Da Vinci surgeon 35ish vs. 500????

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ChiOKC
New Member


Date Joined Feb 2007
Total Posts : 6
   Posted 2/10/2007 6:45 PM (GMT -7)   

Since my diagnosis, I have done some researching of the available treatments but like the must of you, I found it to be a difficult task of deciding the best one for me. However at this point I am leaning towards surgery by the da Vinci method.

Midwest City Regional here in OKC has three surgeons that perform the procedure my urologist Dr Law is one of them. In addition, I have found a Dr ***in in Austin TX that I am considering as well.

Here is my dilemma that I hope some of you can help me with Dr Law has performed 35ish Robotic prostatectomy’s where Dr ***in has performed over 500. I have read that Dr ***in is one of the top 10 (one report says 5th another 8th) robotic surgeons in the country. All I have to go on with my doctor is that he has been very informative and has said that he would support whatever my decision in treatments as well as doctors to perform the treatment oh, and his extreme confidence (of course) in his abilities at robotic surgery. This should be a no brainier but unfortunately, it is not for me.

What I am concerned with is the logistics of traveling to have the procedure done. Those of you that have do you continue to travel back and forth for follow-ups or do you have your local urologist handle it? I guess this would really be the decision of the attending physician.

Help


Rog & Roz

55 years old

Great Health prior to Dx

Dx on 1/12/07

PSA 4.2

Right, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Left, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Looking at da Vinci Surgeons in OKC and Austin

Live in OKC, willing to travel


SJC
Regular Member


Date Joined Jul 2006
Total Posts : 113
   Posted 2/10/2007 7:14 PM (GMT -7)   
I flew to Baltimore (about a two and a half hour flight) for the opportunity to be treated by whom I thought was an expert urologist in terms of clinical skill and academic brilliance b/c of what I beleived to be my best chance for a good result.  Following surgery and my quick and successful recovery, my initial opinion and decision proved accurate.  I visited with my selection once before my return trip for surgery, then again the day before surgery.  I was in the hospital a couple of days; discharged at noon; spent the first night following discharge in a nice hotel on the Baltimore harbor; then flew out the next morning.   I have no need for follow-ups in Baltimore.  The only follow-up I've had with my local urologist was for removal of the staples and catheter.  I had a PSA three months post-op.  The only thing I need to do in the future is have an annual PSA. 
 
The travel for me was not a problem at all.  In fact, I think my flight was probably easier than a two and a half hour drive b/c I was able to stand in the stern galley of the aircraft when we were at cruising altitude.  (It was easier and more comfortable to stand than sit.)
 
Bottom line:  don't let travel interfere in your selection of the surgeon with the most significant experience and exemplar credentials if you want to enhance your probability for a good result.

Post Edited (SJC) : 2/10/2007 7:39:27 PM (GMT-7)


naimnut
Regular Member


Date Joined Jan 2007
Total Posts : 93
   Posted 2/10/2007 7:21 PM (GMT -7)   

This is one decision you don't ever want to look back at with regret.

I've selected a surgeon that is out of town. I'll meet with him on a Wednesday, have surgery the following day, possibly spend one night in the hospital then be discharged to stay in a local motel or return home (my choice). He has a colleague who he has trained who is local who would be willing to deal with the catheter removal, or, he suggests, I should just stay over the weekend and get it checked and removed the next Tues or Weds.

Personally, I want one of the most experienced surgeons operating on me. A measure of his skill is that his surgeries are down to lasting somewhere over an hour. Why? No wasted motions, he knows exactly what to do and how to do it because he's done it over a thousand times. (way more than that)

I expect that I'll go to the local guy for my follow-ups and won't have to see my surgeon again, though I might be wrong. But it is worth it.

One thing I found out is that my insurance will reimburse me for travel costs. airfare at 100%, $50/person/day for food and lodging. this will be a big help. It might be worth it for you to check with your insurance to see what their policy is...

Markus


Age, 53
PSA 3.76, Gleason 6, T1c, scans negative
psa doubling time 35 months
Still researching and deciding treatment options.  Leaning towards da vinci robotic.


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 2/10/2007 7:56 PM (GMT -7)   
hi chi

i thought i posted a reply earlier, but it is not here. since then you have received some great advice so i don't need to repeat it here. the point is to seek the best doctor you can find with the most experience and the best reputation. you can work out the travel logistics. just remember--this is your life you are talking about. do yourself a favor and never sacrifice for 2nd best in life if you don't have to. best of luck and all good wishes.

Dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.


ChiOKC
New Member


Date Joined Feb 2007
Total Posts : 6
   Posted 2/10/2007 8:31 PM (GMT -7)   

Thank You all for your sound advice? As I said this should be a no brainier, I think I just needed a like moral support. I am so glad to have found this site.

I have an appointment with a radiologist next week although I think you guys have helped me to make up my mind. I believe I still need to explore all treatments with a professional before I make my final decision.

 

Rog


Rog & Roz

55 years old

Great Health prior to Dx

Dx on 1/12/07

PSA 4.2

Right, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Left, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Looking at da Vinci Surgeons in OKC and Austin

Live in OKC, willing to travel


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/10/2007 9:35 PM (GMT -7)   
Hi, ChiOkc, Sorry you are joining us. We too are from OKC and have heard of Dr Law. As I would like to see Dr. Law progress with his training in the da Vinci method, I do not want my husband to be one of his trials. We have been to 2 different urologist and an onocologist. The onocologist highly recommended Dr. F.a.g.i.n.. We have very similar scores. Dr. Reitz was my dad's doc. I truly trust that he is pointing us in the right direction. We had an appointment at MD Anderson, and have canceled it. Dr. F.a.g.i.n is the way to go in this part of the country...... Feel free to email me and I will tell you more. haven't met many people from okc, cpgray45@sbcglobal.net
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/10/2007 9:45 PM (GMT -7)   
Find a urologist like we did who will be here if you have the surgery in austin. Would be happy to point you in that direction. Don't stay here for procedure unless it is open. travel if you can
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 2/10/2007 10:36 PM (GMT -7)   
kziz

you believe your stage of pc is T2c which has a question mark after it. unless you had a positive DRE, your stage is more likely stage of T1c which most members have. you did not indicate what your DRE test showed. Stage T1c is certainly preferable to stage T2c as it is an earlier stage of pc.

Dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.


GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 2/11/2007 7:27 AM (GMT -7)   
Hi, Rog and Roz. We, too, went to Dr. F.a.g.i.n. (word police don't like those first three letters). It was a 5.5 hour drive for us. Here's the rundown:

Went for consult. Spent the night. Scheduled surgery for following week.

Had all bloodwork done locally under scrips from Dr. F's office.(Your local uro can handle that, too)

Returned the next week for surgery (checked into hotel on Tuesd./Surg. on Wed./Checked out of hospital, returned to hotel on Thurs./checked out of hotel and returned home on Friday). On Thurs. a.m., after getting settled into hotel room, I drove just a short distance to a drugstore and got the scrips filled. We packed all our own jell-o/pudding/soft foods and were pretty much self-contained during our stay.

Next week returned for cath removal. Drove down same day, drove part of way back and checked into hotel.

8 weeks later, returned for PSA results. Because we were developing issues with incontinence, Dr. F. wanted us back in another month after prescribing medication. Otherwise, he would have scheduled a 6-month PSA. and then turned us back over to a local urologist.

We're set to go back for that 6-month PSA in April and from there on out will be dealing locally.

Dr. F's office/Westlake Hospital has negotiated a great agreement with a resort just a mile or so down the road. Doctor's office will give you a special letter to present at the reception desk to get the rates. Well worth checking into. We were lucky as we got their "summer" discount. Not only was it close, but the staff is truly outstanding and would be there to help for any reason day or night. Also, we asked for the spa section and were able to get a room near the drivethrough for unloading. No long hallways or elevators to hassle with. Could walk up and down the halls for exercise and noone paid any real attention.

His main office is just down the road from the Renaissance. His office in the Hospital complex is the one near Barton Creek Resort.
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/11/2007 10:33 AM (GMT -7)   
Thanks for the additional info on Dr. F.a.g.i.n. We are looking forward to meeting with him in 2 weeks. Hopefully we will be scheduled for procedure as quickly as you were greenacres.

pcdave - We have been told by all 3 docs we have talked to that the stage is T2. Just guessing on the c part secondary to both lobes being involved. 20% of core biopsies postive on both sides. T1 is 5% according to all the info I have seen on staging. I would much rather hear the dr's say T1.

chiokc - Dr. F's website has a 50ish page information booklet that you can print out. My husband says that it has been very informational for him. He recommends reading it. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/11/2007 8:45 PM (GMT -7)   

Hi everyone,  Another Okie here.  I live in  Norman.  You can read all about my journey in KW's Journey.  Look back a few pages.

I decided to go with my local Dr. and the open RRP.  But everyone has to make their decision on their own.

Good Luck.  KW


    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct. 17, 2006 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Scheduled Feb.20th Cystoscope with possible Cottigen injection into bladder neck to help control leaking.
   


ChiOKC
New Member


Date Joined Feb 2007
Total Posts : 6
   Posted 2/11/2007 9:03 PM (GMT -7)   

Thanks GreenAcres that was very helpful think I will get in touch with Dr Fs office again. Talked with a nurse once before but for just a little bit thanks again that was great info boy am I glad I found this site.

Courtney I have down loaded the package and have gone through it several times yes good info there. When I talked with Dr Fs nurse, she also told me about the agreement with the resort. She said she was going to have the Dr and the folks who setup lodging give me a call never did.

So that is why Dr Fs name got **** out I was wondering about that.    Rog


Rog & Roz

55 years old

Great Health prior to Dx

Dx on 1/12/07

PSA 4.2

Right, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Left, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Looking at da Vinci Surgeons in OKC and Austin

Live in OKC, willing to travel


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/11/2007 9:11 PM (GMT -7)   
As much as I HATE this cancer, it is nice to talk to fellow okies. chiokc, we were not told about lodging. We plan on flying down for consult and back the same day, but surgery is obviously different. Which resort is it? Barton Creek? I think I saw that somewhere. Your scores and my husbands are very similar. If you don't mind me asking, whose your doc here?
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 2/12/2007 7:36 AM (GMT -7)   
Yes, Barton Creek. They have a web site - just contact them directly and ask what their Westlake hospital rates are for this time of year. Or call back to Dr. F's office. They're always ready to help. Be sure to book as soon as you're on the schedule. Austin's a hoppin' town (and quite fun when you're not there for, well, cancer surgery).

Westlake Hospital is also wonderful, I might add. Each room is a small "suite." A sofa pulls out for a bed and the nurses offer blankets and pillows. They pretty much show you where everything is and let you help yourself if you want. The waiting area is also nice and comfy.

(Chi and Kziz - we were long-time Okies until returning to Texas a couple of years ago.)

You're so right KW. There are many great surgeons in OK or anywhere who do open. We would have had to travel a good distance for any procedure, so robotic made sense for us plus all the benefits of the procedure and finding the best doc in the area. We looked long and hard to find the best - and are very confident that we did. As you know from his booklet, he's aggressive about post-recovery, too. You want a doc who is an outstanding surgeon, but also wants to see you get back to normal as soon as possible. Once the prostate gland is out, then you realize how important getting the other functions back are.
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


ChiOKC
New Member


Date Joined Feb 2007
Total Posts : 6
   Posted 2/16/2007 12:00 PM (GMT -7)   
Dave

I am exploring all options yes please send me the info and thanks.

Rog & Roz

55 years old

Great Health prior to Dx

Dx on 1/12/07

PSA 4.2

Right, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Left, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Looking at da Vinci Surgeons in OKC and Austin

Live in OKC, willing to travel


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/17/2007 10:55 AM (GMT -7)   

Hi  ~ Rog & Roz,

 

                  A   “Special”  Warm Welcome  to  You!   yeah  

 

I know we can “all” make Your Journey smoother just by being here for you! 

This is truly a great forum!!! ~ You have joined! You are now part our forum family ~ a group of wonderful individuals who are so willing to share their journey with you! 

 

It helps “all of us” ~ to help you ~ if we know where you are on your path.

So ~ Please stay with us and take our hand when you need it!  Keep posting.... OKAY!!   We are all here to help you travel the path with prostate cancer. 

 

 

KNOWLEDGE IS POWER... and POWER conquers fear

YOU MAKE THE DECISIONS… YOU HAVE OPTIONS…

~ and ~

Your decision will be the right decision for you!!!

 

 

We invite you to visit our personal thread in the signature area below.

Our thoughts and prayers will be with you as you continue your search for answers…

 

In Friendship ~ Lee & Buddy

 

“God Bless You”

 

It's a little prayer  ~  "God Bless You"

...but it means so much each day,

It means may angels guard you

and guide you on your way.

 

 

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)

Helpful Hints for New Members... Hope this helps you! :)

 

 

The most important thing is…. Keep posting…..

 on your thread and on others

and keep reading as many threads/postings as you can. 

There is so much information that is being shared.


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/17/2007 11:01 AM (GMT -7)   

Partial Post… by Rog & Roz

I believe I still need to explore all treatments with a professional before I make my final decision.

 

Hi Rog & Roz,

 

By all means continue to research and find your answers.  :-)

 

We are so happy you found us and are allowing us to follow with you on your journey.  It truly is a journey best traveled with friends.

 

Buddy & I invite you to read “Our Journey”…. listed in our signature below.  If you pull just “1” thing from our experience…to make your journey smoother… it will be a blessing for us.

 

Keeping you close in thoughts and prayers,          

In New Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 2/17/2007 5:06 PM (GMT -7)   
I thought it was 50 operations for one to master the techinque? Anywho...anyone had Savatta as a surgeon? The ones I heard from who have had this guy as a surgeon seem so pleased with the outcome. I know he's got a web site. Just wondered if anyone consulted or used him.
 
swim

bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 3/15/2007 10:25 AM (GMT -7)   

Rog & Roz,

 

Hope to hear from you soon… :-)

Heard from kziz that you and ChiOKc are down in Austin!!

What a small world it is!!! 

Our thoughts and prayers are with all of you!


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

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