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Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 11/13/2009 5:57 PM (GMT -6)   
I have been lurking for a while - this is a great place.
 
Diagnosed in Sept 09 at age 54 Gleason 6 Psa 1.3 
 
As much as I tried to talk myself into other treatments, I have decided on Robotic Surgery
 
I have been to Thomas Jefferson - Dr Lallas, Fox Chase - Dr Greenberg and UP - Dr Lee.  Have tentaively decided on Dr Lee for mid January.
 
Looking for comments from anyone that has experience with any of these doctors or hospitals.
 
Thanks - 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/13/2009 6:14 PM (GMT -6)   
Hello and welcome to HW. Sorry you need to be here, but glad you found your way. With your PSA so low and having a Gleason 6 at this point, you should have a full range of options before you. Where do you live, you mention Doctors by name, but not sure where you are at.

Please keep us posted, and if you can, go to the Control Panel and set up a signature of yourself, makes it easier for people to see and understand your situation.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/13/2009 6:48 PM (GMT -6)   
We don't have the details of all your stats (pathology report details), but based upon what you mentioned you probably don't need to rush into anything.  PCa usually takes years and decades to get to the point where it may be found or detectable, autopsies done on younger folk(30's-40's) found them with PCa (studies) say, and it would be usually indolent or low risk territory on those findings, PCa could change over time and become more viralent,but not always. Patients in your risk area have time to decide.
 
Are you aware of the definition of 'indolent PCa' ? Maybe surveilance is a real option?
Maybe there are other options and choices?
Did you have your pathology reviewed by some of the few experts?
Did you see an onco-doc for possible opinion?
 
Are you prepared to accept all the risks that come with surgery? What about postphoning it for perhaps years, and do other drug protocols or options, whereby you can remain continent and not have e.d.(long term) and maybe even keep manhood intact?
 
My brother got diagnosed with similar looking stats about 5-6 yrs. ago now, he has done nothing thus far, no problems, no psa rises, has healthy diet and lifestyle. He will have to decide when and if on his own case.  
 
Good luck to you in whatever way you go, alot roads lead to Rome.
 
 

engineer55
Regular Member


Date Joined May 2009
Total Posts : 121
   Posted 11/13/2009 7:39 PM (GMT -6)   
Just to give a different perspective, I did the WW for a year but it wasn't all that pleasant with the doctors visits, avodart and not real good on the friends and family. Pretty happy to have it out and over with at this point.

But I totally agree there is no rush, and no need to be worried at all, you have several options.
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 11/13/2009 9:31 PM (GMT -6)   
Thanks for all the responses so far.  One of the key decesion makers is that the stage is T2b.  The biopsy was done by the urologist because he felt firmness on the right side.  The biopsy slides were also reviewed by Thomas Jefferson when I went there. 
 
I really did not lean toward surgery initially but even the radiologist at Jeff leaned toward surgery given my age and likelihood for a long term sure from surgery.  The fact that secondary cancers have a higher likelihood from developing from radiation treatment 15-20 years out worries me.  It may be presumptive on my part but I plan to be living 30 years from now - my dad is 88 and going strong.  He was diagnosed with prostate cancer 4 years ago but went the shot route given his age.
 
Does anyone know where I see some info posted about the hospitals and docs from actual patients?  I remember stumbling upon a post - I thought in this forum - with a lot of posts about Dr Lee.
 
Thanks and best of luck to us all
 
Ray

jxmuldoon
Regular Member


Date Joined Nov 2009
Total Posts : 43
   Posted 11/13/2009 9:51 PM (GMT -6)   
I live in philly and have been thinking of some of the same options. Dr. Greenberg seems llike a great guy, a seasoned vet. Dr. Lee is younger but with more davinci experience. Why are you leaning toward Dr. Lee? Lee has done 1800 davincis, Greenberg just a few hundred, but Greenberg has more surgicial experience generally, and has done more than enough davincis.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 11/13/2009 9:52 PM (GMT -6)   
Ray, I am glad you found us. You are making in informed decision. Best of luck to you. If you have any questions do not hesitate to ask. We have all been there.

Keep us informed.

Might recommend that you make a e-mail address with Healing Well for members to contact you and you can contact them as well.

Jeff T
Cajun Country
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 11/13/2009 10:09 PM (GMT -6)   

Hey Ray.....

Finally somebody from my neck of the woods, although I'd rather not see anybody have to be here....I had Davinci by Dr. Lee in 1/09. First class operation all the way, and have had good results so far as you can see from my signature block. My treating urologist had limited robotic experience, but trained under Lee. To his credit, my uro recommended Lee as a second opinion, as well as Dr. McGuiness at Bryn Mawr Urology. I could have gone with either Lee or McGuiness, but I chose Lee once I decided that surgery was my treatment of choice.. I also consulted with a brachytherapist, and an oncologist who had no dog in the race. Rather, he validated my decision-making process. I was told by all doctors that I had a good 6 months from diagnosis to research and make up my mind. Again, very pleased with my treatment, and the staff at HUP was top-notch....hope this helps somewhat, and I'd be happy to answer any questions or further concerns if I can.

Arnie in DE

 

 

 


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


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 11/13/2009 10:28 PM (GMT -6)   
Hi Ray:

#1. Get your slides reread. I did and a second pathologist looking at the same slides had a different read. It made a difference to my treatment choice. And, if you get back to pathologists agreeing you're a Gleason 6, then that's really good news and can give you confidence in taking the time to decide on treatment.

#2. Your PSA is very low. Mine was 1.5. Apparently, sometimes this can signal a more aggressive tumor than the Gleason score might indicate. I suggest you ask the doctors you visit about this.

I'll look forward to future reports,

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 11/13/2009 11:34 PM (GMT -6)   
jxmuldoon
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I live in philly and have been thinking of some of the same options. Dr. Greenberg seems llike a great guy, a seasoned vet. Dr. Lee is younger but with more davinci experience. Why are you leaning toward Dr. Lee? Lee has done 1800 davincis, Greenberg just a few hundred, but Greenberg has more surgicial experience generally, and has done more than enough davincis.

 

I think it was a gut feeling about Dr Lee and UP most of all .I liked Dr Greenberg as well and also liked Dr Lallas at Jeff.  I think any of them (based upon my meeting with them)  would be a good choice.   Ive heard good things about Dr Lee but have not found anyone that has used the other two docs although I have heard good things about Fox Chase and Thomas Jefferson.  I was able to get the exact timeframe I wanted for the surgery from the guy with the most experience.  Plus with Dr Lee's experience , it looks like he has the time for the surgery down to what a traditional open surgery takes (2 - 3 hrs) . 

 

Good luck - please let me know what you decide


diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/10 at UP with Dr David Lee
 
 


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 11/13/2009 11:41 PM (GMT -6)   
Hi Arnie
 
Thanks for the info - I will definently be in touch -
 
Ray
diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/10 at UP with Dr David Lee
 
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 11/14/2009 8:58 AM (GMT -6)   
You're welcome, Ray...........Sleepless has a good point re: second opinion on the biopsy slides
Mine were read locally, (Delaware), but at my request, my uro got a second opinion from Johns Hopkins........ask any and all questions of Lee; he took all the time I needed to answer questions, as did his physician's assistant, Rachel. I'll shoot you an email if you want to correspond privately, although if any of the info is beneficial to others on the forum, we should share it. I, too, was a weed-lurker here at HW before jumping in; although I discovered HW post-treatment, it has been a big help to me in my recovery phase.
 
Arnie in DE
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


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 11/14/2009 9:13 AM (GMT -6)   
My urologist/surgeon recommended Dr. Lee for a secon opinion when I was diagnosed. He is considered one of the best according to my doc. I thnk you can feel confident in Dr. Lee. If my doc (Dr. Alnert Ruenes, Doylestown) says he good, then he's good. I have a great doctor and have the highest confidence in him and his team.
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 11/14/2009 9:15 AM (GMT -6)   
That is Albert Ruenes, Doylestown, PA
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/14/2009 8:25 PM (GMT -6)   
In the Philadelphia area Dr Lee is clearly one of the top docs in terms of reputation and experience. There are other surgeons in the area who are in the same class, but you have made a good choice. Now look ahead rather than looking back. Diet and exercise, positive attitude. We will look for you on the other side
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
6 mo. PSA 0.00 -- 1 light pad/day


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 11/16/2009 7:10 AM (GMT -6)   
Thanks everyone - will keep you posted
diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/10 at UP with Dr David Lee
 
 

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