 35 0r 40 surgery may have a small long term advantage over the other treatments, but at 64 I would choose the treatment with the least side affects.

This is a life changing decision and you have a lot of time to make a decision, so don't rush it and get a 2nd opinion from a prostate oncologist who is not biased in recommending a treatment option.

Stephen Strum, one of the best PC practioners in the country, has one mantra:
Know the biology of your individual cancer.
Choose the treatment that best matches that biology.
Choose the best expert in that treatment.

Most doctors and patients don't spend nearly enough time on steps one and two. PC is slow growing and you have probably had it for 20 or 30 years, so a few months of research won't matter in it's growth, but could afffect your quality of life for the rest of your life.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT

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