Surgeon Question

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defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 12/1/2009 9:21 AM (GMT -6)   
I had my final meeting with my Urologist today to discuss options and test results. I found the size of my prostate was 30-32gms, which is in the normal range, and that my other tests were reviewed and found to be negative. I asked about the surgeons in the practice and found that their head doc does 2 robotics a week and has done so for 3 years. While I know there are a lot of questions I have to ask when I meet with him so I can feel comfotable with my eventual selection, I'd like to ask the forum if that is in a range where I should feel comfortable with his skill, his art, his talent?

This is especially important since I'm really (now) leaning to DaVinci. The long-term results seem to be the same as open, but with less invasiveness, less blood loss and less of a hospital stay. I'm also a believer in technology and am what they call an early adopter enjoying new gadgets. I think, as our knowledge progresses, that robotics will be the surgeroy of choice as Doctors continue to hone their skills and the precisison of the instruments progress. Five years from now robitics may be the sole surgical option.

I also have lots of personal frustration that the available information we use to base our decisions is dated. It all seems to be from 2004/05 and earlier, which means we don't have the best available information to base our decisions. The positives are that new studies seem to be coming out weekly that will aid all our journeys, especially those coming after us by 1-2 years.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 12/1/2009 9:43 AM (GMT -6)   

Not sure if there is a question in there somewhere? Are you asking if 2 a week times three years is enough to be a good surgeon?

If so - guess it would depend on how well those surgeries went shocked

To this day, I have no idea how many operation my surgeon has done. I basically went off my gut feelings and haven't looked back.


Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 12/1/2009 9:57 AM (GMT -6)   
"I asked about the surgeons in the practice and found that their head doc does 2 robotics a week and has done so for 3 years. While I know there are a lot of questions I have to ask when I meet with him so I can feel comfotable with my eventual selection, I'd like to ask the forum if that is in a range where I should feel comfortable with his skill, his art, his talent? "

that is the question

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/1/2009 10:02 AM (GMT -6)   
Sounds like you are good candidate to robotics. I don't agree with your remark about robotic being the sole choice within 5 years. I don't think that will be the case even in 20 years. Access by robotics have some limitations built in, based on body size and weight, size, shape, and depth of prostate bed. I for one ,couldn't have had robotic based on my prostate beds. Besides, there are so many surgeons that just aren't turning to robotics. There are surgeons that still strong advocate the tactile feel of having their hands on your insides in an open operation. My own surgeon, nearly 30 years experience, is of that school.

I have nothing against high tech in many areas of my life. But I don't think a surgical procedure should be based on one's interest or dedication to technology. You need to have the trust in the overall skill of the surgeon that is going to be operating on you, whether it be open or robotic. You only get one shot at the surgical path, and that surgeon better be the best you can access with the rescources you have at your disposal.

I agree, once you make your choice, stick to it, and never look back. Some of what we discuss in general here still has a subjective feel to it, and in the end, what you decide is right for you, is right for you. I think we all respect each other's personal choices in the end. I, for one, do whole heartedly.

Good luck to you as you narrow all this down to a choice.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 12/1/2009 11:54 AM (GMT -6)   

Dear Defender:

Shown below is a posting I did here about a year ago.  This was, of course, for open surgeries but I would expect that for DaVinci, the same sort of experience level might be needed...especially since there are significant new skills that DaVinci surgeons must develop.  So, based on the math, your surgeon might be at the low end of experience on this.

Equally important are the results that your doctor has delivered.  If he/she cannot show you their specific results on cancer cure, incontinence and ED, then I would be concerned.

The importance of surgeon's experience as it relates to prostate cancer outcome is underscored by the results of a study reported in the Journal of the National Cancer Institute (volume 99, page 1171).

Researchers analyzed the outcomes of 7,765 radical prostatectomies performed by 72 surgeons between January 1987 and December 2003 at four major academic medical centers. "Biochemical" recurrence was defined as a postsurgery PSA level greater than 0.4 ng/mL followed by a subsequent higher PSA level. The analysis took into account patient and tumor characteristics, such as pre-operative PSA level and Gleason grade. The men's PSA levels were measured every three to four months in the first year after surgery, twice in the second year, and annually during the following years.

The researchers found that surgical outcomes improved along with the number of radical prostatectomies a surgeon had performed, leveling off only after about 250 surgeries. The five-year probability of experiencing a recurrence of prostate cancer was 18% for surgeons who had performed only 10 operations compared with 11% for surgeons who had performed at least 250 surgeries.

Bottom line on prostate cancer surgery: The results suggest that you can improve your odds of a successful outcome from radical prostatectomy by taking time to find a surgeon with extensive experience.

Finally, I don't recall your other posts.  Hopefully you took the time to consult with a radiation oncologist and a prostate oncologist.  Your stats indicate that any of several treatments should cure your cancer...the big difference is in side effects and quality of life.

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 12/1/2009 12:30 PM (GMT -6)   
defender3:
 
You write: "I also have lots of personal frustration that the available information we use to base our decisions is dated.  It all seems to be from 2004/05 and earlier, which means we don't have the best available information to base our decisions.  The positives are that new studies seem to be coming out weekly that will aid all our journeys, especially those coming after us by 1-2 years."
 
That is precisely why I based my decision primarily on then current medical articles obtained from PubMed, not on books, websites, organizational position statements, or even the advice of doctors.  Scardino's book lent an air of quiet common sense to a highly stressful situation, but I spent almost three months reading the literature itself.
 
Zen9
 
 
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
 
 


defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 12/1/2009 5:47 PM (GMT -6)   
Purgatory - thanks for the response and thoughts. I have to agree that there will always be surgeons and should have clarified an openly general statement. I do believe tchnology will continue to provide enhancements allowing for more precision in the procedure. If so, then we may find that robot assisted could provide advancements that a surgeon cannot replicate. As an example, as we learn more about the linkage between inflamation of the nerves and incontinence/impotence, maybe a more precise instrument could lessen the effects.

Tudpock18 - Thanks for the reference, I'll look through your posts to learn more. I'm certainly going to ask more questions when I meet the surgeon next week (he does both open and robotic surgeries). I'm also arranging for a consultation with another surgeon in Richmond, recommended from this forum, who only does opens. I've pretty much settled on surgery without discussing options with an oncologist. My reasons are simple, my age and the ability to have multiple salvage options 10 years from now if something fails. If I was 65, my choice would be seeds in combination with external beam radiation. Drop me an e-mail if you like and we can converse more.

Zen9 - thanks for the referral to PubMed, I'll check it out. I've read 4 books so far, including Scardino's. I thnk I have the luxury of some time to continue research and consults since I'm not sure I want to be the guy having surgery around the holidays - I can hear the OR chatter now - hey, hurry up with this guy, we got a party to go to!

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 12/1/2009 6:23 PM (GMT -6)   
Defender:
 
Now that I read your journey, I recall that you are in NoVa.  I believe I previously gave you a name of an excellent urologist here if you were looking for someone...Dr. Walter O'Brien.
 
It sounds like you are convinced that robotic surgery is your choice.  If so, I can tell you that my research led me to Dr. Robert Mordkin of Washinton Urology...practicing in the Virginia Hospital Center.  Dr. Mordkin has years of robotic experience, will share his personal stats with you and is the one who has taught DaVinci to many of the NoVa docs who use it.  I "interviewed" him during my decision making process and would have chosen him had I decided to have surgery. 
 
One last plea however, that even the avid surgery guys here will recommend, is that you do more than read books and talk with surgeons.  You absolutely, positively should speak with a radiation oncologist and a prostate oncologist, even if you are pretty sure that surgery is your choice.  This is a HUGE decision...you only get to make it once.  The impact of that decision on your life can be immense.  So...I honestly recommend to anyone making a decision that they take the time to talk with different providers so that they are ultimately confident that they have done the homework and that the decision is right.  Personally, I spoke with multiple docs in multiple practices...including a telephone consult with docs in Jacksonville delivering PBT and docs in Toronto delivering HIFU.  In other words...do your homework...and make an informed decision.
 
Best of luck,
 
Tudpock
Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/1/2009 7:00 PM (GMT -6)   
I fully agree with what Bro. Tudpock just advised. We only get one chance to make our primary treatment choice. Even as a surgery guy (open), I feel that anyone contemplating treatment check out and address all avenues.

WIth your posted stats, and assuming you are healthy otherwise, you are fortunate to have more than one treatment choice, so, as advised, choose well.

We are with you, regardless.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 662
   Posted 12/1/2009 7:31 PM (GMT -6)   
Ok here is my take. A surgeon that has done 50 procedures may be superior at doing the procedure than a surgeon that has done 500 or 5000. Thinks about this...the person that did his first robotic surgery 1500 cases ago is actually using a new system with improved instrumentation that was not available during the first case. Just like everything technological rapid changes in process and instrumentation are always occurring. So all surgeons using new technology are always involved in the process of learning. In the big picture you need to choose the surgeon not the reported number of procedures completed. Watch closely when you visit with him/her. Think about that last statement! Watch Closely!!! The good news is that in modern US medicine, any individual performing frequent surgeries at a major medical center, you can be fairly confident, that this person is at a minimum performing at a level considered to be the standard of care. Because of the requirements of regulatory and accreditation organizations , ongoing and focus professional practice evaluations work well to protect the public. Do exceptions still exist working in hospitals, YES…but, for the most part any surgeon in good standing at a major medical center, and I like the younger ones say practicing only for the past 4-10 years, are most likely satisfying lots of quality evaluations. Warm and fuzzy does not a competent surgeon make. I want someone who looks very fit, has that quick eye, takes in all of me when visiting. The person that does not drop his ink pen, heck I want the surgeon that doesn’t even have an ink pen… she does all of the chart work via small laptop using fast coordinated fingers on the keyboard. I don’t want the person that has all kind of junk stuffed in pockets of the invariably stained lab coat. I want the surgeon that is smartly dressed when in the office, not covered in the standard hospital scrubs. Also I’m particularly interested in the usage of hand sanitizer or good old soap and water prior to and just after my exam. Practice observations can help tell a big story. On the other hand...bad things can happen when all the surgical team, with the best surgeon ever, does everything correctly.

Good Luck

Hero
Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. 75% of one core.
da Vinci at Wash U, Barnes on 11/02/09
Pathology Changed Gleason to 4 + 3 = 7. Gleason 7 present in all 4 quadrants
All(4)periprostatic Lymph Nodes Negative, All(10)pelvic Lymph Nodes negative
Seminal Vesicles tumor free. No prostate extension


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/1/2009 7:56 PM (GMT -6)   
Hero, the devil is always in the small details. I agree.
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 12/2/2009 7:15 AM (GMT -6)   
Greetings, Defender3.  It has been good to correspond with you by email - please let me know if there is ever anything else we can do down here in the capital of the confederecy.  Richmond has been my adopted home for almost 18 years now and has many excellent qualities - not the least of which is the best prostate cancer surgeon (at least in my opinion yeah ).  If you do decide to come to Richmond let me know and I'll buy you lunch!  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


defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 12/2/2009 12:17 PM (GMT -6)   
CPA - I'm actually trying to get a consult with your recommended Doctor now, as well as Dr. O'Brien and I'll look into Dr. Mordkin.

I appreciate all the kind thoughts and suggestions - this community is tops! I'll also start a separate thread on why I feel surgery is for me versus other treatments. I'm not closed to radiation, but there are too many factors telling me surgery is my better choice.
DX 3 Nov 2009, Age 52, PSA 8.7, Biopsy - 4/12 cores (2-20%), Gleason 3 + 3 = 6, T2b, Prostate 32gms, CT Negative, Bone Scan Negative
Winston the Wonder Dog (9yr old Golden) diagnosed with cancer Oct 09, surgery on the 26th and now home recovering. 
My PCa Journey Thread can be found here:  http://www.healingwell.com/community/default.aspx?f=35&m=1638070
 



Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 12/2/2009 11:07 PM (GMT -6)   
Let your "gut feeling" be your guide. Follow your instincts, because there's no way you can digest the wide variety of opinions and data that's available.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0

 


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 12/3/2009 5:33 AM (GMT -6)   

As mentioned in my email, Dr. Bokinsky is an excellent choice. He has done over 1000 surgeries.

I spent the night in the hospital, had the catheter out in 8 days, was continent immediately and have had no ED problems and was back to work in 10 days. Thats no guarantee for you as each person is different but I do recommend him.


62yo
V10.46 Dx Feb-09
RRP 5-5-09
No adverse SE
PSA 6-19-09 -0-
PSA 9-21-09 -0-
 
Thriving, not just surviving!
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/3/2009 9:03 AM (GMT -6)   
For you golfers, does a golfer who has played 1000 rounds of golf have a good chance of playing in the PGA ? Don't we see the pros tank on a weekly basis ?

While I agree experience is very important, aptitude and skill is maybe more important. Some doctors keep tally of their results, which casue some to accuse them of only accepting prime candidates.

I think Steve in Dallas may be closer to the truth in some ways, as unscientific as it seems. Part of what made me feel good about my surgeon, besides being a leading surgeon at a major cancer center, was how he interacted with my wife and I, how he talked about the surgical process, and his quiet confidence that he could do it. I never thought about another opinion after talking to him. I was confident that he was going get a "hole -in- one".
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 12/3/2009 11:42 AM (GMT -6)   
Defender:
 
Further to the point re "experience", here is a quote from an article in USA Today:
 
Indeed, one of the country's most experienced prostate surgeons, Joseph Smith of Vanderbilt University Medical Center, wrote in a 2005 paper that it took him 150 robotic surgeries to achieve the same results as in traditional prostate removal. Smith, who has performed more than 2,500 traditional prostate surgeries and 1,500 robotic ones, says he now uses a robot for about 90% of his procedures.
 
Since I'm not a surgeon, I can't say whether he is right or wrong, but I can tell you that his quote is not unlike what I have read from other surgeons...in fact, some of them say it takes "hundreds" of robotic procedures to be as proficient as their open surgeries.
 
Also, while I would have personally chosen robotic if I had chosen surgery, it is probably worth reading the link that squirm posted entitled "New Quest Article by Dr. Catalona".  In this article, Catalona pretty much trashes robotic surgery with some logical points.  Again, I'm not saying he is right or wrong...just pointing this out so you can be prepared with questions when you discuss robotic surgery...  Also, BTW, in another article in this same issue, Catalona also lays the wood to "Active Surveillance"...
 
Finally, a couple of responses on this thread have indicted their experiences/choices as non data driven, e.g. looking for smartly dressed, meeting minimum standards or not looking at alternatives because the first discussion provided a good interaction.  If this approach worked for these guys, I'm happy for them...every one of us is different.  But, personally I'm more data driven...I want to know how many they have performed and what their specific results have been.  I'm happy to choose from my gut...but only after my brain has been engaged to get properly educated.
 
Tudpock
Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 12/3/2009 12:36 PM (GMT -6)   
Tud - I've read so much my head is spinning! Really though, I've read the Catalona articles and find them helpful, only if because they are updates to older studies or new information. I'm still leaning towards surgery and will be meeting with at least three surgeons over the next couple of weeks. Two were recommend by people from the forum and the third is the head of the Urology Practice where I'm currently being treated. I'm also hearing what everyone is saying and I do agree that I could have a consult with the "best" surgeon, but if he doesn't connect with the wife and I, then I'm moving on.

Mbshine
Regular Member


Date Joined Aug 2008
Total Posts : 67
   Posted 12/5/2009 9:43 AM (GMT -6)   
I asked my primary care physician, my urologist, and six other former physicians from other cities or social friends who are MD's

"Given my situation if YOU were the patient, where would you go and what would you do?"

This is not an advertisement, and I am not on their payroll, but this is the straight dope.

Seven of the eight said they would get their prostate removed surgical at Memorial Sloan Kettering Cancer Center in New York. One of the respondents was a department head and administrator for a branch of Johns Hopkins. the 8th said he would go to MD Anderson in Houston "but, maybe if time and travel in my schedule permitted, I would go to New York to Sloan Kettering. One respondent was outside the US, the rest were in New Mexico, California, and Florida.

Not being a doctor, I don't know what else I might have done differently. I chose medical professionals who I trusted and hoped I had evaluated correctly. They all paused, reflected, and I think gave me thought responses. In every city there are "doctors' doctors" the guys and gals the docs send their own kids and spouses to....this is the only barometer I can offer you.

Best of luck!

mbshine


prostate removed 10 19 09
good prognosis
age 62

( I am abbreviating the bio because the more I learn the more I add, and the basic
thing is I caught it early, made the personal decision to not wait more than a year or so;
went on hormones for 13 months while I had bariatric surgery and lost 70 pounds as a condition for laproscopic surgery and/or Davinci...I have no idea what goes on in the OR...I woke up with no prostate and the pathology report was good.
back to about 85% of activities and strength after surgery)
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