New York Times article on Robotic Assisted Prostate Surgery

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RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 2/14/2010 3:28 AM (GMT -6)   
The article is titled "Results Unproven, Robotic Surgery Wins Converts"
 
Here is the link:
 
 
Happy Valentine's Day to all.
 
RickyD
Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 2/14/2010 5:31 AM (GMT -6)   
Happy St Valentine's Day RickyD and the rest of the bunch at HW -

Very interesting article - and good balance - the main thing is - as stated in the article - it does not matter whether you choose the new robotic procedure or traditional open surgery - as with any surgery - it is the "Measures like the number of operations a surgeon has done “still matter a lot,"
as well as fine tuning that experience " .... say it takes about 200 to 300 robot-assisted operations to become highly proficient."

The question facing those making that life changing decision - which is the best doctor - which is the best hospital for post op care - how many procedures has he done successfully - (would you even know which ones are successful ?) - do you want to be part of the doctor's learning curve?

I am pleased with my choice - my doctor and my hospital.

chocolate / sappy cards hugs
BRONSON
.................
Age: 54 - gay - with spouse, Steve - 59
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis
location: Peteborough, Ontario, Canada
............


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 2/14/2010 9:47 AM (GMT -6)   
In any community, whenever there is change, there is resistance. I have a tough time arguing against my decision for DaVinci, but it is equally important to remain respectful of each of our decisions, as each is different.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6946
   Posted 2/14/2010 11:30 AM (GMT -6)   
My decision for DaVinci was really not driven by the method. The doctor now does only DaVinci. He has a doctor in the same practice who does only open. It was more the choice of the doctor, trusting in his choice of the tools he would use.

And I agree with one of the comments in the article - the outstanding results of a few people in surgery, regardless of type, lead us all to hope that when they pull that catheter, things will get back to normal fairly quickly, which is probably an unrealistic expectation. It certainly was for me. Many of us who are active on this board are part of the rest of the population for one reason or another.

mountain man
New Member


Date Joined Feb 2010
Total Posts : 10
   Posted 2/15/2010 12:14 PM (GMT -6)   
Once again the mainstream media misses the mark. The focus of the NYT article is about surgery type & costs, when the overiding considerations for any patient should be on SKILL and EXPERIENCE of the surgeons under consideration. That was, in fact, the theme if not the conclusion of the article published by Dr Hu last Oct (less than a wk before he performed my DaVinci RRP). Full text can be found at:
 
 
Of course determining experience is the easier of the two. Surgeons I interviewed all gave pretty specific and varied answers to how many RP's they'd performed, over how many years, etc. But they all answered the to me more critical skill question (i.e. cancer eradication) pretty similarly, something like "oh,.. in the 90%'s,... same as everybody else"). Vague at best.
 
Sure would be nice if there was a more objective way for prospective patients to determine success rates, but privacy issues stand in the way I guess.
 
Ralph 
 
      

DX age 56 
psa 4.0
biopsy Aug 09 gleason 3+3=6; T1C; 2 of 12 cores (40%/50%)
RRP 10/20/09, B&W/Faulkner Boston, Dr Jim Hu 
path report gleason 3+4=7; T2C NX MX; 1.9 cm & 10%
perineural invasion present
lymphatic invasion present
margins & seminal vesicles negative
lymph nodes not tested
post op psa 11/23/09 - 0.0!
no incontinence after cath removal (confidence pads for 1 wk)
ED complete so far (but some signs of life)


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 2/15/2010 12:20 PM (GMT -6)   
Law suits are the reason. It's all cma.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 2/15/2010 3:55 PM (GMT -6)   
 
 
Very interesting article since the doctor featured was my surgeon Dr. Patel.  I am happy with the surgery just not the recurrance of the cancer.  However, I am sure it was not the result of the surgery that some of the cells escaped.
 
Jerry1
Age 70
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  4+4 = 8 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
10/15/09 PSA 0.3
10/26/09 surgery to remove 3 clips in bladder neck  
11/16/09 PSA 0.3
12/14/09 PSA 0.4 
12/28/09 PSA 0.5
Start salvage radiation treatments on January 18th. 

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