Choosing a Surgeon??????

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

mochapj
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/12/2007 8:04 PM (GMT -7)   
Hi All,
 
My father was just diagnosed with PC this week. He is 65.  I think his stats are PSA 7.4, Gleason 4+3, t2a, and that's all I really know.  He has been watching his PSA for several years with this being his 3rd biopsy.
He went to the local urologist for a consult this week and to receive the above information.  I went with him as did my mother.  Since he had a week from the "phone call" until the consult we have been doing as much research as possible.....of course all of the choices stink!!  But he is leaning toward surgery...perhaps Da Vinci...of course our local guy could do it...but he's only done 11...
 
We talked about Henry Ford (we live in Michigan) and the local guy said it might be better to go to University of Michigan.
 
We are SO confused and bewildered....all of the treatment choices and then all of the literature says you must pick a GREAT surgeon an "artist"  but how do you find out who the "excellent" ones are?????
 
He does have an appointment with Dr. David Wood at U of M on July 11th, for a second opinion type of thing...
 
He is willing to travel out of state......how do you choose who is good?
 
A loving, devoted and scared daughter
Julie
ps....my dad travelled with me to China in 2004 to help me bring home my then 10 month old beautiful daughter...and I am hoping he can go back to China with us in 2011 for a "return visit"

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 6/12/2007 8:22 PM (GMT -7)   

Julie,

There is no perfect way to choose what you feel is the right surgeon.  Most of us that have had Da Vinci's and sought out expertise generally looked for a surgeon that had done at least a couple of hundred procedures.  In my case my surgeon has done over 800 Da Vinci's when I had mine done and is now over 1,100.  There are several surgeons in the country that have done hundreds and some of them fairly close to where you are at.  A good surgeon will share with you their complication rates so be sure to ask.  I guess in addition to the number of procedures done the most important part is the confidence that you build in the surgeon.  A surgeon that not only talks to you about the surgery but also spends time discussing the rehabilitation process really cares about your total outcome and not just getting rid of the cancer.  Several people that participate on this forum have used Dr. Menon at Henry Ford and have all expressed a great experience and very good outcomes.  I am sure some of them may reply to your post.

Good luck and keep us posted.
 
Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 6/12/2007 8:35 PM (GMT -7)   
Perfect advise from Tamu,
Get a known surgeon and you will get self assurance. Did I do the right thing? Should I have done something different...etc. I travelled and have no regrets. My surgery went well but my post op pathology did not. But I sure am glad I went to one of the best surgeons. I know it was the right decision.

Tony

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 6/12/2007 8:47 PM (GMT -7)   
Julie,

My DH had his done at the U. David Wood did his robotic 2 years ago.

swim
 


aviator
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/13/2007 4:58 AM (GMT -7)   
Just remember that doing a large number of procedures doesn't necessarily mean that they are all being done well, especially for procedures that are fairly new.  A surgeon who began doing them when the technology first came out gets a "head start", so to speak, and gets referred a number of patients simply because he's the only one doing the procedure. 
 
 All procedures have learning curves for the surgeon, and the learning begins during the residency program, so almost by definition you are likely to be "on the curve" if you have it done at a teaching center (which isn't always bad), or if you have it done by someone who has only done a few of the procedures.  But also, all surgeons learn differently, and some never seem to master certain techniques despite doing a fair number of them, which is obviously why this question is so hard to answer.
 
If there is any way you can talk to people who observe the surgeon regularly, you are most likely to get valuable information from them.   This would include operating room personnel, anesthesia people and assistant surgeons.
 
I faced this decision myself 2 weeks ago.  In fact, I elected open radical prostatectomy instead of the robotic or laparoscopic procedure based on the knowledge that my surgeon had done a "significant" number of the procedures and was known to have a high level of skill and confidence doing the procedure.  I don't regret that decision.  My course has been uneventful and I ended up having [b]zero[/b] incontinence since catheter removal (an outcome that is frequently linked to the technical skill of the surgeon).
 
I had an inside track, though.  I'm a surgeon at the hospital where I had the procedure done.  But I think the principle is quite valid.
 
 

spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 6/13/2007 5:00 AM (GMT -7)   
Hello Julie,

It is with regret that I welcome you here, but you will be with carring friends.

As you look for the right surgeon experience is going to be a key factor. In my case the surgeon had performed 1000+ DaVinci procedures before mine. Next we were able to get a personal testimonial from a previous patient; this was very reassuring. Finally the face-to-face interview was the clincher. The confidence we came away with was very important.

Please keep asking questions because we'll be here to help any way we can 24/7.

Glen
Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. boundaries
DaVinci surgery on 02/23/06
 


ldoun
New Member


Date Joined Jun 2007
Total Posts : 19
   Posted 6/13/2007 5:55 AM (GMT -7)   
My local Urologist wanted to do my robotic surgery but had only done about 40 procedures. My research found many studies that indicated surgical outcome was greatly improved with the surgeons experience. I set a threshold of 100 minimum.

With research on the web I developed a list of surgeons who were on the faculty or speakers at the various schools and training symposiums particularly the 2006 "Advanced Robotic Techniques of Prostatectomy Symposium". These are the surgeons who are at the top in experience and up to date on the latest developments. This list gave me the starting point of choosing a surgeon.

The personal meeting and being comfortable with the surgeon is very important and must be considered.

Dr Minon at Henry Ford developed much of the currently accepted techniques used in Robotic RP. Henry Ford does more Robotic Prostatectomies that anyone (they say 20-25 per week). I am sure Dr Minon doesn't do all of them but I have nothing but good reports about Henry Ford Vattikuti Urology Institute. As far a U of Mich, my research indicated they are best at open surgery in your area.

Prostatectomy outcomes are highly variable so nothing can be predicted with certainty. You make your best choice and hope you got the best results.

Jim
Age 64
5'6" 145#
PSA pre-op 5.2 (12% free)
Gleason 3+4=7
Robotic RP 4/24/07 Dr. Albala, Duke
Post-op- Organ confined Gleason 7


Joes411
Regular Member


Date Joined Mar 2007
Total Posts : 87
   Posted 6/13/2007 7:24 AM (GMT -7)   
Julie,

Dr Walsh talks about the importance of surgeon "skill and experience" in his book Surviving Prostate Cancer. This is a great book (a must have in my opinion) for people dealing with prostate cancer. In his opinion skill and experience are vitally important. I opted for a more experienced surgeon and traveled for my surgery.

Getting info on the number of surgeries a surgeon has done is not that difficult. If you find a surgeon you are interested in a little digging around on the internet can usually get you that info. You can always call the doctors office and ask if the internet does not work.

Determining the skill of a surgeon is a little more difficult and subjective. Once I identified a number of highly experienced surgeons, I searched the internet for the experiences of others who had used them. I found allot of that type if info on this website using the search tool. You can also get that type of info by just googling the doctors name. Based on the positive experiences I read on this site and others I picked my surgeon (Dr Kawachi / City of Hope hospital).

I have heard of Dr Wood but I can't recall what I read about him. Dr Menon at Henry Ford was one of the surgeons I was considering. As Jim mentions above he is one of the pioneers of Robotic surgery and has done allot of them

Good Luck,
Joe

Age: 51

PSA  Jun06  4.1  (PSA Jun05  1.2)   DRE negative

1st Biopsy Nov06 – Atypical cells but no cancer

2nd Biopsy Jan07 – 1 of 16 cores positive

Stage T1c   Gleason  3+3=6

DaVinci Prostatectomy 5/17/07

Pathology: clean margins, clean seminal vesicles, organ confined


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 6/13/2007 12:42 PM (GMT -7)   
Julie

Menon, Tewari, Wood and I forget the other guy, all worked on the same initial robotic procedures piloted / tested here in Detroit if that says anything. Most of these Docs around here are transient; they move around a lot. We saw no reason to head to Henry Ford when Wood had moved over to the U the year before and our insurance happens to be U of M owned. Keepin it in da family :>)

Wood has some of his numbers on the U of M web site. His bedside manner isn't my favorite however, he wasn't hired to be a buddy. He was hired to do a job. Since Paul is cancer free, drip free from day one and has decent function...I'd say he did what he was hired to accomplish. Grace and good luck held their own place I'm sure. Wood only gets partial credit :>)

Swim
 


mochapj
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/13/2007 4:43 PM (GMT -7)   
Thanks all for your responses...of course you all know the turmoil we are having. I think Dr. Wood is at least a good place to start and that will probably be where my Dad decides to have surgery. I will attend his consult with him...it seems as if the 3 of us, Mom, Dad, and me make a fairly decent team

Julie

bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 6/13/2007 5:41 PM (GMT -7)   

Hi ~ Julie, Dad, & Mom,

  

A   “Special”  Warm Welcome  to  You!   yeah   

We 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...  It helps “all of us” ~ to help you ~ if we know where your loved one is …on their path. So ~ Please stay with us and take our hand when you need it!  Keep posting.... OKAY!!

  

KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear

 

THEY MAKE THE DECISIONS… THEY HAVE OPTIONS…

~ and ~

Their decision will be the right decision for them!!!

 

Our thoughts and prayers will be with all of you!

 

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)

Prostate Cancer Resources, Helpful Hints, and Topic Thread Links

This link is also located at the top of each prostate forum page... ;)

Post Edited (bluebird) : 8/26/2007 7:30:40 PM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 6/13/2007 5:50 PM (GMT -7)   

Hey ~ Julie,

 

As you spend time here on the forum… you’ll find that we all have a journey to share and you can pull from any or all.  Whatever helps to make your dad’s journey, your journey, and your mom’s journey ~ smoother.

 

Yep ~ it’s a family disease!!!  So ~ stay close and continue moving forward.  We are all on your TEAM now…  yeah   so pull from our strength as we send it to all of you.  Buddy & I invite you to visit our personal thread… listed in our signature above in your welcome letter.  Keeping you close in thoughts and prayers.  In Friendship ~ Lee & Buddy

 

New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, December 17, 2017 3:12 AM (GMT -7)
There are a total of 2,906,387 posts in 318,951 threads.
View Active Threads


Who's Online
This forum has 158289 registered members. Please welcome our newest member, shibainu123.
192 Guest(s), 4 Registered Member(s) are currently online.  Details
shibainu123, Starlight*, Hibee, Nowitshell