Any Experience with Penn Presbyterian Med Center?

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Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 4/2/2010 7:54 AM (GMT -6)   
I'm still researching what to do for primary treatment, but I'm leaning towards robotic assisted surgery. My next consult is with Dr. David Lee at Penn Presbyterian Med Center in Philly. I think I recall seeing some posts from some people who had surgery there and was wondering if there were any insights I could get and how their experience was.
Bill
Age 52, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 4/2/2010 8:19 AM (GMT -6)   
Hi Bill..........I'm one of those guys. Burlcodad & Positional are two others that I know of on this forum who had surgery with Lee at HUP. You can look at my signature and see where I am stat-wise. Lee is very personable and will take his time with any/all questions. His skill level is exceptional with the Robot. I'm extrememly pleased with my outcome. My care at Presbyterian Med. Ctr. was top-notch. He was not the only surgeon or other treatment specialist I consulted, but in the end, I felt he was the best guy for the job. I don't know if you have checked out other opinions with other forms of treatment, but you should. If you have, and are still convinced that Robotic surgery is the way to go, you're in great hands with Lee. If you have any specific questions, fire away, and we will try to answer. Keep us posted.
 
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, NO MX, 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......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 4/2/2010 10:02 AM (GMT -6)   
Hi Bill
 
As Arnie said, Dr Lee did my surgery about 10 weeks ago.  I was very pleased with him and the care I received  at Penn Presbyterian.  I also looked at Thomas Jefferson and Fox Chase but in the end went with Dr Lee because of his reputation, experience and gut feeling after meeting him.  The operation was truly painless for me and the recovery was unbelievably quick. I was out of the hospital within 20 hours of the completion of the operation and the catheter was out in six days.   I was back to work (desk job) in two weeks. I experienced the usual incontinence and ED side effects but the incontinence is just about gone and the ED is making strides.   Most importantly I got a really good post op pathology report. 
 
There are many options available to someone your age. You need to decide what is best for you.  I started out wanting anything but surgery but in the end after several second opinions and a lot of reading decided that surgery was best for me.  I felt overwhelmed when trying to decide but felt a sense of calm when I reached a decesion. 
 
Good luck. Please feel free to email me with any questions.
 
Ray
Diagnosed 9/09 at age 54  
PSA 6/09 1.3
Stage 2b (biopsy done because of firmness felt on right side) 3 positive cores out of 12 (all less than 25%) Gleason 6
 
Surgery  1/13/10 at UP- Penn Presbyterian - Dr David Lee. Home 1/14/10 Nerves spared on both sides -Catheter removed 1/19/10  Path report scheduled for 2/11/10
 
Pathology Report Gleason score was upgraded to 7 (3+4)
no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, gland involvement 2-10%
 
Since report was good and recovery going well next appt is now  the first psa test appt scheduled for 4/22
 
Incontinence - Initial 6 pads a day, 3 Weeks - 3 pads a day relatively dry at night
 
ED - yes but seeing some improvements - levitra 10 mg 2x week
 
 


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 4/2/2010 1:07 PM (GMT -6)   
Thanks to both of you for the feedback. I'm still reading about other options, mainly brachytherapy, but I'm not sure I want a treatment that might limit future options. The surgery seems like it still leaves radiation as a follow-up, if necessary.
 
I'm glad to hear of the positive results regarding the PSA levels. That's my main concern. I'm of course also concerned about the side effects of surgery since those seem to last longer than with other forms of treatment.
 
Are you both finding the length of recovery from incontinence and ED to be similar to others?
Bill
Age 52, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 4/2/2010 6:06 PM (GMT -6)   
Im not sure  how my recovery compares to others but I will say I am well ahead of where I thought I would be at ten weeks. 
 
Im down to leaks and squirts with one or no pads depending upon the day's activities.  I am also seeing good progress on the ED front as well.
 
Good luck with your research and thought process.  There are a lot of extremely kind and generous folks that have helped me tremendously.  Please dont hesitate to ask questions here or feel free to email me if you like. 
 
Ray
 
 
Diagnosed 9/09 at age 54  
PSA 6/09 1.3
Stage 2b (biopsy done because of firmness felt on right side) 3 positive cores out of 12 (all less than 25%) Gleason 6
 
Surgery  1/13/10 at UP- Penn Presbyterian - Dr David Lee. Home 1/14/10 Nerves spared on both sides -Catheter removed 1/19/10  Path report scheduled for 2/11/10
 
Pathology Report Gleason score was upgraded to 7 (3+4)
no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, gland involvement 2-10%
 
Since report was good and recovery going well next appt is now  the first psa test appt scheduled for 4/22
 
Incontinence - Initial 6 pads a day, 3 Weeks - 3 pads a day relatively dry at night
 
ED - yes but seeing some improvements - levitra 10 mg 2x week
 
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 4/3/2010 8:40 AM (GMT -6)   
Hey Bill...........recovery on incontinence and ED fronts are individual things and can vary due to so many factors. My incontinence cleared up faster than I anticipated, and although I let go of pads at 3 months, I could have a little earlier. ED is coming along and is not linear in improvement. But it is gradually improving, and I guess I'm blessed with some patience, so I continue with pills and pump and hope for a return to as close as before as I can get. BTW, where are you from? Obviously, within striking distance of Philly in the mid-atlantic region.----Take care, Arnie

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, NO MX, 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......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1


positional
Regular Member


Date Joined Jan 2010
Total Posts : 25
   Posted 4/3/2010 9:12 AM (GMT -6)   
Hi Bill,
 
I have to join Ray & Arnie in praising Dr. Lee for his efforts.
 
He's very experienced and takes extra steps which, in my opinion, is a sign of an experienced and caring doctor. You can see from my signature that I have an extracapsular extension. Dr . Lee assured me he cut more tissue around the prostate during surgery just for a possibility of the case like mine.    
 
Initially, I was going to perform HIFU procedure, but, since my prostate had too much calcium, there was a danger ultrasound wouldn't be ablt to get through to the cancerous cells. I ended up with surgery and, so far, don't have ant regrets. 
 
I'm two months after surgery and, except for ED, everything is pretty much back to normal.
 
Take care,
 
Mark
 
 
Age - 54
Diagnosed - 09/2009

Gleason - 3+3

PSA - 6.7

4 out of 12 cores positive on the left side

MRI shows none on the left side and "cancerous" issues on the right side

RRP on 02/03 with Dr. Lee in Philly

One night stay, nerves bundles are preserved on both sides.

After catherer removed - 90% continent

Pathology report:

Prostate - 66g

Capsular involvement: Into but not through capsule.

Seminal vesicle invasion: None

Positive margins: None

Gleason score - 3+4=7

Extracapsular extension: Yes, right anterior aspect, 27 and 33 mm from apex (blocks 1GG and 100)


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 4/5/2010 3:27 PM (GMT -6)   
Thanks to all of you again for the assurances about Dr. Lee. I can't get my consult with him until the end of the month, but I guess that's still not too far out. I see the Radiation Oncologist tomorrow, the Medical Oncologist next Thu, and I have an additional consult with a Dr. Schaeffer at Johns Hopkins just to get another opinion from someone at another facility.
 
Arnie,
I live in Westampton, right near Mt. Holly.
Bill
Age 52, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 4/5/2010 6:12 PM (GMT -6)   

Good for you, Bill..........I too consulted a medical oncologist, just for a "center field" point of view. Also saw brachytherapist and another robotic surgeon in Philly before deciding on Lee. Gather all the info and opinions, bounce it off of us here at HW, and then make the decision that's right for you.

Arnie


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, NO MX, 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......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 4/6/2010 10:26 AM (GMT -6)   
Small world Bill - I live in Lumberton

Diagnosed 9/09 at age 54  
PSA 6/09 1.3
Stage 2b (biopsy done because of firmness felt on right side) 3 positive cores out of 12 (all less than 25%) Gleason 6
 
Surgery  1/13/10 at UP- Penn Presbyterian - Dr David Lee. Home 1/14/10 Nerves spared on both sides -Catheter removed 1/19/10  Path report scheduled for 2/11/10
 
Pathology Report Gleason score was upgraded to 7 (3+4)
no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, gland involvement 2-10%
 
Since report was good and recovery going well next appt is now  the first psa test appt scheduled for 4/22
 
Incontinence - Initial 6 pads a day, 3 Weeks - 3 pads a day relatively dry at night
 
ED - yes but seeing some improvements - levitra 10 mg 2x week
 
 


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 4/8/2010 2:33 PM (GMT -6)   
My wife and I met Dr. Lee today. He gave us a very good impression and confidence in my decision to go with him for the surgery. Soooo, I'm scheduled for 19 May. He could have done it sooner, but I really want to attend my son's graduation from Rider (without having any post-op issues). At least, my son had better be graduating from Rider this May!
 
All your feedback helped too. Thanks again.
Bill
Age 52, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 4/8/2010 3:53 PM (GMT -6)   
Good luck Bill
 
There is a preop class run once a month.  I did not attend due to the scheduling of my surgery but I know Mark did and found it useful.
 
Good luck with the graduation - I graduated from Rider manyyyyyyyyyyy years ago
 
Ray
Diagnosed 9/09 at age 54  
PSA 6/09 1.3
Stage 2b (biopsy done because of firmness felt on right side) 3 positive cores out of 12 (all less than 25%) Gleason 6
 
Surgery  1/13/10 at UP- Penn Presbyterian - Dr David Lee. Home 1/14/10 Nerves spared on both sides -Catheter removed 1/19/10  Path report scheduled for 2/11/10
 
Pathology Report Gleason score was upgraded to 7 (3+4)
no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, gland involvement 2-10%
 
Since report was good and recovery going well next appt is now  the first psa test appt scheduled for 4/22
 
Incontinence - Initial 6 pads a day, 3 Weeks - 3 pads a day relatively dry at night
 
ED - yes but seeing some improvements - levitra 10 mg 2x week
 
 

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