New member - TS1191

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142
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Date Joined Jan 2010
Total Posts : 7084
   Posted 2/7/2011 5:51 PM (GMT -6)   
TS1191 posted questions in another thread -
Welcome to Healing Well. It looks like Mel has already spoken up on his experience with the doctors you mentioned - perhaps others have as well.
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I'm a 50yo recently diagnosed with presumed T1c disease: PSA 3, Gleason 6 (3+3). Have decided on robotic prostatectomy. Deciding whom to see for surgery. After extensive review of info (including this site - very informative/candid: my thanks to all who post) am trying to decide between Wood and Menon. Each has an excellent reputation. I have no problem looking past the wrapping (Wood the academic vs. Menon the effective marketer). Am interested in experience and surgical expertise above all.

1. There is a fair amount of info on the site re: Dr. Menon - generaly that he is confident, experienced, and effective, with most happy with the alternative to the urinary catheter. Has anyone had experience with Dr. Wood other than in consultation?

2. What's the difference between "standard nerve sparing" vs "veil of Aphrodite" vs "super VIO"?

3. I assume at U of M it is the standard nerve sparing approach?

Many thanks in advance.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 2/7/2011 6:34 PM (GMT -6)   
Nerve sparing is nice but it offers no guarantees. There is more to it than just the nerves...Men who have strong, spontaneous erections before surgery do much better than men who were already needing a little help..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/7/2011 6:50 PM (GMT -6)   
Welcome, hope you find some good answers here. I sincerely hope that erradicating your cancer is #1 on your list of priorities. Nerve sparing is great, but not at the expense of leaving cancer behind. This is something that can not be guaranteed ahead of time by any doctor.

Please keep us posted.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
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 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 175
   Posted 2/7/2011 7:34 PM (GMT -6)   
There are many aspects to surgery or treatment for PC besides the Surgeon.
1) Have you reviewed all your options and understand the ramifications - the big item is the cure not the erection afterwards
     a) My case - nerve sparing didn't work because that is where the cancer was located
     b) Maybe you want to talk about nerve graft if they find the same problem with you.
2) Each Surgeon has his plus and minuses so you need to know what type of support you will have after
     a) If additional procedures are needed for strictures etc
     b) Can you see him if you need to or will you be sent to PA, resident or intern or your local urologist.
3) Facility at which the surgery is done.
     a) Opt for one which does RP more than once or month - surgical staff are familiar
     b) Post Surgery recuperation - if nurses aren't familiar with RP patients and problems you could be in trouble
     c) Cleanliness - Guy on here asked the question about cleanliness - I got a staph infection and this may have contributed
        to problems post surgery
4) Convenience - I am in the cornfields of Ohio - so there are some larger hospitals locally - Dayton, Columbus, Cincinnati,
     Cleveland and Toledo but all are more than 1 hr away - Columbus being 2 and Cleveland 3 hrs.  I just had a post surgery
     problem fixed at Cleveland Clinic because my local urologist did not want to do the procedure because he did not do the
     procedure enough to be proficient.
5)  Some of the guys recommended starting to exercise your erection - get a vacuum pump and pump it all to get blood moving
     prior to surgery as well as you viagra or cialis - my surgeon didn't think of that until the surgery was done.  It may not have
     helped me but it could help you.  Talk to your urologist about it.
6) If married or have a partner discuss the WHAT IF's - continence, ED etc and make some of your decisions on that.
 
Focus on the Cure not the side effects which will affect you but their degree will not be known in some cases to 2 months to 15 months later.
 
Good Luck
 
Tom
 
Cancer 50   Gleason 3 + 2  40%  PSA 6.8   
Cancer was apex of prostrate - nerve sparing couldn't be done effectively
Free from cancer 10 yrs in June.
 
 
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