Has anyone done surgery in Asia, Australia, or Europe?

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KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/19/2010 10:23 AM (GMT -6)   
This is an offshoot of my earlier post “How much does prostate surgery cost in the US?”

I am a 52 year-old American working in Japan, just diagnosed with prostate cancer. I am trying to explore all of my options. I live in Asia and have insurance that will reimburse me anywhere in the world except, in the US. I have not been able to find the surgeon that I want in Japan.

Has anybody had surgery done by, or do you know of, a surgeon outside of the US that has a good reputation and LOTS of experience doing either open or robotic assisted surgery?

Any suggestions, or ideas about locating such a surgeon and arranging such a surgery would be more than welcome.

Thanks.

KJN

PSA 6; Gleason score 6, pattern 3+3

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/19/2010 4:24 PM (GMT -6)   
Brother colin45 had open surgery in Thailand and seems to have done so well that he is seldom seen here -- you might see if his email is available.
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


Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 1/19/2010 4:44 PM (GMT -6)   
I had my surgery done in Sydney, Australia, by Prof Phillip Stricker, he is one of the best we have got they tell me, I am certainly very happy with my results.  Please check out the link below
 
 
 
Kev
Age 51yrs
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week. ED- okay with Meds.
PSA at 12mths no change remains 0.03
"Everyday in Everyway I get better"


maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 1/20/2010 12:14 AM (GMT -6)   
My surgeon here in Perth Western Australia, was MR Jes Judge, a most skillful and caring Urologist, 95% of his patients are continent from catheter removal day one, as I am.

Good luck with your plans.

Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd August 09 0.6
PSA 25th November 0.6 (I am now 69)
PSA 18th Jan 09 0.6


brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 1/20/2010 7:34 AM (GMT -6)   
I am 6 months SPO from RALRP in Luzern, Switzerland. My doc had 300 and counting under his belt. You can see below my results. I expected 35-40K as a bill for all. It was less than half that.
70 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0. Doubled from 3.5 to 7.0 in one year.
Neg. CT and Bone Scan
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. A. Mattei in the Kantonsspital. New Gleason was 4+4=8
pT2c G3 pN0 (0/14)
Catheter out in 5 days (home in 3 days)
No incontinence
Positional neurpraxia in hip and knee resolved 90+% in 5 months.
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO. Nearly usable one month later. At 5 mo. with 100 mg Vitamin V, pretty good. Now beginning 5 mg Cialis daily.
3month PSA less than 0.01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/20/2010 9:55 AM (GMT -6)   
We have a brother here under the name of Collin, who lives in Thailand, and had his surgery done there with great sucess so far, perhaps he will see your post and respond.
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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 1/20/2010 10:38 AM (GMT -6)   
Hi David I have already given all the details that I have about Thailand in an earlier post

I have also been watching your continued problem and hope they soon come to an end Colin
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/09 24 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/20/2010 10:52 AM (GMT -6)   
Thank you Colin, I knew you had a good experience with your surgery
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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 1/20/2010 5:20 PM (GMT -6)   
The Sydney surgeon suggested by "NotHard" has a very good reputation in Australia. I had another in the same practice do mine (Dr. Raji Kooner). He also has an excellent reputation (bit of a show pony though). These are the two robotic guys that I know of in Sydney. Prof Tony Costello in Melbourne also has a very good reputation and was a pioneer of robotic surgery in Australia. But there are numerous other first class treatment facilities (St George in Sydney for example). As well as the usual treatments Cryotherapy and HIFU are available at some hospitals.
Bill

KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/22/2010 6:11 AM (GMT -6)   
Thanks for all the input. I have been looking them up on the internet. It seems there are many good choices out there. Now, the trick is to narrow it down and try to organize the logistics. I'll let you know how it goes. Still open to any other suggestions.

KJN

skippy_1954
New Member


Date Joined Jan 2010
Total Posts : 6
   Posted 1/22/2010 6:47 AM (GMT -6)   
I'll second NotHard in recommending Prof Phillip Stricker of the St Vincents Prostate Cancer Centre in Sydney.
As to the cost, my own open prostatectomy in Nov 2007, done entirely as a private patient, had an all-inclusive cost of approx. AUD 24,000 (USD 21,500) of which my Australian private health insurers have refunded about two thirds.

___________
Skippy_1954 (Australia)
age at dx 53,
PSA at dx 6.0,
biopsy, Aug 2007: T2aNxMx Gleason 7 (3+4)
open RRP + PLND 01Nov2007, both bundles spared,
post-op pathology pT2aN0Mx, Gl.7 (3+4), margins negative, no perineural involvement, lymph nodes clean.
PSA since surgery undetectable (below 0.04).
Continence back to 100% of pre-op state within 2 mths of surgery;
potency initially nil, 30% at 12 months, 50% at 24 months with regular tadalafil + sildenafil before practical attempts.

creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 1/22/2010 5:04 PM (GMT -6)   
KJN, We had Prof Stricker in Australia as well - he saved my hubby's life, continence and sexual function at the time. He did the open with my hubby but also offers robotic. If you email him with your stats on the website Kev suggested, he will probably reply personally with a comment or suggestions. cheers and good luck.
Creed_three (Lana) - with husband "CJ" now aged 52 yrs (49 years at diagnosis).
PSA (2002) 2.1. (2006) 3.5.  1 x 5% core of 12 positive at biopsy. Open Radical Prostatectomy with nerve sparing April 2007 Sydney, Australia. Gleeson 3 + 4 = 7. 2 small multifocal lesions. Contained. Undetectable <.1 PSA since: June 2007-0.01, Oct 2007-0.02, April 2008-0.02: Oct 2008-0.03, Nov, 2008-0.02, April 2009-0.03. Next PSA April 2010.


KJN
New Member


Date Joined Jan 2010
Total Posts : 11
   Posted 1/24/2010 4:39 AM (GMT -6)   
Thanks. Dr. Stricker sounds interesting. I looked at his website. I am waiting for a second opinion on my slides from the States, then I will send him my information through his website. Going to an unfamiliar country to have surgery would be a challenge, but worth it for a good surgeon.

skippy_1954
New Member


Date Joined Jan 2010
Total Posts : 6
   Posted 1/24/2010 8:56 AM (GMT -6)   
Unfamiliar it might be, but you'll find Australia much easier to adapt to than Japan.
Not only on account of it being an English speaking country, but also due to a close similarity of lifestyles and attitudes to those seen in the US.
Skippy_1954 (Australia)
age at dx 53,
PSA at dx 6.0,
biopsy, Aug 2007: T2aNxMx Gleason 7 (3+4)
open RRP + PLND 01Nov2007, both bundles spared,
post-op pathology pT2aN0Mx, Gl.7 (3+4), margins negative, no perineural involvement, lymph nodes clean.
PSA since surgery undetectable (below 0.04).
Continence back to 100% of pre-op state within 2 mths of surgery;
potency initially nil, 30% at 12 months, 50% at 24 months with regular tadalafil + sildenafil before practical attempts.

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