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Vanderbilt Hospital, Nashville, TN

Posts: 9
Joined: Mar 2012

Has anybody had experience with Dr. Joseph Smith at Vanderbilt, Nashville, TN?

lewvino's picture
Posts: 1007
Joined: May 2009

Yes, He was my surgeon in Aug 2010. Was very pleased with his skills and my results.
Pre surgery Gleason 4 + 3 (7)
Post surgerty Gleason 3 +4 (7)
Positive margin noted post surgery.
99% Dry the day the catheter was removed
100% Dry now

100% nerves spared on one side and 70% spared on the other side.
Use Levitra and having excellent erections.

31 month post surgery PSA 0

If you have any other questions would be glad to respond.

Live near Chattanooga Tn.

Lewvino (larry)

Posts: 9
Joined: Mar 2012

So glad you responded! Yesterday, I went looking for you in the member directory due to a prior post you had made. Do you realize how many members there actually are??? It's amazing...

Did you have any other tests prior to surgery other than a needle biopsy/DRE? I just wonder why no MRI or any other type of scan has not been suggested (for hubby) to rule out the possibility of cancer elsewhere. Was Dr. Smith your original urologist, or did you start with your primary doctor, who then referred you to Vanderbilt? It would be helpful to know your step-by-step journey in this process. Also, I don't get the post-surgery Gleason score...please explain.


lewvino's picture
Posts: 1007
Joined: May 2009

The pre surgery Gleason score was from the Needle Biopsy. The post Surgery Gleason score is more accurate since the entire prostate that was removed from surgery was sent to the lab.
Hence a Slight down grade overall. Still a Gleason 7 but the primary cells were 3 instead of 4 as indicated in the needle biopsy.

My journey started with my local Dr.
I was 54 at time of diagnosis and checked since my father had prostate cancer. My PSA was elevated.
Dr ordered a round of antiboitics to rule out infection then retested. PSA has gone up slightly in the two week period. He then referred me to a local urologist who then order the needle biopsy.

My wife is a RN (First assist Surgery) and checked out my local urologist for me at the hospital gossip line (LOL) He was rated first rate in surgery but he only performed traditional surgery.
After discussing all my options with him he highly recommended Dr. Smith at Vanderbilt if I was going to have Robotic instead of Traditional surgery.

My journey then took me to exploring:
Proton - This was my fathers treatment and he is doing well 13 years post treatment. However my insurance denied coverage for Proton.

Hifu - Ruled out by my own choice
Surgery - Ruled out due to precision of a Skilled surgeon with Davinci Robot
CyperKnife - Two years ago I was told they would not treat a Gleason 7 with CyperKnife. I believe this has changed now
Prostrcision - Visit to Atlanta. A Scan was done and the Dr only gave me a 60% chance of being cancer free in 10 years following his treatment. I felt this was a roll of the dice and mentioned I was going for one more visit at Vanderbilt. Dr. Critz then asked if I was going to see Dr. Smith.
Once I Replied yes he stated he is one of the best Davinci Surgeons you can find.

Radiation - Ruled out since I wanted that as a 'backup' plan if my cancer returns

Davinci - Talked to one local Doctor and Dr. Smith. Chose Dr. Smith due to his experience level with the Davinci.

Local Prostate cancer support group - Over 85% of the men had been to Dr. Smith and all had great experiences with Dr. Smith. Heard glowing story after story about His care level for his patients.

If I recall your husband was a Gleason 6 which might be why no further scans were ordered.

Again if further questions glad to answer or speak with you and your husband via phone.

Lewvino (larry)

Posts: 1
Joined: May 2013

Thank you for the ocmments on Dr Smith. I me tiwt him this week and have decided to let him perform my dobotic prostatectomy. I am 47 with a Gleason of 6 (3+3). I had a slightly  eleveated PSA on 12/28/12 that actually decreased on 1/4/13 but has remained the same since. My digital exam felt normal and the protate is small but after a PSA3 test, my urologist performed a biopsy which came back positive. While it is only a 6, I have a high voume amount.

Can you tell me about the local support group in Nashville you were referring to. I really have no one to talk with about this and to say  I am nervous is an understatement.


Thanks again 

hopeful and opt...
Posts: 1542
Joined: Apr 2009

http://www.ustoo.org/Chapter_NearYou.asp      meeting tomorrow

Also you can google man to man, another national support group

I am sorry for your diagnosis, we all go through all the negative feeling for the first two or three months.

Recommend that you have a second opinion on the results of your biopsy by a world class pathologist so that you are not over or under treated.

Recommend that you also have other diagnostic tests, ie MRI with a tesla 3.0 magnet . the high resolution of this test can show extracapsular extension.


lewvino's picture
Posts: 1007
Joined: May 2009

To clarify...My how time flies....My surgery was Aug 2009 not Aug 2010 as stated earlier!


Posts: 5
Joined: Feb 2012

I've heard that there was a Dr @ Vanderbilt Hospital that has great success with salvage prostectomy, but I didn't get his name ? Do you know if this is same Dr ?


lewvino's picture
Posts: 1007
Joined: May 2009

I would assume it would also be Dr. Joseph Smith. He is the head of urology and has done extensive work with open surgery, robotic surgery and bladder surgery. If I needed a salvage prostectomy he is the one that I would speak with.


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