Boston Area Help / Robotic/Laparoscopic Urologist /Ongologist

Is Robatic/laparoscopic or Proton Best?
0
Robatic - 0.0%
1
Proton - 100.0%

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

GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/27/2009 3:41 PM (GMT -6)   
Looking to consult with an Urologist / Ongologist around the BOSTON, AREA. Wondering if any of our group knows or had experience with an Urologist / Ongologist who is good and well experienced with Robotic / Laparoscopic and "tissues / nerve-sparing" prostate procedures (very important to me). Thanks in advance. Just got the news. I am 57 very active and my diet is 98% animal fat free for the past 30 years. No medical problems at all. PSA 3.4 biobsy 3 out 12 3+3's all. Gleason 6. Also I am open to "open Surgery" if found to be better.

Post Edited (GTA) : 8/31/2009 2:52:39 PM (GMT-6)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/27/2009 4:14 PM (GMT -6)   
GTA,
Welcome to the site. You will get a lot of information and opinions on this site. I'm one of the few that didn't have surgery.
With your initial stats, low psa and G6, you will have a very high probability of a very favorable outcome regardless of the treatment you choose. Quality of life issues and side affects should play an important part of your decision and the doctor you choose will probably matter more than the treatment you choose.

Carefully research all options as to their normal side affects and determine if you can live with them. My advice is to seek opinions from a radiologist, a brachytherapist, a surgeon and a prostate oncologist to get a good idea of all the treatments available. You have plenty of time and since this will affect your quality of life for the rest of our life it's worth the time and effort.
I'm sure those from the New england area will have some recommendations for you.
Johnt

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/27/2009 5:54 PM (GMT -6)   
Thanks John.
What I read in different respectable publications (unbiased) and different leading school hospitals that a man in my age group, with good health, surgery would be best and survival without PC would be in the highest percentage, about 95 to 98%. But I am taking your advice and I will be seeing all the specialists you mentioned. Like everyone of us, I just want to get it done and get on with my life. Like you advised I will do my homework and hopefully get the best specialist to help me. Thanks again and God bless. GTA

Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 8/27/2009 9:36 PM (GMT -6)   
Welcome to the site. With your stats all methods have roughly the same cure rate. Boston Mass General hospital has a Proton radiation machine. You may want to include a consultation there in your due diligence plan. Take your time. Don't rush a decision. G6 is a slow growing cancer.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


Siewife
New Member


Date Joined Jun 2009
Total Posts : 14
   Posted 8/28/2009 11:16 AM (GMT -6)   
My husband just had surgery at the Brigham with Dr. Jerome Richie and his team.  Dr. Richie only does open RP but has a colleague (Dr. Hu I believe) who does the robot.  Dr. Richie was very open in explaining pros and cons of both approaches - indeed of all approaches - and was helpful in encouraging us to take time to make decision. 
 
In terms of care - found that the Brigham took great care of both husband and me.
 
Most important to think through the long haul - whatever option you choose will result in side effects and these are the things that provide the biggest challenge especially if you have not had any symptoms prior to dx.  That said, well worth it to head for those zeroes!
 
Best to you.
husband, age 56
psa 4.3
biopsy 5/20/09 - 2/14 positive, 3+3=6
consultation 6/4/09 - revised to 3+4=7
open surgery 7/31/09; discharge 8/4
catheter out 8/7
T2a, N0, Mx, Gleason 7 (3+4)


letsky
New Member


Date Joined Aug 2009
Total Posts : 1
   Posted 8/28/2009 12:29 PM (GMT -6)   
I had Dr Ali Moinzadeh at Lahey Clinic. He's done hundreds of them.

GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/28/2009 1:04 PM (GMT -6)   
Thanks Geebra,
I will add a Proton consultation with MGH, Boston. I understand all procedures have their advantages and side effects. I want a procedure that will free me of "biopsies" and additional radiation and many Dr's visits. My 3 positive cores of 2 cores each were about 1.6 mm and only 5% involved, I wonder if I could be a candidate for  Proton ?

GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/28/2009 1:19 PM (GMT -6)   
Hi SieWife Thanks for replying,
You and your husband must have done a lot thinking about choosing "open SURGERY" instead of other procedures. Can you share with us why the open Surgery vs. the ROBOTIC ?  I hope your "Hubie" doing well, my best wishes to both of you. thank you again for sharing your thoughts. GTA

GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/28/2009 1:31 PM (GMT -6)   
Thanks Letsky for sharing your Dr. with us. Sharing your experience with Dr. MoinZadeh before and after your procedure will be very helpful for guys like us in the Boston Area. A little history about your PC would be very important to us as well. By replying to us we know you care and want to help,  as we all should. Thanks again and best wishes.

Siewife
New Member


Date Joined Jun 2009
Total Posts : 14
   Posted 8/28/2009 4:02 PM (GMT -6)   
Dear GTA -
 
We were convinced that we were going to do the robotic surgery until we met with Dr. Richie.  Think you will find overall that whichever procedure doctor does most (Dr. R has done thousands) is the one that that they advocate.  That said, Dr. R did not advocate for one over other except to make the following point:
- open allows the surgeon to feel the tissue.  Prostate cancer tends to be "sticky" in feel and there is no feeling with a robot and thus no ability to tease out the nerves or to feel if it has spread.  He thinks you can spare nerves more easily with open.  He ended up sparing about 60 percent on one side and all on the other.
I come from a family of surgeons so to hear about the feel and the look was something familiar and comfortable to me personally so that made us feel better with this option.  Longterm studies do not show huge differences.
 
Dr. also recommended that we read Patrick Walsh's book Surviving Prostate Cancer and that continues to be hugely helpful.
 
Best in your decisions - keep us posted!
husband, age 56
psa 4.3
biopsy 5/20/09 - 2/14 positive, 3+3=6
consultation 6/4/09 - revised to 3+4=7
open surgery 7/31/09; discharge 8/4
catheter out 8/7
T2a, N0, Mx, Gleason 7 (3+4)


GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 8/31/2009 3:41 PM (GMT -6)   
Hi SieWife,
Thank you very much for sharing your decision with us which gave us a clear and simple explanation to why "open". Thank you also about the recommendation of Dr. Walsh's book which I ordered after reading your Post. I am leaning towards surgery but I will be consulting with other specialists as well. I will. for sure, share my experience with our group. I did look up Dr "R" and found out he is one of the top prostate doctors in our area. Thanks again, and best wishes to you and your husband. Hope he is doing well.

GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 9/8/2009 4:50 PM (GMT -6)   
Hi Siewife
Patrick Walsh's book "Surviving Prostate Cancer" 2008 edition, is a book every family should have on hand. My wife asked me to make sure I thank you  for recommending the book. We both wish you and your husband the best. Thanks, GTA

Siewife
New Member


Date Joined Jun 2009
Total Posts : 14
   Posted 9/12/2009 9:41 AM (GMT -6)   
Hi GTA,
 
You are your wife are most welcome - just wish you weren't on this journey!
 
My hubby just returned from 6 week follow up appt - all restrictions removed (can't lift anything heavy for 6 weeks is biggest one) - happily went out and took down some dead branches and did other yard work he has been wanting to do.  Incontinence is getting better all the time - he is on the right track.  Awaiting PSA result and will post what I hope will be 0 :)
 
Hope things are going well with you and you are reaching closure on your decisions.  Best to you
husband, age 56
psa 4.3
biopsy 5/20/09 - 2/14 positive, 3+3=6
consultation 6/4/09 - revised to 3+4=7
open surgery 7/31/09; discharge 8/4
catheter out 8/7
T2a, N0, Mx, Gleason 7 (3+4)


GTA
Regular Member


Date Joined Aug 2009
Total Posts : 27
   Posted 10/5/2009 6:53 PM (GMT -6)   
Hi Siewife,
I am glad to hear that your husband is doing well and doing some yard work. Hope his PSA results was satisfactory. I am almost at the end of my research. I will be meeting with 3 different specialist together for the final consultation. I will let you know my final decision. Take care and best wishes to both of you. GTA
57 year old
1st. biopsy atypical
2nd. biopsy 7/17/09 3 out 12 cores positive all 3x3's gleason 6
T1c
Had a moderate PBH for past 4, 5 years. Medication did not help.
Deit: 98% animal fat free for past 25 years at least.
Activity: Walking 5 to 7 miles every other day. Cycling 12 to 15 miles every other day.
Action taken: Still in the research and learning stage.

New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, September 21, 2018 8:52 PM (GMT -6)
There are a total of 3,005,599 posts in 329,243 threads.
View Active Threads


Who's Online
This forum has 161784 registered members. Please welcome our newest member, Thunderdaytona.
262 Guest(s), 6 Registered Member(s) are currently online.  Details
spottydog10, sebreg, Girlie, arieco, ks1905, Jack & Diane