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Prostate Robotic Surgeon recommendations

Sayaprair
Posts: 1
Joined: Feb 2013

My husband was recently diagnosed with PC – gleason 7 – 3,4 – he is 50 years old.  We are trying to figure out options – and doctors are recommending surgery.  We are not sure what to do – but given everyone is pushing surgery due to his age, I want to ensure my husband has the best possible doctor.  Reading about the incidence of incontinence makes this very scary!  I am hoping someone can recommend a surgeon on Robotics in the Seattle area. 

Also, I’ve been reading a book on Proton radiation.  Any information on that treatment option would be appreciated.

Thanks very much.

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Sayaprair

I am sorry for your husband’s diagnosis of PCa. I was also diagnosed with the bandit at the age of 50 back in 2000.
At those times surgery was considered the “golden” standard treatment for PCa but a dozen years after, many other ways for treating have “evolutioned” reaching similar standards to surgery. Which one to choose is dependent of the status of a patient. In other words, the age, health conditions and proper diagnoses will lead to a better and definite choice and, therefore, to better outcomes.

Doctors like to recommend radical approached to young patients, they follow the standards of their institutions, but PCa treatments may cause more harm than good. It is our responsibility of being well informed about the consequences that a particular therapy can cause. You need to research and get second opinions on anything before committing and should try to consult only specialists.

 

You have not shared other details in the diagnosis process. What took your husband to get a biopsy?
What have been his PSA chronology levels?
Did he get any image study? What about the results from digital rectum examination (DRE)?
What are the descriptions written in the pathologist’s report? What type of prostate cancer has been found?
Were there any symptom experienced by your husband before biopsy?
What are the blood tests performed by his doctor to verify aggressivity of cancer?

What is his Clinical Stage?

All treatments cause side effects, some becoming permanent and ruining the normal ways of living. You should get details on all possible effects and take those into consideration when deciding. It may not be possible to father a child again. Incontinence (urine and stool) and erection dysfunction (ED) are typical. When my wife and I choose surgery, we had to sign an agreement consenting all the causes and risks and relieving the surgeon from any wrong doings. His responsibilities were limited to the practice of surgery.

I recommend you to resist any proposal of a treatment if not totally aware and convinced. Cancer do not spread overnight and in particular PCa is somehow slow growing (10 times slower than lung cancer, 4 times slower than breast cancer) providing the patient with time to educate himself on all the matters. You need to do something but do it coordinately.

 

Radicals such as all forms of surgery (open and robotic) and radiotherapy (pronton, IMRT, CK, Bracky, etc) may provide a cure; however, these can only assure success if the cancer is contained. Localized status may indicate the presence of metastases (spread outside of the gland) to which surgery alone would not confer high points. Some doctors suggest combination treatments and some only control.

I recommend you to prepare a list of questions to expose to the doctors you and your husband will be visiting. Do not worry if the list contains odd or weird questions. Here are some ideas to your list;

http://csn.cancer.org/node/224280
http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

Here is a compendium on Prostate cancer and care;

http://www.lef.org/protocols/cancer/prostate_cancer_01.htm

 

Good books about PCa, diagnosis and treatments;

“A Primer on Prostate Cancer, The Empowered Patient’s Guide” by Dr. Stephen Strum and Donna Pogliano; which explains well the whole process of diagnosis.

A “Guide to Surviving Prostate Cancer” by Dr. Patrick Walsh (third edition); which may help you understanding options between surgery and radiation.

You can obtain used copies from Amazon site.

Here is a link dedicated to Pronton treatment;

http://www.protonbob.com/proton-treatment-homepage.asp

 

Diet and a change in live tactics become important to counter the treatment effects. Physical fitness programs and proper nutrition are important when dealing with prostate cancer. Here is a well described document on nutrition;

http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

 

I like to see you so engaged in the care of your husband. Some guys do not admit it but our wives confer us the best care we could expect.

 

Best wishes for your husband and peace of mind to you.

 

VGama

SeattleJ
Posts: 32
Joined: Mar 2011

Sayaprair,

Vasco always provides great information and this is no exception. Remember you have time to do your research and find the best treatment program for your husband. Don't rush--even aggressive cancers don't grow and spread overnight.

My cancer was a 4+3 and involved most cores. It was aggressive and had possibly involved a lymph node. I was treated at Seattle Cancer Care ( which is affiliated with the Fred Hutchinson Cancer Research Center and is considered world class) and went through a clinical drug trial and then open (not robotic) surgery. That was, I beleved at the time, the best course of action (I still do for me). The care was excellent as were the results but there were and are other options that should be considered including various forms of radition. Unfortunately there is not one clear cut correct treatment path for prostate cancer--just many options and potential side effects to consider. Make sure you get more than one medical opinion on anything that you are considering.

I have also been told that Swedish has an excellent program but I can't verify that.

This board is a great source of info. It's good that you found it.

Good luck!

John

 

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