number of surgeries 300, is that ok? Also, is surgery the way to go?

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Regular Member

Date Joined Aug 2010
Total Posts : 22
   Posted 8/4/2010 9:16 AM (GMT -6)   
First of all, great forum here...been reading/learning lots.

My Father was diagnosed last month. Obviously very devastating for all of us.

PSA- 9.9
G7 (3+4)
6 of 10 positive (two were 2% at 3+3 so nothing to worry about)
The part to worry about-
left base (conventional type seen in 2/2 cores, involving 50% of submitted tissue, G7 (3+4-pattern 4 accounting for 40% of tumor)
left mid (conventional type seen in 2/2 cores, involving 50% of submitted tissue, G7 (3+4-pattern 4 accounting for 40% of tumor)

We are looking into surgery and seed treatment.

Have a meeting with the surgeon tomorrow, but already know he has done 300 and a bit.
about 2-3 week. He has been doing it for 4 years.

I know reading here that more is better and that a minimum of 250 is a must, some say 500.

Is the 300 number a deal breaker in your opinion?

Shouldn't the decision be made on our overall opinion of the surgeon, not just the number?

Also, how do you find out more about a surgeon? I'm in Canada and there is limited info on the web when I google his name.

After researching we do have some questions to ask him but are there any you feel that are not obvious and that we should ask?

Thanks in advance!!!!!

Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 8/4/2010 9:41 AM (GMT -6)   
Hello a777,

First, welcome to the forum where no one wants to be. But, you've come to a good place.

When you speak of surgical experience I'm assuming you're talking about laprascopic da Vinci surgery.

I'm a Canadian too and a Toronto surgeon, who does gynecological surgery with da Vinci, not prostate, said while experience with the equipment was a good thing, it wasn't the most important thing. She compared it to making a great chocolate cake. Some cooks could, with minimal experience, make a fabulous chocolate cake time after time. Others could make a thousand cakes and they'd still be dreadful. As I have an aunt who loves to make chocolate cakes (and has made hundreds of them) which cakes are mostly useful to keep in the car trunk for a) weight over the rear wheels and b) to put under a slipping drive wheel when it snows, I thought this good advice.

I suspect even the best surgeon learns something with every surgery, but in the technical skill department I was told by a urologist surgeon from Mayo that 75 surgeries was plenty sufficient.

Bottom line I think you're looking for experience and skill. Knowing how many the surgeon has done is a good thing. Talking to the people who work with him/her --- anesthetists and OR nurses --- is a better reference. Nurses on the recovery ward also know who has the touch and who doesn't.

Please, keep us posted and let us know how the meeting goes tomorrow.

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
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 8/4/2010 10:46 AM (GMT -6)   
Hello and welcome

I think sometimes people get over zealous on the sheer number of surgeries a particular surgeon claims. Its not just about the number, its about the quality of the surgeries. With some of the more noted surgeons, with claims of over 1,000 surgeries and more, it would be interesting how many the surgeon actucally did himself, as oppose to watching over a jr. surgeon in his prescence. All urologist/surgeons are taught open surgery in medical school, but robotics is the current trend and rage with surgery, so if you go robotic, you would definitely not want to be on someone's learning curve.

Yes, determining the quality of the surgeon can be hard to determine, as he/she isnt going to give you references of someone that wasn't happy, and the net only provides so much information. That's why its good to get more than one opinion, even among surgeons, if you are allowed those choices.

You have time to think through all your options carefully, don't let any doctor, radiation dr, or surgeon hurry you into an instant decision. On your primary treatment, you only get one chance to have it done right. No reset button.

Good luck and keep us posted

David in SC
Age: 58, 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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

Regular Member

Date Joined May 2010
Total Posts : 264
   Posted 8/4/2010 10:51 AM (GMT -6)   

Is there a prostate cancer support group in your community?

If there is, most likely they will have opinions on who the 'go to' surgeon is.

I used to go with my dad to our local support group and there were some very knowledgeable people there.

Here are some of my stats:
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA 7/15/10 Zero Club membership card issued (trial membership with 90 day renewal)
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