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Looking for good/experienced robotic prostate surgeons in Los Angeles area

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Prostate Cancer
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larry088
Regular Member
Joined : Dec 2016
Posts : 25
Posted 1/1/2017 10:04 PM (GMT -8)
Hi All,

Happy New Year to all of you. I just did prostate biopsy 17 days ago, found I have prostate cancer with Gleason 7. I got the E Coli infection in my blood and urine after the biopsy procedure (bad luck). I am still on IV antibiotics for one more week (home care) and followed by oral antibiotics for another 3 weeks. My urologist wants me to do the prostate surgery by him, but I have doubt on him after I got the infection from a simple biopsy performed by him. I have read a lot of information on the PC treatment recently. I think the Da Vinci robotic surgery sounds one of good choices. I was wondering anybody can suggest any good/experienced robotic prostate surgeon in Los Angeles area? I like to collect as much info as I can, also want to meet/talk another 2 to 3 more urologists to find the best/right treatment for me. Thanks a lot for any feedback.
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halbert
Veteran Member
Joined : Dec 2014
Posts : 5849
Posted 1/2/2017 4:06 AM (GMT -8)
Hey larry,

First of all, slow down. Even with a G7, you have time to make a thoughtful decision. PC is not like other cancers, at the G7 level, you have months, not days, to make a decision and research your options.

We tell every newbie in here to take a careful look at all options, and to make consultations appointments with specialists in every treatment mode. Urologists are surgeons, so they recommend surgery--usually by them. Others will check in soon with specific answers to your question, and they can steer you to the best people in the LA area. (I'm on the east coast).

It's a heck of a christmas gift, isn't it. I got my "call" on Dec 5, 2014. My christmas season that year sucked. Hang in there. The answers are out there that work for you.

We've all had the "I have to get this out of me right now!" mind game. But it's not always the best answer.

Here's a first thing to do first: Have your doctor send your slides to either Dr. Epstein at Johns Hopkins in Baltimore or Bostwick Labs. All they do is PC diagnosis. Their second opinion is one you can take to the bank. Who knows, maybe you'll get a downgrade!

And then at the top of the topic page on this forum, is a 'sticky' topic called, "for the newly diagnosed". Please read through it. Lots of good information there.
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 11468
Posted 1/2/2017 6:57 AM (GMT -8)
Welcome to HW, sorry you need to be here.

Heck of a Christmas gift.

Learn all you can about this thing. Let me echo Halbert, slow down a little. It's a shock to learn you've got PC, but this isn't like other cancers. In general is a slow grower so you've got plenty of time to make an informed decision.

In the southland there are also a number of great radiation oncologists with some great treatments. You should check those out as well.

The guys in you area will be along to make some recommendations on who to talk to.

Andrew
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Paxton
Veteran Member
Joined : Aug 2016
Posts : 1468
Posted 1/2/2017 7:02 AM (GMT -8)
Hi, Larry. Glad to meet you, but sorry it has to be here. I know you didn't ask to join this "club" but now that you're here, we can help.

As halbert mentioned, we Gleason 3+4=7 patients have the luxury of time. We have a variety of prostate cancer that is very slow-growing, especially compared to other types of cancer. I was also diagnosed as G 3+4=7, receiving "the call" in early July. I was easily able to take almost 4 months to learn, discern and decide upon my treatment. I then started radiation in mid-November and finished just before Thanksgiving. The experts tell me I could have taken even longer with no impact on long-term survival. The moral of this story is that you don't have to rush.

Since you haven't told us much about yourself, I'll ask that you do that. Look at some of the other auto-signatures at the bottoms of various posts and try to tell us those same facts about yourself. You can add a signature via editing your profile on the maintenance page.

Once you've told us a bit more, you will probably start getting a lot of other suggestions and questions.

One question I will ask is "Have you considered options other than surgery?" This is a leading question, as it is early for you and you may not have had the chance. We always recommend that newly diagnosed men read the sticky thread "For the Newly Diagnosed" before they make any permanent choices. Once you've read and absorbed that thread, you will realize that there may be several treatment options that have similar success rates (I know there were for me, and I was a 3+43=7 guy). Each and every treatment has side effects. For many low and favorable intermediate risk patients, several treatments may have the same success rates but have different side effect profiles. Personally, I ended up making my choice based more upon the side effect profiles than efficacy, as there were 4 or 5 choices all having similar success rates.

Above all, give yourself time. As long as you are not diagnosed with one of the aggressive varieties of prostate cancer (and with G3+4=7, you're not), you can take months to decide without adding risk. I still (and will always) remember the shock of my diagnosis. It took me some time to regain rational thought, and I am forever grateful to the folks here for slowing me down enough that I could make a sound decision and move forward.

P.S. I believe that some of the best radiation oncologists for PCa in the whole country are out your way. Perhaps Tall Allen will see this and help with some names to consider.
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Michael_T
Veteran Member
Joined : Sep 2012
Posts : 4049
Posted 1/2/2017 9:06 AM (GMT -8)
Sorry to hear about your diagnosis and wow...that must have been tough with the E Coli infection. Sounds like you're on the mend from that and I wish you a speedy recovery.

I agree with the advice you've been given up thread. First, get a second opinion on the biopsy slides from Epstein at Johns Hopkins. Second, your comment on "collecting as much info as you can" is right on. That said, if you're serious about that you shouldn't limit yourself to talking to urologists. Uros are surgeons by training and they will give you good information about surgery, but most likely not-so-good info about other treatment options. Keep in mind that as a Gleason 7 (assuming that it is 3+4), you would be considered favorable intermediate risk--that means that any treatment has an excellent chance of curing you. You very well may decide to have surgery, but my advice would be only to choose after seeing what your options are.

So I would add radiation oncologists to your list of consults. In the LA area you have good options at UCLA: Dr King for SBRT and Dr Demanes for HDR brachy. (FYI, I had HDR brachy at UCLA and several years later I'm doing well.) Both SBRT and brachy would be good options for you in addition to surgery and both are world-class doctors.

In terms of urologists, I live in the South Bay and Garrett Matsunaga was my urologist and performs a lot of robotic surgeries and has a good reputation. But since I wasn't a good surgical candidate I have no direct experience with him in that regard.

Good luck to you and let us know how we can help!
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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 1/2/2017 12:02 PM (GMT -8)
Hi Larry-

It's not your Uro's fault that you got an infection, as long as he gave you an antibiotic before, during and after the biopsy. Perhaps you've had a history of taking that kind of antibiotic in the past? There are resistant e.coli in your rectum that the antibiotic didn't kill off.

Anyway, now that that's past, you have time to talk to doctors from various specialties, and make a calm, rational decision.

As for Uros, I think Rob Reiter at UCLA is good, and there are good ones at USC, Cedars-Sinai, and City of Hope, too. For ROs, you should talk to Chris King and Jeff Demanes at UCLA. I also like Howard Sandler at Cedars-Sinai.

You may be interested in attending a prostate cancer support group at the Cancer Support Community Benjamin Center in West LA. We meet the 2nd Monday of every month (so, next one is Mon Jan 9) from 6PM-8PM.
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larry088
Regular Member
Joined : Dec 2016
Posts : 25
Posted 1/2/2017 3:15 PM (GMT -8)
Thank you all for your replies, suggestions, and comments.

Yes, I will be slow down and try to make a decision in few months. Anyway, I am thinking doing the treatment in the summer time when my kids are off school if I decide to do a treatment instead of AS. Yes, I will try to get a second opinion on the biopsy slides from Epstein at Johns Hopkins first......Do we have a link somewhere in this website to teach me how to send the biopsy slides (photos?) to Epstein at Johns Hopkins? I didn't limit my options to robotic surgery, I will consider radiation, AS, or any other therapy.

My father was diagnosed with PC at age 75, my brother was at age 65. I was at age 54, just too early to accept it (I know I have a high chance to have PC because of my family history). Anyway, I will calm down and do my research on the treatment options, and find a doctor I feel most comfortable to go with. Thanks.
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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 1/2/2017 3:23 PM (GMT -8)
Here's the link:

pathology.jhu.edu/department/services/secondopinion.cfm

Usually all you have to do is call your urologist's office and ask them to send the slides to Johns Hopkins for a second opinion. It's a very common practice. I think they charge $250 if your insurance doesn't cover it.
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CLDCR
Regular Member
Joined : Aug 2015
Posts : 71
Posted 1/2/2017 6:07 PM (GMT -8)
Hey Larry,


Agree with all of the above.....surgery is not the only option. If you decide to go ahead with it Dr Clayton Lau at City of Hope in Pasadena is the best choice.

Look at all other options first please.

Good luck,

CLD
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HBFF
Regular Member
Joined : Sep 2016
Posts : 31
Posted 1/5/2017 8:55 AM (GMT -8)
Hey Larry. Email me and I can give you my experience over the last four months with Doctors in the LA area. I had surgery in September and I am back to work starting to get back with my life.
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tennisplayer
Regular Member
Joined : Nov 2016
Posts : 453
Posted 1/5/2017 2:47 PM (GMT -8)
Welcome to the club no one wants to join!

Like others have said: don't rush. You have time.

I was a Gleason 3+4, and I chose surgery. To be honest though, I should have found this forum when I was first diagnosed.

I spent several months getting second opinions from surgeons, and researching the surgical treatment. My diagnosing urologist- also a surgeon - sent me to a Radiation Oncologist in his group to at least hear about that option. I listened to all he had to say, but in a way my mind was already made up. I was from the "get that cancer out of my body" school.

My surgery involved complications such as internal bleeding, and eventually blood clots. Now I'm fine, and my pathology looks promising. My continence has been excellent. Sexual function still needs some time. But the month after surgery was rough.

Got to this forum about 6 weeks after surgery. I have read of many patients with a similar diagnosis to mine who chose radiation. There are several different types, and the side effects are different than surgery. Radiation treatment seems to offer very similar outcomes as surgery for a Gleason 7 patient.

Hindsight is 20-20, and I can't say surgery was not right for me. But I can say I wish I'd taken a little more time to fully research radiation.

Bottom line is take your time, get fully informed, and be glad you got to this forum. Make the choice that feels right.
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larry088
Regular Member
Joined : Dec 2016
Posts : 25
Posted 1/5/2017 9:06 PM (GMT -8)
Hi Tennisplayer,

Thanks for your feedback based on your personal experience/journey. Actually, I did a lot of readings on the radiation after Tall Allen and other members suggested me to consider radiation too. Up to now, I am leaning on SBRT (at UCLA medical center) more than robotic surgery. Personally, I am afraid of surgery.... just a mental thing. I also have requested my pathologist to send my slides to Dr. Epstein in Johns Hopkins to get a second opinion. I am very glad I found this website right after I was told I have a prostate cancer. Anyway, I will continue to do my homework in the next few months until I am 100% sure I make the right decision.
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larry088
Regular Member
Joined : Dec 2016
Posts : 25
Posted 1/5/2017 9:18 PM (GMT -8)
I forgot to include my signature, here it is...
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halbert
Veteran Member
Joined : Dec 2014
Posts : 5849
Posted 1/6/2017 3:08 AM (GMT -8)
Larry, here are a few other suggestions I followed when I was exploring my options:

Get yourself one of those legal size expanding file folders and get copies of ALL your paper. Everything. CD's of your scans too.

Carry a notebook and pen with you, to jot down questions as they come to mind, and to take notes at the consults.

Take someone with you to your appointments, because you'll have so much info to process, a second set of ears is needed

If you're a reader, get Dr. Patrick Walsh's guide to prostate cancer, Dr. Sholz's Arrival of the Prostate Snatchers, and Aaron Katz's Definitive Guide to Prostate Cancer. They all give different perspectives, but I found that taken together, they gave me a LOT of information to help me decide MY best course of action

Keep hanging around here and asking questions...and unload your mental gyrations when needed.
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Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 10/24/2017 11:45 AM (GMT -8)
City of Hope is where I had my RP in early 2007. The doctor that did it was Dr. Tim Wilson. He is still in the LA area but no longer at CoH. but my bias says if I had to do this all over again it would start with Tim. But CoH is an excellent place for RP because they have performed a lot of them there with a high reputation for low morbidity (when compared to others).

UCLA, UCI, USC all have great PCa programs as well.
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