Husband's Test Results; Dr's Experience with Robotic Surgery and His Comments

Post Edited (mariateresa) : 8/27/2007 6:15:57 PM (GMT-6)

Mariateresa:

First of all, what wonderful news about the CT scans - what a load off your hearts and minds.

As for the surgery, I cannot comment on that as I had proton, but all I have read from the guys who have had surgery is that it's very important to find a surgeon who has done alot of these procedures.  I'm sure they will give you their suggestions on this.

Again, glad to hear the CT scans gave you good news and thoughts will continue to be with you.

Dutch

Post Edited (mariateresa) : 8/27/2007 6:19:22 PM (GMT-6)

Maria Teresa,

We here of course don't know everything your physician knows about your husband.
But we do know many,many physicians!

DO NOT AGREE TO ANY TYPE OF SURGERY WITHOUT A SECOND OPINION.  PERIOD.

Your latest news indicates you have some time to see another physician and get in line for surgery with him or her if you so choose. 

I, like Tony, am suspicious of a physician making such a statement about the nerve bundle?
Maybe there is some information we do not know. 
Considering only what you have said, Perhaps the physician is just giving you "worst-case-scenario" - at worst giving you some insight at the physician's historical success at avoiding severing the nerves.....

Regardless, the second opinion is absolutely necessary.
After you make the appointment, your slides & data will be sent & faxed to the second physician.
I don't remember where you live or where you are seeing this first surgeon.
But, if Henry Ford is at all accessible to you for the surgery and follow-up visits, I personally would not hesitate to switch to a major facility such as this and its team of physicians.

Even if you stay with the first physician, the second opinion is more than an exercise.
It is your right  and you need to KNOW what you are choosing,  especially if you decide to go with the first surgeon.

Your husband will likley have incontinence for up to 12 to 16 weeks post surgery.  Some have almost none.  Some have more.  Your physician dismissing Erectile Dysfunction to injections and not mentioning incontinence seems another sign of where he or she is on the learning curve.
As for the possibility of the need for radiation, until the post-surgery biopsy, you will not know.
If there is verfication of capsular penetration, I would assume a physician would FIRST consider Hormone Therapy before post-surgery radiation.

Perhaps the physician is telling your husband all of these things and not you.
We don't know everything about his case.
Regardless, make the second opinion appointment ASAP.
If your physician is worth his salt, he will welcome a second opinion.

Your Friend,

C^Cedar
ICTHUS!

mariateresa,

What onderful news on your husband's scans!!  This calls for a celebration!

I am bzup's wife and while I have read hundreds of posts on this forum, I have not commented up until now.  PLEASE consider a 2nd opinion as to treatment, specifically surgery in your husband's situation.  When my husband was diagnosed, we spent a couple of months researching and consulting with physicians.  We spoke to 3 doctors in person and consulted with 2 by telephone before settling on Dr. Vipul Patel in Columbus.  Our local urologist was qualified and willing to perform a radical surgery, but did not have a lot of experience with the robot.  He suggested we consult with one of his partners OR with a doctor from one of the major hospitals in the area.  Next, we consulted with a radiologist to discuss seed implants (our first choice of treatment).  The radiologist was very qualified to perform the implants, but after learning more about the potential difficulties, we reconsidered our thought on surgery.  Third, we consulted a highly regarded surgeon at Duke.  He was VERY qualified to perform radical surgery, and we really liked him, but if we were to opt for surgery, we prefered the robotic.  Next, I emailed the Cleveland Clinic and asked about Dr. Gong.  Dr. Gong graciously called us to discuss our particular situation.  He was very well trained, but agreed that Dr. Patel at OSU was an excellent choice for a surgeon to perform a robotic surgery.  

My point in offering this information is that seeking multiple opinions is a great way to get comfortable with the terminology, the procedures, the options, the variable success rates and outcomes.  Please consider getting at least one other opinion.  I have read wonderful things about Dr. Menon (sp?) at Michigan.  You only get one chance at the operation and you have every right to expect the best outcome for your dear hubby.

As for sparing the nerve bundles - this is an excellent reason to seek out another opinion.  I don't think I'd feel comfortable hearing that news from one doctor.  If you seek other opinions, and those docs concur, you will rest easier knowing that you have double-checked his theory.

Here is an excellent article that our son forwarded to us, yesterday. http://www.cnn.com/2007/HEALTH/conditions/07/24/cancer.prostate.reut/index.html

Best wishes. Our thoughts are with you as you work through the decision-making phase of your journey.

This site has been a blessing to those of us who have personally traveled on the road to Pca recovery and cure.

Maria Teresa,

PLEASE listen to what everyone else has suggested.  Get a second opinion!!  In most cases a robotic surgeon that feels both nerves need to be removed due to the extension of the cancer will recommend a good open surgeon because this situation is when the "feel" is important.  Your contact with Menon's group was the right move.  Follow that up with an appointment.

Praying for you.

Tamu

Post Edited (mariateresa) : 8/27/2007 6:20:43 PM (GMT-6)

Post Edited (mariateresa) : 8/28/2007 4:56:09 PM (GMT-6)

Post Edited (mariateresa) : 8/27/2007 6:30:28 PM (GMT-6)

Maria Teresa,

I'm greatly relieved to read that you are in touch with Dr. Menon.  He is one of the most experienced da vinci surgeons in the world.  I considered having him perform my surgery. One of the main reasons I went with Dr. Vipul Patel at Ohio State was that my insurance would cover, in addition to the medical treatment costs, all the travel and lodging, etc.

Regarding the question posted above about how a surgeon could be over 1,000 surgeries, I can answer that. My surgeon is doing 5-6 surgeries a day, 3 days a week. He is now at 1,700+ surgeries. Menon is similar.  There are no more experienced da vinci surgeons anywhere in the world.

Regarding nerve sparing, DO NOT GO TO your current urologist who expressed doubts about being able to spare the nerves.  Let an expert like Menon or Patel or one of the other top guys make that judgement call. With da vinci, nerve sparing is the norm, not the exception.

I read your other thread in which you expressed (understandably) your frustration at your urologists slowness in attacking this disease.  It is regrettable but not necessarily a complete disaster.  This is a comparitively slow growing disease and you are in touch with a top Doc. If anyone can treat this disease, Menon can.

BTW, I'll just mention that you may want to confirm whether your insurance has any additional resources available to you, as a cancer patient. I found my ins (UHC) has a cancer resource center. When you're diagnosed, and you call them, they basically open another insurance policy on you that provides access to 20 "centers of excellence" for treatment.  Depending on who your insurance is with, you may have something similar.

Best regards and you will be in my prayers

Post Edited (mariateresa) : 8/27/2007 6:33:47 PM (GMT-6)

Post Edited (mariateresa) : 8/27/2007 6:37:41 PM (GMT-6)

Maria,

I was puzzled that Dr. Menon suggested that I do the nerve-sparing procedue.  In all fairness, it was only a phone consultation, but he had my biopsy information.

I'll be intereted in how your meeting goes --- he's considered to be one of the best.......