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Looking for Kaiser N Calif Recommendation for Surgeon for DaVinci at Walnut Creek

Charles_S
Posts: 2
Joined: Oct 2009

Looking for a Bay Area urologist in Kaiser for Da Vinci RP. My urologist has done the procedure about 25 times, and he's probably good but I'm a little nervous about the lack of experience. I've read Patrick Walsh's Guide To Surviving Prostate Cancer and he recommends at least 100 surgeries. Anybody have a recommendation for a local urologist in the Kaiser network? BTW I am 6 months out from the initial diagnosis with a Gleason 3+4 and PSA 7. I tried a radical diet, vegan plus flax seed plus pomegranate unfortunately PSA was 7.8 at 3 mos. and last week 8.4, so time to take action.

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Charles, Good look on finding a Doc. I can't help you since I live in Tn. but just wanted to let you know this is a great forum.

100 surgeries is way to low for the Davinci. My doc that I chose had done over 2,000 with the robot. Experience counts in my opinion. But of course you don't want to feel like an assembly line patient either. My Surgery came in at about 3.4 hours.

I had my Davinci in Aug 2009. I'm age 55 (Gleason 3+4) as you are. My PSA pre-surgery was 5.1. I also tried diet change, pomegranate, flax etc and saw my PSA rise from 4.1 to 5.1 pre surgery. I'm still doing the diet post surgery. Had my first Post surgery PSA this week and came back as a 0.

Walsh's book is excellent.

Larry

Paul_S
Posts: 10
Joined: Nov 2009

Hi Charles, I'm also in the Bay Area with Kaiser. I wish you the best of luck and God's Speed with your treatment. Yes, time to take action. Please let me know what you find out and who you find with more Da Vinci experience. I was going to do Brachytherapy but I'm now having serious second thoughts. Something is telling me don't do it, so I'm looking into the Da Vinci RP. I'm thinking that having the pathology report to tell me what's really going on, and getting the cancer out is the best thing. Hope to see your next post. Thank you! - Paul

Paul_S
Posts: 10
Joined: Nov 2009

Check out Paraplu's post about Kaiser's Dr. Martinez in Walnut Creek. Here's the link: http://csn.cancer.org/node/167515

BELESSA
Posts: 6
Joined: Feb 2009

Dr. Thomas Shu is probably the most experinced and in my openion the best. Look him up. He is at Kaiser Homestead campus

William Parkinson
Posts: 60
Joined: Oct 2009

Larry is right; 100 is way too low. Research done at Memorial Sloan-Kettering suggests that even with the open procedure, it takes 250 surgeries before the surgeon's increasing skill begins to level off. And, I think that the robotic approach would, in all probability, take even more practice. Look for someone who has done maybe 350 or more procedures (at the least) and who has a great reputation. Good luck!
Cheers
Bill

RiverRider
Posts: 15
Joined: May 2009

Yet another study showing that experience does count.

http://www.ncbi.nlm.nih.gov/pubmed/20533547

This study did not look specifically at robotic surgery and the need for practice but nevertheless, it gives some interesting data on those with fewer and greater numbers of surgical experience.

One might conclude it would be better to get "open" surgery done by a Kaiser doctor who had done 500 to 1,000 open surgeries rather than robotic done by someone with 20 to 70 such DaVinci surgeries.
It would seem, at this time, in NorCal Kaiser that only about 3 guys have even passed the 50 mark and the others are moving up very slowly. I'm guessing most of the others are doing no more than 2 robotic prostate surgeries per month.
I'm sure, if a active patient demanded it, they would and could get the specific numbers upon which to make a well considered decision.

I've been with Kaiser since about 1963 and if you really push them, they will give you the info. After all, you are the patient, the customer, who is paying the system.
I'm also sure, they don't want talk of this "numbers" subject to go around since they have to insist that care from any Kaiser doctor is equal to any other choice.
Of course we know that is absurd.

Oh, that study again...

http://www.ncbi.nlm.nih.gov/pubmed/20533547

Paul_S
Posts: 10
Joined: Nov 2009

Thanks Belessa,

His name is actually spelled Hsu at Kaiser in Santa Clara. Dr. Thomas Hsu.

Paul_S
Posts: 10
Joined: Nov 2009

Hi Belessa,

Thanks for your recommendation to Dr. Hsu. I met with him this last week. His resume is pretty amazing. At this point I am probably going to go with him as the Homestead Campus is more convenient location wise. I was wondering what you're experience is with Dr. Hsu and why you've recommended him. I have to make a decision soon so I'm looking forward to your reply. Thank you very much, Paul

BELESSA
Posts: 6
Joined: Feb 2009

Hello Paul,

Dr. Hsu is one of the experts that introduced and set up the LRP at Stanford. He does both the Robotic and traditional LRP. He performed my surgery on may 8,2009. I did not have the Robotic, rather the traditional LRP and I am extremely happy with the outcome. I had Gleason (3+3) with PSA of 5.3 before surgery. I am 49 years old. Discuss with him all your concerns and make sure you are comfertable with all the responses before you decide. I found him to be very personable, logical and caring person. If you have further questions, drop me e-mail at belesa@comcast.net and I will try to respond and give you my number to discuss.

Good luck and I have no doubt you will be fine.

Paul_S
Posts: 10
Joined: Nov 2009

Hi Belessa,

Thanks so much for your reply. My stats are just about the same as yours were. I also met with Dr. Rosenbaum in Walnut Creek and was impressed with him too. I've decided to go with Dr. Hsu in Santa Clara because he's much closer to where I live. He's also such a smart guy and his resume is pretty amazing too. Surgery date is set for Jan. 14th. After all the research and struggling to comes to terms with everything it feels good to have the knowledge learned and a decision made on how to move forward. The rest is all in God's hands now.

Thank you! - Paul

jmontilla
Posts: 2
Joined: May 2010

How was your experience with Dr Hsu ?

Paul_S
Posts: 10
Joined: Nov 2009

Hey Charles, How are you doing? Have you found your surgeon yet? Hope you're doing OK. - Paul

Sportzgy
Posts: 1
Joined: Nov 2009

Hello!

I'm in the same boat and actually saw Dr. Rosenbaum at the Walnut Creek Kaiser last Friday for a consult. He's done about 150 or so RP with DaVinci and I thought he was a very reasonable guy. He took his time and answered all my questions thoroughly. I also saw his former partner, Dr. Choi at the Santa Clara Kaiser facility and had the same impression. They both spoke highly of the other.

I'll probably go with Dr. Choi because he's closer to where I live, but if I hadn't had such a good impression of him, I would have driven to Walnut Creek for Dr. Rosenbaum.

Good luck with everything!

Paul_S
Posts: 10
Joined: Nov 2009

I've heard good things about Dr. Choi as well. Best of luck to you!

Paraplu
Posts: 37
Joined: Feb 2009

Hi guys, 8 months after surgery I'm not checking this board out too much anymore, but here my 3 cents.

I picked Dr. Arturo Martinez in San Francisco's Kaiser Urology dept for a number of reasons. In my opinion the surgeons who did 100+ surgeries at Walnut Creek were young kids who did not have any experience with any of the other kind of surgery. Call me chicken, but the equipment is a combination of computer driven and mechanically operated, so if something stops working you want a guy who can finish the job. I asked and the robot does stop occasionally, has to be rebooted and will work fine but I've been told that on occasion the surgeon has to finish the job manually.

Given that I wanted a doctor who has done many surgeries but also many different type of surgeries, one who could feel his way around if needed. On top of that I needed someone I felt very comfortable with, someone who listened, took the time, gave me the time and who gave me the impression that all he wanted was the best for me.

Anyway, good luck everyone! See my blog on progress if you want to see how it turned out. (Great by the way) and let's hope all doctors are perfect and all patients heal quickly.

sallyspencer1
Posts: 6
Joined: Jun 2010

Hi Paraplu
How do I find your blog please? My SO is interviewing Dr. Martinez next week. Thanks
Sally

mrspjd
Posts: 688
Joined: Apr 2010

Unsure, but this might be what Paraplu is referring to (another thread with his experience) since he has no "blog" on his csn home page:

http://csn.cancer.org/node/167515

BTW, this is not an endorsement of any kind of tx, in fact, I would strongly suggest that before you decide on any tx, you make sure the PCa is properly staged by getting a 2nd opinion on the biopsy at a reputable source (such as Johns-Hopkins pathology, etc). Also, ask your SO's doctor whether a pelvic CT and a bone scan might be appropriate (depending on the results of the 2nd biopsy), & have your SO consider an endorectal MRI w/spec as this will further help clinically stage the PCa. The results you obtain may well empower you to decide on the most appropriate tx that will have the best long term result for your SO. Once you have the PCa properly staged, talk to many different skilled and experienced doctors (if possible, both in and out of Kaiser) i.e. radiation oncologists, urology oncologists, open and robotic surgeons, and read several pages of posts on this site.
Hope this helps. Good luck.
mrs pjd

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