Doctor Consultations - Conclusions

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windycitytiger
Regular Member


Date Joined May 2011
Total Posts : 79
   Posted 5/31/2011 7:08 PM (GMT -6)   
I met with the two top prostatectomy doctors in Chicago today - one who has done nearly 2,000 robotic procedures and the other who has done more than 5,500 open procedures. Very interesting day to say the least. After much conversation with my wife, we have decided to pursue the open option.

It boiled down to a matter of various studies and data. It seems that most broad, prospective research has been done in an attempt to show that robotic is as good or better than open. It is very difficult to find studies that conclusively show that robotic is better. At best, robotic is as good as open and at worst, it's inferior.

There is much discussion about the shorter hospital stay and the reduced time with the catheter with robotic. However, I'm OK with a second day of full care in the hospital and studies have shown that with catherizations of 7 days or less there is a greater chance of needing the catheter re-insterted (ouch!).

So, in my very simple mind it boils down to a simple equation. I have found a very experienced and successful open surgeon with the promise of results as good, if not better than robotic. Similar recovery times and well-documented surgical margin, continence and erectile function data.

I plan to schedule the procedure for mid-July and will post info on my path leading up to, and after the procedure.

Wheeler
Age 50
PSA 5.7
Biopsy 8 of 12, 6@3+3, 2@3+4
Probably having surgery in July

HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 414
   Posted 5/31/2011 7:35 PM (GMT -6)   
Wheeler - It definitely sounds like you have done your due diligence, learned everything you possibly could, weighed your options, and made a decision. I certainly commend you for doing so as I know that it isn't an easy thing to do. I wish you the best and I hope you will report back here with your results. The information found on this forum serves to help others that will inevitably embark on the same journey.
John (HD_Rider)
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 3 cores at 3+3=6 and one core at 3+4=7 (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

windycitytiger
Regular Member


Date Joined May 2011
Total Posts : 79
   Posted 5/31/2011 7:47 PM (GMT -6)   
John - I see that you have a DaVinci procedure scheduled very soon. Please don't take my conclusions as anything but my own findings. The doctor I met with who specializes in the robotic procedure was terrific and I would have been quite comfortable having him do my procedure. I was presented two compelling cases and simply went with my gut. Best of luck with your surgery and let us know how it goes.

Wheeler
Age 50
PSA 5.7
Biopsy 8 of 12, 6@3+3, 2@3+4
Probably having surgery in July

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/31/2011 8:30 PM (GMT -6)   
After over two years of watching this forum I would agree that open and robotic are in pretty much of a tie and in this case the decision goes to the doctor in whom you have the greatest confidence. Good for you for studying your options and reaching an informed decision -- that is what this site is all about.

Keep us informed of your progress
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day
9 mo. PSA 0.00 -- 1 light pad/day ED remains
12 mo. PSA 0.00 -- still one light pad and ED
16 mo PSA 0.00 -- light pad just for security, ED still an issue

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/31/2011 8:59 PM (GMT -6)   
Wheeler,
 
I spent four days in the hospital after my DaVinci, so averages didn't count much for me. Every case is unique.
 
The doctor and quality of care at the hospital are the keys.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

sfigato
Regular Member


Date Joined Dec 2010
Total Posts : 144
   Posted 5/31/2011 9:02 PM (GMT -6)   
Good luck windy, I went down a similar path.
I assume 5,500 is Dr C
I went with open in the end, with another doc
Age at diagnosis 48
Gleason 3+3
Pre-Surgery PSA 5.1, 5.7
Cores Positive: 10 of 12 up to 40%
Treatment: open Surgery Dec 2010
Feb 14, 2011 PSA < 0.10 (effectively zero)

windycitytiger
Regular Member


Date Joined May 2011
Total Posts : 79
   Posted 6/1/2011 6:45 AM (GMT -6)   
You are correct about Dr. C. Very thorough and very experienced with a database of statistics on all of his patients.
Age 50
PSA 5.7
Biopsy 8 of 12, 6@3+3, 2@3+4
Probably having surgery in July

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 6/1/2011 7:08 AM (GMT -6)   
Wheeler,
I had my DaVinci surgery on a Friday morning and stayed in the hospital until Monday morning.  I think the extra time was a result of some extra work he did on some bowel adhesions, and wanting to make sure the digestive system was working OK.  So, as 142 said above, averages can be misleading, and every case is unique.
 
I've never envied the guys who go home 24 hours after DaVinci surgery, though.  The insurance companies may like that, but the hospital seems to me the best place for initial recovery.  I felt so much more ready to go home Monday than I would have on the day after surgery!  The idea of a speedy discharge sounds attractive, but a restful couple of days in a hospital setting was right for me, even though I'm not fond of hospital settings.
Age 65
Dx in June 2010.
PSA gradually rising for 3 years to 6.2
Biopsy confirmed cancer in 6 of 12 cores, all on left side
Gleason 7 (3 + 4)
Bone scan, CT scan, rib x-rays negative.
DaVinci 8/20/10
Negative margins; negative seminal vesicles
5 brothers, ages 52-67 ; I'm the only one with PCa
Continence OK after 7 weeks. ED continues.
PSA 1/3/10: 0.01

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 6/1/2011 9:05 AM (GMT -6)   
Wheeler: You have done your homework and made a decision. That is one of the difficult steps and you have made it. I had open and must say I agree with you conclusion. I have friends that had the robot and did just a bit better and I did but I have done much better than many that have had the robot. Not sure there is much of a difference. Best of luck with surgery.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/1/2011 9:13 AM (GMT -6)   
Just for the record, I was only in the hospital overnight with my open. Out of surgery by 12 noon, and home by 5pm the next day. I had no better or worse recovery period than did any others who were posting here during the same period.
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30
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