Scheduled Surgery

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Educator
Regular Member


Date Joined Oct 2007
Total Posts : 37
   Posted 10/30/2007 12:02 PM (GMT -7)   
I have now had my consultation and surgery scheduled for 12/28/2007. This is two months away and worries me some as I want this thing gone from my body yesterday. I have lost four siblings and two parents from cancer of various types, none being from the prostate.
 
My surgery is at Vanderbilt Medical Center with Dr. Duke Herrell. It is my understanding that he has 400 surgeries under his belt but most of those were laprascopic. I really do not know the number of Robotic surgeries he has performed but it looks like I should have asked. It appears the prefered doctor at Vanderbilt is Joseph Smith but there is a a six month back log waiting for him. I do not believe I can take waiting that long so I schedule with Dr. Herrell. I do not know of anyone that has used Dr. Herrell so if any of you do know of someone please let me know maybe I can get more information. He appears to be very knowledgable and caring and he is the Director of Robotic surgery for VMC so I guess he can't be too bad.
 
His statement that I had good paramaters with a 6 gleason and low PSA made me feel better about waiting the two months but when I read some of these post on this forum it is apparent that the scores given to you on the initial biopsy really don't seem to mean much since many of your scores were elevated post operation.
 
Again if anyone knows or have use Dr. Herrell I would appreciate the information.
 
Educator
 
Diagnosed 10/15/2007
Age 55
PSA 4.2 9/15/2007
PSA 3.9 10/1/2007
TC-1
 
Prostate, Transrectal Needle Biopsy 10/05/2007
 
Results 10/5/2007
 
A-D Right Base, Right Mid, Right Apex, Left Base;
Benign Prostatic Tissue
 
E. Left Mid; Adenocarcinoma, Gleason's Grade 3+3=6, 10% involved
 
F. Left Apex; Adenocarcinoma, Gleason's 3+3=6, Less than 10% involved
 
2 of 12 involved as two samples were taken from each area.
 


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 10/30/2007 1:04 PM (GMT -7)   

Hello Educator,

I do not have any info on Dr. Herrell, but it sounds like you are comfortable with him. You still have 2 months to do further research if you have any doubts. I like yourself was anxious to get the surgery over and done with asap, but I still had to wait over 2 months.

So take this time to get in good shape. Practice your Kegel exercises, and start a daly walking regiment. If you're already a walker/runner this will help speed up your recover.

Good luck to you, and try not to drive yourself crazy with the "What if's".

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. margins
DaVinci surgery on 02/23/06
Last PSA 08/26/07 @ 18 months "0"


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 10/30/2007 3:21 PM (GMT -7)   
Hi Educator . . . boy can we relate to "wanting this gone yesterday" and I think the one thing we come to learn and eventually accept when we get tossed these events to deal with is the WAITING. . . . never easy but you get used to it.

Two months is not very long from diagnosis with your numbers, so take a deep breath, stay with us for support; you will be on the other side of this before you know it.

We don't know your doctor, but judging by his "Director of Robotic Surgery" title, he is most likely teaching the procedure as well as doing it and if you have a good feeling when you are talking with him, that's half the battle.

Our own personal opinion has always been that although a doctor may have a lower number of these under his belt, he's perhaps still in the very cautious and careful stage which is important too. When we were at the pre op session for our doctor, the nurse at the hospital was looking up the time of our surgery, her comment was that he was booking less time for the procedure now as in the beginning and we left feeling like we were in cautious hands. Again . . .only our opinion as to numbers performed.

Good luck to you and please keep us posted.

;o) Linda & Bob


Bob (61) - Laproscopic Prostate Removal Sept 27, 2006.
2 of 12 malignant biopsy samples - gleason 3 + 3 = 6.
 
Pathology - cancer completely contained, even a second more aggressive, previously undetected cancer)
PSA UNDETECTABLE Nov 2006, Feb, May, Oct2007.  ONE YEAR!!!! WHOOO HOOOO! 

Bob also has two secondary conditions -- Polycythemia (elevated red & white cells & platelets) and . . Myelofibrosis) -- If anyone has experience with or information on these, please email us.


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 10/30/2007 3:49 PM (GMT -7)   
Educator,

As you know from my previous replies Dr. Joseph Smith did my Da Vinci a year ago this week. I never met Dr. Herrell but Dr. Smith told me that Dr. Herrell was the one that headed up the bringing of the Da Vinci robot to Vanderbilt and knows more about it then anyone there. I knew Dr. Smith's backlog was getting longer even though I was told at my last appointment that he was doing more Da Vinci's in a month then anyone else in the country.

Take the next two months to get yourself in very good shape. As it gets closer to surgery date if you need any information specifically about the surgery at Vanderbilt let me know.

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
Undetectable PSA on 6/25/07


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 10/31/2007 5:01 AM (GMT -7)   
Just because one surgeon is more experienced than the other doesn’t always mean you’re in less capable hands. There were two surgeons who did the DaVinci at my urologist’s office. One had over 1,000 and the other had over 300. I’m probably in the minority but after doing my research I chose the one who had over 300 since I knew of him beforehand through a friend, his impressive medical school and medical background, and the successful outcome of surgery that a couple of guys had who had him do their surgery. Additionally, he goes around the Southeast training other surgeons in the DaVinci procedure. I know opinions vary as to the number of surgeries involved during the “learning curve,” but I figured 300 was sufficient, and maybe even less. It all depends on the skill of the surgeon. Some pick it up faster than others.

Looking back, I could not have asked for a more successful outcome, and, after speaking with a few guys who had the more experienced surgeon, fared far better than them. I was in surgery for only an hour and forty-five minutes, was up and walking that afternoon, went home the next day, had absolutely no bloating or gas pain, negative margins, capsular penetration and seminal vesicles, was out of the pads at five weeks, had erections at six weeks, and am fully continent six months post-op. Another benefit of having the surgery done were I did was that both doctors work as a team and were in the operating room. My surgeon was at the controls and the other surgeon was at my side assisting. I felt very comfortable knowing that if complications arose during surgery I had two experienced surgeons there.

Bottom line, it all depends on the skill of the surgeon, and not necessarily the number of surgeries, although it is an important factor to take into consideration. I know I would never pick a surgeon who had only done, say, 50.


Age: 49
Diagnosed: March 25, 2007
PSA: 3.0
Biopsy: Gleason 6. Five of twelve core samples positive with <5% each. No perineural invasion seen.
DaVinci Surgery: May 21, 2007 at Florida Hospital, Orlando, Florida. Surgery took one hour and 45 minutes. According to my surgeon, everything went textbook and the prostate peeled away nicely.
Post-op Pathology Report: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes.
Continence: Out of the pads at five weeks. Still have some very minor stress incontinence at times but it's not an issue. Still Kegel every day and will continue to do so.
Erections: Yes! With the assistance of Cialis.
1st Post-op PSA: <0.1 2nd Post-op PSA: <0.1
Family history: My Father had his prostate removed at age 67 in 1997 and has had a <0.1 PSA for the past 10 years. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.
 
 
 

Post Edited (JCL) : 10/31/2007 6:12:39 AM (GMT-6)


Educator
Regular Member


Date Joined Oct 2007
Total Posts : 37
   Posted 10/31/2007 6:13 AM (GMT -7)   
Thanks to everyone for their comments. You guys have a way of making a person feel better. I think my choice is a good one.

I am new at this and can't really offer any advice to anyone but if I had some to give I would sure give it to you.

Thanks again

Educator
 
Diagnosed 10/15/2007
Age 55
PSA 4.2 9/15/2007
PSA 3.9 10/1/2007
TC-1
 
Prostate, Transrectal Needle Biopsy 10/05/2007
 
Results 10/5/2007
 
A-D Right Base, Right Mid, Right Apex, Left Base;
Benign Prostatic Tissue
 
E. Left Mid; Adenocarcinoma, Gleason's Grade 3+3=6, 10% involved
 
F. Left Apex; Adenocarcinoma, Gleason's 3+3=6, Less than 10% involved
 
2 of 12 involved as two samples were taken from each area.
 


Educator
Regular Member


Date Joined Oct 2007
Total Posts : 37
   Posted 10/31/2007 6:16 AM (GMT -7)   
Thanks to everyone for their comments. You guys have a way of making a person feel better. I think my choice is a good one.

I am new at this and can't really offer any advice to anyone but if I had some to give I would sure give it to you.

Thanks again

Educator
 
Diagnosed 10/15/2007
Age 55
PSA 4.2 9/15/2007
PSA 3.9 10/1/2007
TC-1
 
Prostate, Transrectal Needle Biopsy 10/05/2007
 
Results 10/5/2007
 
A-D Right Base, Right Mid, Right Apex, Left Base;
Benign Prostatic Tissue
 
E. Left Mid; Adenocarcinoma, Gleason's Grade 3+3=6, 10% involved
 
F. Left Apex; Adenocarcinoma, Gleason's 3+3=6, Less than 10% involved
 
2 of 12 involved as two samples were taken from each area.
 


myman
Veteran Member


Date Joined Feb 2007
Total Posts : 1219
   Posted 10/31/2007 6:20 AM (GMT -7)   
Educator,

As Tamu & Glen have said...use this time to get yourself in shape, eat well and get your rest. That way you'll be presenting the best "you" for your doc to work on.
Continue to educate yourself but take time to enjoy your life, too. It's a journey and you're on the first leg of it. Your numbers look good so expect an outcome that reflects that.

All the very best to you,
Susan
Husband Diagnosed 11/17/05 Age: 63 No Symptoms
PSA: 7.96, Positive DRE
Biopsy Right: 6 of 6 Cores Positive Biopsy Left: 1 of 6 Cores Positive
Gleason: 4+3 = 7 Stage: T2B N0 MX
3 mo. PSA Post LRP Surgery: 11.8, 12.9, 13.9 Bone scan, CT scan, Endorectal MRI, Chest XR - neg.
09/06/06: 6 mo. PSA: 18.8 Distant lymph node involvement Start HT Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
06/06/07: PSA 0.1
09/05/07: PSA 0.1

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