Denver CO Surgeon Recommendations?

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Denver Guy
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/8/2010 4:34 PM (GMT -6)   
 
Hi,
 
New here to the forum, so if I make any newbie errors, please forgive :-)
 
I am 48, and I have my prostate biopsy scheduled for Aug 16.   My PSA levels are now rising exponentially:
 
  • July 2008 - 1.0
  • Jan  2010 - 1.8
  • July (1st week) - 3.2
  • July (4th week) - 3.4

Since my DRE's were normal, no enlargement and no signs of infection (urinalysis normal), my urologist has recommended the biopsy.

Since I'm relatively new to Denver, does anyone out there have any experience/recommendations for surgeons in the Denver metro area for daVinci robotic surgery?  A good friend of mine had his surgery 1 year ago with Dr. Fagin in Austin, and had excellent results (cancer gone, incontinence gone, and no ED after only 2 months).

If I do end up needing surgery, I have several friends in Austin, so that would be an option, but I would prefer to stay in Denver with my family if possible. 

 

 


July 08 PSA 1.0
Jan 10 PSA 1.8
July 10 PSA 3.2
August 10 PSA 3.4
Waiting for Biopsy and Results

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/8/2010 6:49 PM (GMT -6)   
When I had my surgery here in Durango Dr Shandra Wilson from the University of Colorado flew over to work with my Urologist. I'm darn happy with the outcome, I had open surgery as there is no robot locally. My recovery has been fast, everything works and I'd recommend her highly.

www.uch.edu/find-a-doctor/doctordetails.aspx?doctorid=1678&sid=351117&sort=3&pg=1]click for info
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Fairwind
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Date Joined Jul 2010
Total Posts : 3748
   Posted 8/8/2010 7:36 PM (GMT -6)   
Dr. Jones at TUCC convinced me he is as good as any you will find in Denver..

http://www.tucc.com/
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Denver Guy
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/8/2010 7:39 PM (GMT -6)   
Thanks!

I saw her web page, and her credentials looked good. Also, the UofCO hospital in Aurora had a very good listing on the (can't think of the name right now) news magazine annual hospital ranking. I've gone through 2 surgeries out of town before, and would much rather be at home ASAP.

By the way, I've been to Durango on business 2x, the second just last week. Great city, nice people, nice mountains, and good food. First visit was driving over to Grand Junction, then down through Ouray and Silverton. Needless to say, I did not know about the million dollar highway until I got up there. Everything was fine until about 1/3 of the way to the Red Mountain Pass, and I went around a sharp hairpine curve, and around the bend I was greeted by an RV taking up both lanes. The RV had to back up, since I could not move over to the shoulder, since there is none (well, 3 inches), no guard rail, and a 1,500 foot drop to the valley below. The rest of the way was "look at the rock wall, look at the rock wall" :) :) :). The second visit was I25 to Walsenburg, then Hwy 160. I think the most spectular views in CO are in San Juan mountains on your side, though my wife says I need to see Estes Park and Aspen.
July 08 PSA 1.0
Jan 10 PSA 1.8
July 10 PSA 3.2
August 10 PSA 3.4
Waiting for Biopsy and Results

Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 8/8/2010 8:11 PM (GMT -6)   
Denver Guy said...
Hi,



New here to the forum, so if I make any newbie errors, please forgive [img]/community/emoticons/smile.gif[/img]



I am 48, and I have my prostate biopsy scheduled for Aug 16. My PSA levels are now rising exponentially:



<ul>
* July 2008 - 1.0

* Jan 2010 - 1.8

* July (1st week) - 3.2

* July (4th week) - 3.4
</ul>

Since my DRE's were normal, no enlargement and no signs of infection (urinalysis normal), my urologist has recommended the biopsy.

Since I'm relatively new to Denver, does anyone out there have any experience/recommendations for surgeons in the Denver metro area for daVinci robotic surgery? A good friend of mine had his surgery 1 year ago with Dr. Fagin in Austin, and had excellent results (cancer gone, incontinence gone, and no ED after only 2 months).

If I do end up needing surgery, I have several friends in Austin, so that would be an option, but I would prefer to stay in Denver with my family if possible.


Wait until your biopsy results before you rush into radical surgery. You have much to learn. For one thing the University of Colorado offers cutting edge treatments but not DaVinci surgery. I believe St Luke's has the machine. That said I'd go with two of the CU urologists for open surgery before I'd go with any other out here for Davinci. That's just my opinion and being I chose neither radical surgery you should wait and see what your biopsy results are before you worry about who or what to choose .
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
 
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
 
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
 
7/30/08 - Psa: .32
11/10/08 - Psa.62 -
April 2009 12 of 12 Negative Biopsy
 
2/16/10 12 of 12 Negative Biopsy 

Post Edited (realziggy) : 8/8/2010 8:18:18 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/8/2010 8:20 PM (GMT -6)   
Denver,

Welcome, but I agree with Realziggy. You don't know if you have PC at this point, and even if you do, it may be very low level and indolent, which means you could have the whole spectrum of treatment or non-treatment before you. This is a good time , if you haven't done so, to get educated in all the treatment options including AS. There are no re-set buttons once a treatment has been done.

Good luck to you, as you await your biopsy. Had 3 of them myself, none of them fun, but not all that bad either. Please let us know how you make out, hopefully you won't need to be here.

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, 8/6 .06, next test 11/10
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

Denver Guy
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/8/2010 9:07 PM (GMT -6)   
Thanks for the replies, but please look at my original post. I did say "if I do end up needing surgery", I'm not planning on rushing out and demanding surgery. I've been through four major surgeries since 2004 (three cervical spine and one shoulder - bad car accident, sigh), and one is more than enough. I'm just researching who / where in the Denver area if the biopsy shows cancer, and the docs recommend surgery. The UCH in Aurora does have the daVinci robotic surgery at the Cancer Center at the Aurora campus.

My urologist here in Denver is majorly concerned, since my PSA has more than tripled in 2 years, and nearly doubled in 6 months (I don't ride a bike 30 hours per week, no infection, no enlargement, no eja-tion 72 hours prior to the PSA tests, etc.) My doc has discussed potential treatments, including watchful waiting, radiation, etc. Each has its pros and cons and does depend on your situation.
July 08 PSA 1.0
Jan 10 PSA 1.8
July 10 PSA 3.2
August 10 PSA 3.4
Waiting for Biopsy and Results

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 8/8/2010 9:48 PM (GMT -6)   
While you are waiting for your biopsy, get a copy of Dr. Patrick Walsh's book, "Guide to surviving Prostate Cancer" 2007 edition, and learn everything you need to know at this point..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 8/9/2010 7:35 AM (GMT -6)   
I stand corrected CU Hospital received a Davinci November 2009.
 
Who is your present urologist Denver guy? If you are looking for recommendations mine is the director of research at CU Hospital.
 

The Walsh book while good I think is becoming dated.

Post Edited (realziggy) : 8/9/2010 7:58:08 AM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 8/9/2010 2:51 PM (GMT -6)   
The core information in Walsh's book is invaluable. It never goes out of date. Yes, today's treatment options have moved ahead a little, especially in the field of radiation, but there have been no astounding breakthrough's in treatment since the book was last revised in 2007..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

sparky5280
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 9/1/2010 10:04 AM (GMT -6)   
DenverGuy, my urologist was Dr. Edward Eigner (Urology Associates) who did my DaVinci surgery last year, at Sky Ridge Medical Center out on I-25 and Lincoln (Lone Tree).

Email me and I can give more information if you want or need it.

As stated before, don't rush into anything until you have as much info as you can handle.

good luck.

Rick

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 9/1/2010 11:11 AM (GMT -6)   
Dr Jones who works out of TUCC will do my surgery on a third generation davinci machine this Friday at Swedish Hospital. I'll let you know how that works out...

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 9/1/2010 2:11 PM (GMT -6)   
Hey Fairwind........Good Luck Friday! I hope all goes well.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 9/1/2010 8:45 PM (GMT -6)   
Thanks...You ALL have been a great help to me navigating through this..

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 9/1/2010 8:58 PM (GMT -6)   
Denver Guy,

I agree with others that have stated that your Biopsy results will help you decide if/how you might be treated. There is an ever growing list of viable treatment options that might suit you if you have PCa.

I have friends that were treated by doctors at both TUCC and U of C. All of them swear by (not at) their doctors and treatment choices. I think both organizations can take good care of you.

I was treated at Kaiser Perm. (St. Joesph hospital's Davinci), by a realtive rookie surgeon. He must have been well trained or I was real lucky (so far).

Good luck and best wishes.
PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09

Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.

ED - Trimix works well; levitra @ 90%
PSA - 7/31/09 <0.06; 12/1/09 <0.06; 3/29/10 <0.06; 8/4/10 <0.06

windquest
New Member


Date Joined Aug 2010
Total Posts : 9
   Posted 9/1/2010 9:59 PM (GMT -6)   
Denver Guy,

I was in the same boat....mine was negative which of course if great but I did exactly as you are doing and that is looking at treatments expecting the worst. I make these comments....this is your life, look at EVERY option and EVERY Doctor and EVERY Hospital. Don't settle for anything but the best....no matter what. I am a quality of life guy so my approach was to ge the best treatment possible with the fewest side effects. Some guys will just want it out, and no consideration of the side effects.....you have to choose here. Also remember the words of other forum members when they tell you that this may not be a true cross section of cases...I suspect many who have had excellent treatment and recovery post less and less....or not at all. I know I am a cynic in this statement, but now days, Doctors are "selling" their procedures...watch out! You need to pick your comfort level, you need to pick the Doctor and you need to be the one who makes any decisions.I fired three UDocs for their self centered, self promoting procedures before I felt comfortable.....get second opinions....if you are positive or negative, send the slides out for a second opinion....there is no need for a bug rush here. And good luck.

And Fairwind.....all the best my friend, my thoughts and prayers are with you on Friday...may the outcome be all you hope for!
2008-Age 60-PSA 3.4
2010 April-PSA 4.3
2010 July-PSA 5.3
July-August Cipro 21 days, Follow up PSA 5.3
August 19th-Color Doppler Ultrasound / 6 Core Biopsy
Results August 23rd.

Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 9/2/2010 7:33 AM (GMT -6)   
Good Luck fairwind. May your recovery be an easy one.

As far as all those giving advice to Denver Guy he appears to have only posted here one day and hasn't been heard from since. I don't know why someone here would pass up an opportunity to take advice from others in his area but that seems to be the case. Hopefully his biopsy came back negative.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A

2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study

4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal

7/30/08 - Psa: .32
11/10/08 - Psa.62 -
April 2009 12 of 12 Negative Biopsy

2/16/10 12 of 12 Negative Biopsy
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