Experience with treatment centers in Seattle?

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AKRoamer
New Member


Date Joined Nov 2008
Total Posts : 15
   Posted 9/2/2009 3:58 PM (GMT -6)   
Hello-
 
Let me start by saying I have not been diagnosed with PCa.  Hoping that will not happen, but trying to cover my bases.  I live in Southeast Alaska (Ketchikan), we do not have a urologist here.  I have to travel to Seattle for appointments.  I've been seeing Dr. Corman at Virginia Mason since my elevated PSA was picked up on a routine physical last summer.  Started with him because it was the first place that could get me in for a biopsy when I needed it, but have felt very comfortable with his experience.
 
I was hoping anyone who had treatment in the Seattle area could share their pros and cons.  I suppose the big 3 places would be UW Med Center (and its relationship with the Fred Hutch center), Swedish Hospital, and Virginia Mason Hospital.  Because of the expense when I have to travel for a urology appt- airfare, hotel, etc- I feel like each appt is sort of like an interview to see if this is a place I would seek PCa treatment, if needed. 
 
I'm due to see the urologist again in December, with a PSA test 2 weeks before that visit. 
 
I've been lurking on this site for a year, picked up a lot of information from it.  Thank you to anyone who would care to respond.
 
Dan
Age 49
PSA 6/2003 1.5
PSA 7/2/2008 4.8, % free PSA 8
PSA 7/14/2008 5.2, % free PSA 8
3 weeks Levaquin
PSA 9/2008 5.8, % free PSA 7
Biopsy 10/08 10-core all neg, no sign of PCa, told prostate was enlarged
PSA 12/2008 5.2, % free PSA 7
PSA 2/2009 4.7, % free PSA 8
PSA 5/2009 5.2, % free PSA 8
Biopsy 6/2009 12-core all neg, no sign of PCa, prostate "slightly enlarged".


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/2/2009 4:20 PM (GMT -6)   
Welcome to HW! Sorry that you have to be here, but hope we can help. I actually live in Seattle and did the research for my father who had his RP done at Virginia Mason in Seattle by Dr. Chris Porter. As a family, along with a few medical opinions, we decided to go with the Da Vinci RP for my father. We thought this would be his best chance for cure based on his stats. My father was extremely pleased with Dr. Porter and the entire team at Virginia Mason. My father is located out of state, similar to yourself and we had no problem, getting records faxed and mailed over for medical opinions by the VM team. In addition, Dr. Porter discussed treatment over the phone as a phone consult and we had all his pre-op appts scheduled a couple of days before his actual surgery. They were fabulous about getting things scheduled to meet our needs. I have heard amazing things about Dr. Corman as well. I believe he was voted one of the top Seattle docs for 2009.
If you decided to go the seed implant route, we have the pioneers of seed implantation in Seattle. Dr's Grimm, Blasko and Sylvester started seed implants and have trained doctors from all over the world. If might be worth your time to meet with one of them while you are down here. Hope that helps! Let me know if I can answer any additional questions!
Father's Age DX 62 (now 64)
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 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 9/2/2009 4:28 PM (GMT -6)   
The best diagnotician anywhere is Stephen Strum in Ashland Ore. Most urologists are not very good at diagnosing PC; just look at my signiture, it took 10 years 5 urologists and even then the DX was wrong.
If you are willing to travel to Seattle then go to Ore and see the best. Pick up his book "A Primer on Prostate Cancer"
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


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/2/2009 4:36 PM (GMT -6)   
Hey John! I agree Strum is fabulous. Were you able to get in to see him? He lives about 30 minutes from my parents and when I called a couple of years ago the waiting list was long and he was only treating a very limited number of patients at the time.
Father's Age DX 62 (now 64)
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 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 9/2/2009 6:17 PM (GMT -6)   
I go to The Cancer Treatment Center of America in Zion IL and I think they are awesome. They have a center in Seattle. Might be worth checking into.

peace to you
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) 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 .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 9/2/2009 8:41 PM (GMT -6)   
doting daughter,

I didn't find out about Strum until I was well into my research and read a lot of his papers then his book. I wish I had know about him 10 years ago. While I was searching for a robotic surgeon my wife's oncologist heard about it and told her before I did anything I should get a 2nd opinion from Dr Sholtz, Strum's ex partner, and set up an appointment for me. The rest is history as you can see by my signiture.
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 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


Amy41
Regular Member


Date Joined Jan 2009
Total Posts : 30
   Posted 9/3/2009 1:08 PM (GMT -6)   
My husband is being treated at SCCA - which is connected to Fred Hutch and the UWMC so all in one boat.  We have been treated very well - though his case is much different then yours they have been great with us in terms of working with our schedules- surprises me that Juneau would not have a decent facility for your regular appointments but maybe travel to Seattle for surgery etc.

rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 9/3/2009 7:47 PM (GMT -6)   
My brother had the seed implants at seattle prostate (I believe that is the Swedish hospital). He was very happy with them.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


AKRoamer
New Member


Date Joined Nov 2008
Total Posts : 15
   Posted 9/5/2009 7:01 PM (GMT -6)   
Thank you to those that replied.  I'm not trying to put the cart before the horse, since I have not been diagnosed with PCA. I always hope for the best but try to prepare for the worst.  Traveling "down South" for appointments complicates things.  My low % free PSA really bugs me, the urologist says my PSA is definitely too high for age and pprostate size.  He had me on a course of antibiotics before biopsy #1 and ibuprofin before biopsy #2, my PSA actually increased a little after each med. 
 
Doting Daughter- thanks for the information on your Dad's experience at Virginia Mason.  I've been pretty impressed there so far. I know they see a lot of patients each day but I've never felt like it was an assembly line at my appts.  The Doc has been good, and the nurses' level of experience and professionalism makes an unpleasant experience a lot more tolerable.  I hope your Dad continues to improve.
 
John T-  I read Dr. Strum's book recently, I think I learned more from it than any other book I've read on the subject.  Should things go south and a biopsy comes back positive, I'll definitely do my best to get an appt with Dr. Strum.  I have relatives in Grants Pass, about 50 miles from Ashland.  I've followed your posts for awhile, they have opened my eyes to thinking that you have to be responsible for getting as much info as possible on your particular situation to make an informed decision and not rely on general categories a doctor may put you in.  This is a little off the subject, but as I recall did you have your IMRT study and plan done in Seattle and your actual IMRT sessions at a different location?  I've always wondered if that is an option for people.
 
Amy 41- thanks for sharing the info about your experience with SCCA.  In my case, both Ketchikan and Juneau are served by traveling urologists that come up from the Puget Sound area for about 3 days each month.  I found you usually see a different one each appt, and they enter the room reading your chart for the first time.  I had my first biopsy scheduled with one in Ketchikan last fall, at the appt I was told their dinosaur of an ultrasound was broken and they were not planning to fix it.  The urologist offered to do a finger-guided biopsy but I said no thanks.  A half-hour office visit with the traveling urologist was running $475, when I see the doc at Virginia Mason it runs $160 (No prefered providers here or Juneau).  My insurance picks up the cost for it, although I pay a lot out of pocket for the expense of traveling to Seattle I feel I get better treatment.  I know that SCCA - Fred Hutch Center has produced some amazing miracles in the treatment of other cancers, things that are considered routine treatments now.  Here's hoping that tomorrow's advancement will be just what your husband needs.
 
Dan
 

Age 49
PSA 6/2003 1.5
PSA 7/2/2008 4.8, % free PSA 8
PSA 7/14/2008 5.2, % free PSA 8
3 weeks Levaquin
PSA 9/2008 5.8, % free PSA 7
Biopsy 10/08 10-core all neg, no sign of PCa, told prostate was enlarged
PSA 12/2008 5.2, % free PSA 7
PSA 2/2009 4.7, % free PSA 8
PSA 5/2009 5.2, % free PSA 8
Biopsy 6/2009 12-core all neg, no sign of PCa, prostate "slightly enlarged".


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 9/5/2009 7:30 PM (GMT -6)   

AKroamer,

I had my CT scan and ultrasound for planning done locally and the scan was sent to Seattle to a physicist who did both the seed and the IMRT plan. The treatments were done locally.

Best of luck on you next biopsy. You are doing the right thing by taking control of your own situation and seeking out the best doctors.

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 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

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