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otisg
New Member


Date Joined Aug 2009
Total Posts : 1
   Posted 8/28/2009 7:14 PM (GMT -6)   
I am in the process of finding a surgeon for a robotic prostatectomy. I've met with Savatta in West Orange and he made a good impression. Will see Esposito out of Hackensack next week and maybe Sawczuk. Can anyone share your experiences with these or others in NJ. Kim at Robert Wood has a nice web site but I haven't found anything else on him.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/28/2009 7:18 PM (GMT -6)   
Scardino at MSK.

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


TheoTeacher
Regular Member


Date Joined Jul 2009
Total Posts : 47
   Posted 8/28/2009 8:13 PM (GMT -6)   
Not to be silly, but why limit yourself to your area?  Research a doctor, a hospital and get their stats - most are published. See what they have written, where they studied, where they trained.  It's all fairly public info.  If you have to travel and hour or two it's worth it.  I live in NY and travelled to John's Hopkin's in Baltimore because I believed that was the best place for me.  Airfare to Baltimore from NY was only $49 and I had points for a hotel.  My wife and I stayed for several days, a nice vacation!  Ok, NOT a vacation at all but I felt, and still feel, it was what worked for us.  You might want to think outside the neighborhood.
Good luck.
Dad dx at 72 with Pca; RP at 73; Died 11/08 at 88 from Pca met.
3 Uncles have had Pca; 2 deceased from Pca met.
Me: Age 51: Joyfully Married; father of 7!
Routine Physical 11/07 PSA 1.73 DRE normal
Routine Physical 1/09 PSA 2.77 DRE abnormal.
1st Urologist visit 2/09 DRE normal, small - PSA 6.3!
Biopsy 3/17- St. Patty's Day! 3 of 12 cores positive with 5-8% Pca
3+3 Gleason; Visit Johns Hopkins 3/26/09 and decide for surgery.
Lapro RP 6/29/09; discharged 6/30/09
Cath out 7/9/09 Gleason unchanged 3+3;
"Larger amount of cancer" than expected.
Organ confined Pca, positive margin as "artifact" of surgery.
All other tissues clear.
7 wk psa 8/20/09 - 0.05

"We walk by faith, not by sight."


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 8/28/2009 8:30 PM (GMT -6)   
One of the best at MSK is James Eastham, but I don't think he is a robotic guy. My cousin has interviewed a number of DaVinci docs and settled on Dr. Colman at MSK. Had a very good result. I agree with Theo - why limit yourself by geography. I had a surgery at Duke, even though like you, I live in NJ.

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


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 8/28/2009 9:52 PM (GMT -6)   
Samadi at Mt. Sinai is great. I drove an hour into the city to get the best. I interviews five surgeons. Orange is only forty five minutes or so, right? I'd seriously look at NYC for some top 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.
One year PSA - undectable!

ED Website: www.FrankTalk.org - frank discussions of Erectile Dysfunction - check it out.


seekeroftruth
Regular Member


Date Joined May 2008
Total Posts : 36
   Posted 9/6/2009 6:45 PM (GMT -6)   
hi,
i also live in jersey i researched everything to death and finally i went with the fox chase cancer ctr in philly pa.

dr stephen borjan my idol and hero performed robotic, fantastic. not only is he a world class surgeon but he is double that as a person


my 2 cents

rick
new jersey
age 45 hi im rick
first ever psa 4.5
dre negative
biopsy june 08 1 0f 12 cores positive <5% score 3+3 =6
Davinci robotic surgery 9-5-08 philly pa Dr Stephen Boorjian {great guy made me feel so comfortable }
Fox Chase Cancer CTR
home 9-6-08
first 7 days very painful bladder spasms very tough getting up or down
9-12-08 final path report
still 3+3 6
total confined to prostate
margins negative
seminal vesicles negative
lymph nodes negative
dry from day one not one leak
usable erections week 8 with 50mg Viagra although the orgasms are nothing to write home about

1st psa 10-29-08 at 8 weeks post op <0.1 undetectable
2NS psa test 1-29-09 <0.1 undetectable
dr said six months till next one everything's great
no erections without the pill still 4 months out
have usable ones but cant maintain it
awesome orgasms much better then before i know its hard to believe but its true


nemo57
Regular Member


Date Joined May 2008
Total Posts : 43
   Posted 9/8/2009 9:11 AM (GMT -6)   
I had Lanteri and Esposito and thought they were great. I also went to N.J. cancer institute and John Hopkins In Baltimore for opinions. There are alot of Great doctors in this area you will find the right one for you. Good luck
New Jersey
Age 51
Psa 0.9
Biospy 1 core positive
Gleason 3+3-6
Surgery date Aug.11, 2008 at Monmouth Medicial Center
Robotic Surgery By Dr. Lanteri And Dr. Esposito
Both nerve bundles saved. Margins clear.
Gleason score stayed at 3+3-6. Cancer contained to prostate.
1-2 pads a day. No problems at night.
First PSA Oct 2008 <0.1
No Ed problems
Cancer free 1 year Aug 2009


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 374
   Posted 9/8/2009 12:19 PM (GMT -6)   

I had DaVinci with Dr. David Lee at Presbyterian Med. Ctr/HUP...............couldn't be more pleased. I too could have gone to Hopkins or MSK because of proximity, but chose HUP-------also consulted with David McGinnis of Bryn Mawr Urology in Phila. I was equally as comfortable with him as Lee. Don't quote me, but I believe he's affiliated with Jefferson Med. Ctr.

                         Arnie


Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point.
3 month PSA--<0.1
6 month PSA--<0.1


huey
Regular Member


Date Joined Jul 2009
Total Posts : 27
   Posted 9/8/2009 1:17 PM (GMT -6)   
This is a great thread. I've decided after months of my Dx to have surgery and now I'm weighing open vs robotic. This is a great thread because it shows that we do have alot of choices when it comes to finding good surgeons to perform this operation. Many of the comments are positive about the surgeons that are being used and this helps new members to decide which path to take. One suggestion I would like to make, is it would be helpful in the future if we could all put who our surgeon was and the hospital used in our profiles so that new members could find the best doctor for their situation.

Thanks
Huey
Age: 64
Dx: 6/2/09, Age 63
G: 3+3
PSA: 2.04
Samples: 12, 1PC, 20%
DRE:positive
Stage: t2a
Still trying to decide on treatment.
New PSA 7/28/09: 1.3. I don't understand it???
9/8/09: Surgery is my decision for treatment.


SHU93
Regular Member


Date Joined Aug 2008
Total Posts : 328
   Posted 9/8/2009 2:59 PM (GMT -6)   
Esposito, I was very happy with!! Just looking at his background, him and Lanteri actually train other Urlogists on the Surgery. They work closely with the DaVinci company on improvements. Their first objective was mine, the best chance of cure. The nerve sparing for ED was just a bonus if possible. He actually did frozen biopsy's during the surgery to ensure all was gone... The office is very busy but he takes the time with each of his patients to talk everything. I would highly recommend him if you decided on robotic surgery.
 
Good Luck!
 
Age Dx 37, 7/2008, First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008, Biopsy: 6 out 12 Postive all on right side, Gleason 7 (3+4). Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008, Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008, PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
4 Post OP PSA's from 9/2008 to 6/2009: <0.1
 
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 9/8/2009 4:44 PM (GMT -6)   
David McGinnis (Bryn Mawr) did mine. He explained that back when he was doing laproscopic he had trained Dr. Lee and then when he went to robotic he had Lee sit in in his surgeries to give him advice. I figured that a doctor who was comfortable enough to ask his student to teach him was my kind of doc.
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 - now light pads

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