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ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 5:08 PM (GMT -6)   
Hi, newly diagnosed for prostate cancer. 46 years old. 12 point biopsy with 6 cores positive. Gleason 6 (3+3) with PSA of 6.4. Have spoken to two Urologists in Columbus Ohio with one more scheduled next week. Both say I need to have my prostate removed. One does Robotic, the other traditional. Waiting to see what third doctor says but leaning towards robotic. Can anyone recommend a good robotic surgeon in Columbus Ohio? A little overwhelmed here. Any recommendations or testimonials would be greatly appreciated.

Thanks,
RSE

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/16/2011 5:43 PM (GMT -6)   
Hello and welcome, RSE

I had open Surgery, and many have had robotic here. Have you considered having Seeding/RT done as your primary treatment? Probably pay to get an opinion from a good Radiation Oncologist to see if your situation would merit that as a possibility. Good luck as you continue to research your options.

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 2/11 1.24
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 9/10,

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 5:54 PM (GMT -6)   
Thank you David for the quick response. Both Urologists told me that with my age and the fact that the 6 positive cores were not contained to one lobe or area, they want it removed. My appointment next week is with a urology oncologist so hopefully it will make things clearer (or just confuse me more). Ugh.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/16/2011 5:57 PM (GMT -6)   
It will be good to get that other opinion you have set up. I was not the right criteria for seeding at the time, as I have 7/7 positive cores, high % of cancer, and was a strong Gleason 7 at the time. You are 10 years younger than me when diagnosed, so that is another factor to consider for sure.
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 2/11 1.24
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 9/10,

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 6:09 PM (GMT -6)   
Yes both Urologists pretty much said the same thing. My age played an important fact in their overall recommendation. They told me that my odds of eradicating it would be with removal. They both scared me with mentioning the difficulties of a salvage operation if I chose radiation first and the cancer returns. My sister talked me into getting one more opinion which I now think is probably a wise move.

It's hard for me to understand all the numbers and letters in your signature, but it looks like you have been through and still going through a lot. I wish you well and appreciate your responses.

Tigerfan53
Veteran Member


Date Joined Jan 2011
Total Posts : 929
   Posted 3/16/2011 7:12 PM (GMT -6)   

Welcome to the site, there are a lot of caring, knowledgeable people here.  Sorry for your diagnosis.  I agree with David that you should see a radiation oncologist to get his opinion.  I would also urge you to send your biopsy slides to either Johns Hopkins or Bostwick Labs (I think that’s the other place most often recommended on this site) for a second opinion on the pathology.  Take some time to educate yourself about prostate cancer.  It is a slow growing cancer.  I recommend a book called “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer” as a good starting point.  Also, what ever treatment you choose, get a doctor with as much experience as possible.  The best outcomes are achieved by the most experienced doctors.

 

I am currently trying to decide which treatment to go with: either brachytherapy (seeds) or robotic surgery.  And have been going round and round and back and forth on those options.  One doc told me I should do Active Surveillance, but I don’t think I could handle that.

 

Best of luck to you on journey.


Diagnosed Dec 2010
PSA 5.3
Biopsy 50% in 1 of 12 cores, Gleason 6

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 7:29 PM (GMT -6)   
Thanks for the information. This can all be so overwhelming. I go to bed each night with my mind made up on pursuing a specific direction and wake up the next day with a totally different one. I was told by one that brachytherapy would not be recommended due the the cores that were positive being located all over. External beam radiation would be preferred if I chose not to go with surgery. I am hoping the chat with the oncologist will help sway me some. I know the logic is depending on the specialty of the doctor you talk to is the direction he/she is going to recommend. Hopefully it will all play out and I will have a clear mind going into whatever decision I make. Thanks.

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 3/16/2011 7:33 PM (GMT -6)   
Welcome CMH. Your getting some good advice from others here, but you have to make the ultimate choice. At your age and with a long life expentency the most aggressive treatment might be wise. And you will hear from others about their experience and what they consider to be the most aggressive tx. out there. Once you decide, do not look back, look forward. Good luck and keep us posted.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4
Started IMRT Jan. 2010 72gys
7month post SRT PSA .2

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 7:43 PM (GMT -6)   
Thank you Michael. I am looking forward to what others have to say and offer. This is a great site for information. I will keep updating. My visit with the oncologist is on the 24th, so plenty of time to study more and rack up some good questions. :)

mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 375
   Posted 3/16/2011 10:07 PM (GMT -6)   
Not much for me to add to what others have said already. You have a tough decision, for sure, very young for PCA. I was young too, as my signature shows below. I'm coming up on my third anniversery from surgery, all 0 psas, no incontinence, but still have to use trimix for sex. The problem is we know there is a high incidence of ED with surgery, yet some guys have surgery and go back to having normal sex. Wouldn't it be great to have surgery and have everything turn out to be just the way it was before?Will you be the one? I don't know, who does. The best surgeon you get increases your odds of recovery from ED but still you never know. The guys who have brachy/other radiation treatments statistically do better for ED. I  had a nerve sparing robotic surgery but I still have to use trimix. I am definately disappointed by the results of my surgery because I didn't win the lottery with ED, but given my personality and family history of other cancers I did what was right for me.........
My age= 52 when this all happened.
DRE=negative,
PSA went from 1.9 to 2.85 in one year, biopsy ordered,
Second biopsy on 08/14/08 found 2/12 cores positive for CA on R side, 1 core=5%CA, other core=25% CA, Gleason score= 6 both cores,
Bilateral nerve sparing robotic surgery on 09/11/08, pathological stage T2A,
No signs of spread, organ confined,
6 0's in a row, still use trimix for ED

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 3/16/2011 10:14 PM (GMT -6)   
I'm not sure I fully understand the age argument. What is the reason these docs say if you're young you need to have surgery? What is their definition of young? I was 57 at dx and was told I was young and had to have surgery. Of course I balked at that and decided not to go that route.
age 57 2/2010
PSA Feb 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA Oct 3.97, Dec 2.78, 3/9/11 2.42

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 3/16/2011 10:28 PM (GMT -6)   
Concerned,
You may not be getting the correct information on seeds.
There is no age factor for seeding and younger patients do just as well as older patients. In fact they do better as the long term side affects are much less severe, especially incontinence and ED.
Seeding is done throughout the prostate and 5mm into the bed, and as long as the cancer is contained or in the margin it is as effective or more effective than surgery. There is no criteria based on the number of positive cores or the Gleason grade. Seeding gives a much higher dose than IMRT with less radiation exposure to good tissue.
The only restriction on seeding is a very large prostate, over 60cc, which cannot be shrunk by meds. Meds can usually shrink it by 50%. Patients with current urinary issues or have had a TURP may not be the best candidates for seeding.
You doctor is correct in that surgery is not recommended after seeding, but he didn't mention that you can be reseeded, have cryosurgery or HDR brachy with the same results as radiation after a failed surgery.
If you want the correct information then see a brachytherapist who has performed at least 500 procedures. If you are seeing a urological oncologist for a 2nd opinion be aware that he is a surgeon just like your urologist and not a radiologist or brachytherapist. A good 2nd opinion would be from someone in a different field like a radiologist, brachytherapist or a medical oncologist that specializes in PC. Make sure that your 2nd opinion doctor is not referred by by your urologist so he can give you a good opinion without any conflicts of interest.
From what you have stated you are a perfect candidate for seeding; you are also a perfect candidate for surgery or external radiation and all will work with similar effectiveness in curing your cancer, but all have a different set of short and long term side affects.
JohnT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 10:29 PM (GMT -6)   
Both doctors told me 46 is very young to have prostate cancer. Basically they said I have a potential of another 40 plus yrs and based on my pathology report the best odds to eradicate is surgery. I'm new to the whole thing but both Urologists said the exact same thing. I'm kind of confused too. I think more importantly is that the six cores that came back positive (3 -15%, 2 -5%, 1-40%), 2 more more had HPIN, 2 others were noted as suspicious, and 2 benign. One of the 15% cores noted perineural invasion which doesn't sound good from what I am reading.

Does this make sense? A little confused.
46 yrs old
Diagnosed 3/3/11
PSA 6.4 Gleason 6 (3+3)
6 of 12 cores positive, 2 High Grade PIN, 2 Suspicious, 2 Benign.

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/16/2011 10:37 PM (GMT -6)   
I'm 40, I've shared emails with patients in their mid 30s.

Look, yes, we are very young, but look at it this way, the younger and fitter/healthier you are, the better your recovery assuming you pick a doctor/surgeon tha is very competent in his/her field.

We have very similar pathology. I am now 2 months out of my surgery and things are great, i really mean that. I went through absolute hell for two months but I gained something from it.

There are no guarantees, but chances are we will live to see 70-80. Right now I'd be happy with that.

In my mind there was no other option but robotic surgery. My prostate had cancer and I wanted it out of me and I hoped it would be confined to it. On paper it looks like that's the case now. However, most of the doctors I spoke to said radiation would also probably have great results for me. What I didn't like, besides retaining the prostate, was that it's hard to operate once a patient has had radiation in case it fails whereas radiation after surgery is possible.

I know you're scared, shocked and depressed right now, but I can absolutely assure you that it only gets better. You have hit the lowest low already and within a few months you'll be looking back at your fight with renewed perspective and a certain sense of serenity and maturity that I cannot put into words.

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 10:46 PM (GMT -6)   
Thanks for your encouraging words. Everyone on here is very nice. So did any of your cores come back noted as perineural invasion? Was the cancer contained in your prostate?

I lost my father 19 months ago to esophageal cancer and my mom 6 months later to lung cancer. So obviously just saying the word scares the crap out of me.

I obsess about my health and this has me off the scales. ! :)
46 yrs old
Diagnosed 3/3/11
PSA 6.4 Gleason 6 (3+3)
6 of 12 cores positive, 2 High Grade PIN, 2 Suspicious, 2 Benign.

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/16/2011 11:02 PM (GMT -6)   
yes, mine was completely contained and I got a 0 on my first PSA test. I'm told everything will be fine and that I ( we) fall in the 97% category of not getting it back within 10 years ( studies don't go beyond that really).

Terrible about your parents. My mother also lost both her parents to cancer within a year when she was only 16.

Prostate cancer is very curable. Esophageal cancer is far more dangerous. Lung cancer is also no joke. The first thing my urologist told me when he informed me I had cancer ( I had similar pathology as you ) was that if I had to get cancer, I got the best kind and that this would not affect the longevity of my life. My surgeon assured me of the same and I believe that to be true now 2 mos out of surgery.

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/16/2011 11:06 PM (GMT -6)   
Thank you. You have put me in a better light and maybe I can fall asleep now. My mind has been racing all evening. I am very happy to hear about your prognosis and it definitely gives me a ray of hope for myself!!

Scott
46 yrs old
Diagnosed 3/3/11
PSA 6.4 Gleason 6 (3+3)
6 of 12 cores positive, 2 High Grade PIN, 2 Suspicious, 2 Benign.

Ausboy
Regular Member


Date Joined Mar 2011
Total Posts : 92
   Posted 3/17/2011 4:03 AM (GMT -6)   
Hello CMH
Sorry to hear about your diagnosis, it's alll a bit overwhelming at first I must agree. But there is good news (pca) is not a death sentence by any stretch of the imagination. Like davidg says its treatable.
 
couple of tips from a relatively recent diagnosis
 
1) As far as your treatment goes find a doctor you are comfortable with and trust, research, ask around, as this is more important than the treatment you choose, an expirienced competent doctor who treats the whole you is the most important factor, shop around.
2) consider having your pathology reviewed by another PCA specialist pathology service, might be totally different result!
 
good luck

AJ 47 (Maryland)
Regular Member


Date Joined Aug 2010
Total Posts : 64
   Posted 3/17/2011 6:31 AM (GMT -6)   
Hello and Welcome --
 
I too was 46 (last year) when I learned of my cancer.  My doctors also explained that, based on my age, it needed to come out.  I asked all the questions after reading Patrick Walsh's book (a must read--2nd ed. only) and elected robotic which was actually suggested by the doctors at Hopkins even though they don't do very many (I had a hernia repair with mesh that worried them about having to abort an open RP (and being a malpractice lawyer didn't help much either ;)).  Do your reading but trust your doctors and your instinct.  You are in a very good location for some of the best surgeons in the world.  Consider Cleveland Clinic, Henry Ford Hospital in Detroit or Northwestern.  As you will learn soon if you don't know already, particularly with robotic surgery, the number of prostate surgeries a surgeon has done means the world.  A recent article cited on the list states that a doctor must have +1,200 under his belt  to be considered proficient.  Others say +600.  Some of the doctors at the institutions I mentioned have done more than 5,000.  Now those numbers are impressive and with those numbers comes a great deal of experitise and clinical data.   I had surgery on a Tuesday at 7 a.m., was back in my room at 1:30, and was walking the halls briskly at 4:00.  I was discharged the next morning, wore a suprapubic catheter for 8 more days, and came home on day 9.  Never had a leak but do suffer ED and what I will call post traumatic stress which is fairly normal.  We are all here for you so ask any questions you want.  Also, although I am not recommending any particularly doctor, I will say that Dr. Tewari's website at Cornell is very comprehensive and he answers lots of questions that commonly come up with regard to robotic v. traditional RP.  You might learn something there that may help may help you make your decision.

PSA 1.5 to 3.2 in 11 months. First 12 core biopsy on 2/10 negative in 11, atypical in 1. Second 13 core biopsy on 5/10 at Hopkins positive in 2 with Gleason 3+3 (focal). Robotic "Super VIP" Mani Menon on 8/10. Postoperative Gleason 3+4 (70%/30%). Focal ECE right posteriolateral mid. Neg. margins, lymphs, SV. First PSA 9/14 <.1. 2nd PSA 1/5/11 < .1 Never incontinent +ED. Bi & Trimix work!

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 3/17/2011 6:57 AM (GMT -6)   
ConcernedCMH:
I am in total agreement with AJ 47. Get Walsh's book and read it for all the relevant chapters addressing biopsy and pre-treatment decisions. Given my biopsy and pathology (see my signature) I took the path of least agony. I picked a academic center of excellence for my treatment, a doctor with over 3,000 prostate surgeries completed, and a urology department that has been rated continuously in the top ten hospitals in the country. Plus the hospital was only 30 minutes from home.

Some of the anguish for you appears to be multifaceted. What procedure, what doctor, what hospital and what side effects am I willing to deal with long and short term? Try to eliminate some of these early on so you can focus on the bigger issues. After reading Walsh's book you will be far more knowledgeable about treatment options than can be obtained by picking up bits and pieces here on this site and other that deal with prostate PC. Plus you are getting information from a real doctor. For me, I look to HW for psychological support, past experience of how members coped with issues, and lending support to others who need it. Trust the knowledge of real doctors who know urology and your individual personal case with the data they have on you. Use the book knowledge you gain to ask better questions and confirm the questions have.

In my experience, if you select surgery, be open to either procedure, open or robotic because the stats indicate nearly the same outcome. The biggest difference is the skill level of the surgeon. The hands of the surgeon are his/her tools the robot is a tool as well and only works as well as the surgeon operating it. That is one of the main themes that you will get out of Walsh's book and his bias is clearly toward open retropubic prostatectomy. Makes sense since he created modern nerve sparing surgery back in the 1980s when he studied his surgery technique through videos he took of each operation he performed.

So read, don't rush and pick a skilled well experienced doctor attached to the procedure you wish to have done.

Best to you,
Mike S.
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010 J. Hopkins
Path: Gleason 6, Neg Mar, Neg LN, Neg Sem Ves
9/15/10 1st post op PSA <0.1 undetectable
3/11/11 PSA - TBD <0.1
Incontinence - seeing some progress
Aug -Sept 2010 - 4-5 pads
Oct 2010 3 pads
Nov 2010 2 pads
Dec - Feb 2011 1 pad all day - 1 pad at night
ED: slow improvements

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 3/17/2011 9:45 AM (GMT -6)   
Dear Concered:
 
I find it difficult to add anything to the excellent advice you received from JohnT on this thread.  I'll just reemphasize that if you only keep seeing urologists you may face the possibility of only getting a surgical bias.  IMHO you owe it to yourself to visit with a good radiation oncologist or prostate oncologist who will allow you to understand all sides of the story so you can intelligently assess all options.
 
Depending on your individual case, today's radiation choices, e.g. brachytherapy or brachytherapy/IMRT are likely to give you equal chances of cure with less onerous side effects and better QOL.  You owe it to yourself to at least consider these options.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

ConcernedCMH
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 3/17/2011 9:46 AM (GMT -6)   
Thanks guys, I will get the book today. I appreciate the directions. I seem (probably like many others when first diagnosed) to get hung up on the negative issues which causes a lack of focus on a clear path. I will read the book and hopefully that will provoke some good questions for my visit on the 24th. Both urologists told me that I had time to research and study, but advised me to come to a decision in a timely manner because it appears I have been living with this for some time.

I guess my biggest fear is that they will operate and find that it has spread beyond my prostate. I am sure this would be a huge fear for anyone just dianosed with any form of cancer. I freaked last night when I noticed the 'perineural invasion' noted on one of the cores. Researching things on the internet just put me in a bigger panic mode.

I appreciate everyones advice and reading other's experiences definitely helps me out! Thanks everyone.
46 yrs old
Diagnosed 3/3/11
PSA 6.4 Gleason 6 (3+3)
6 of 12 cores positive, 2 High Grade PIN, 2 Suspicious, 2 Benign.

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 3/17/2011 11:22 AM (GMT -6)   
Concerned,

When first diagnosed, I was determined to have surgery to "get it out". After spending time on this site and taking the advice of many here to explore all options, I changed my mind. I opted for a combo of BT and IGRT which has very comparable cure rates to surgery and fewer side effects based on what you will read here. I'm very happy with my decision. I strongly urge you to follow Tudpock's advice above. At least talk to a radiologist/oncologist about that treatment option.

If you do that and are still convinced that surgery is the route for you then go for it. You have to decide what is right for you after looking at all the alternatives and the possible ramifications. Best wishes on the journey.

Joe
Age 68 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA as of 12/9/10 - 0.1

lowandslow
Regular Member


Date Joined Jan 2011
Total Posts : 122
   Posted 3/17/2011 3:18 PM (GMT -6)   
Concerned, welcome to the place where people actually understand. A great group of people here. I am 3 days post robotic surgery, James Center in Columbus Dr. Abaza performing. Throw me an email for more specifics. Im sore but doing not too bad. Walked almost a mile total today.
Age 48
November 2010 PSA 4.1
Biopsy 12/22/10
Diagnosed 1/12/11
3 of 7 cores positive 30% involvment all on right side. Left side clear.
No perinural invasion noted
Gleason 7 (3+4)
Robotic scheduled for 3/14/11 at James Center Ohio State U. Dr. Abaza

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/17/2011 3:48 PM (GMT -6)   
AJ 47 said...
Hello and Welcome --



I too was 46 (last year) when I learned of my cancer. My doctors also explained that, based on my age, it needed to come out. I asked all the questions after reading Patrick Walsh's book (a must read--2nd ed. only) and elected robotic which was actually suggested by the doctors at Hopkins even though they don't do very many (I had a hernia repair with mesh that worried them about having to abort an open RP (and being a malpractice lawyer didn't help much either ;)). Do your reading but trust your doctors and your instinct. You are in a very good location for some of the best surgeons in the world. Consider Cleveland Clinic, Henry Ford Hospital in Detroit or Northwestern. As you will learn soon if you don't know already, particularly with robotic surgery, the number of prostate surgeries a surgeon has done means the world. A recent article cited on the list states that a doctor must have +1,200 under his belt to be considered proficient. Others say +600. Some of the doctors at the institutions I mentioned have done more than 5,000. Now those numbers are impressive and with those numbers comes a great deal of experitise and clinical data. I had surgery on a Tuesday at 7 a.m., was back in my room at 1:30, and was walking the halls briskly at 4:00. I was discharged the next morning, wore a suprapubic catheter for 8 more days, and came home on day 9. Never had a leak but do suffer ED and what I will call post traumatic stress which is fairly normal. We are all here for you so ask any questions you want. Also, although I am not recommending any particularly doctor, I will say that Dr. Tewari's website at Cornell is very comprehensive and he answers lots of questions that commonly come up with regard to robotic v. traditional RP. You might learn something there that may help may help you make your decision.


Well said. And yes, Tehwari is considered one of the best. Concerned also has Menon nearby in Detroit. I agree that ideally you want your surgeon to have many surgeries under his/her belt. I'd say 1500+ is optimal. Mine had 3000+

I'm curious about what you say about post traumatic stress. I am 2 months out of surgery and so exhausted on a daily basis. I feel old and beatdown. Do you have any decent links on this?
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