Looking for a surgeon -- any recommendations?

lat

My 54 year old husband was recently diagnosed with prostate cancer: Gleason 6, T2b, PSA 3.1. Radical prostatectomy has been recommended. We live near Minneapolis/St. Paul MN and can travel to Mayo Clinic in Rochester, University of Minnesota Medical Center, or any hospital in the metro area. Any recommendations for specific surgeons specializing in prostate cancer, radical prostatectomy and urologic oncology? We are interested in building a team with a urologist/surgeon, radiation oncologist, medical oncologist.

Thank you! LAT

Trew

Look at Proton Therapy
Why surgery? At 54 hubby has a lot of life in him. Why risk incontinency and Ed problems? Please, take a serious look at proton therapy. Contact Loma Linda U- they have a web site and get their free book and DVD. There are other facilities that offer proton therapy- LLU pioneered the treatment- but with your hubby's grade of cancer why would you risk the dangers of surgery? There are so many happy proton patients running around, enjoying life, sex, continence.

copy paste this address and scroll down and read the short review on proton therapy. And then expand your search. There is a lot on this forum- all sites in the US are listed in one thread. It is something you should really consider. You have a proton perfect tumor it sounds to me.

http://procure.com/protontherapy/tumorstreated?gclid=CO_u99ql76QCFUIUKgodM0Mo1Q

One more thing, read through all these posts on all the threads and see how many proton patients you find complaining of Ed, incontinence, and all the stuff we discuss after surgery. Their news letter is full of positive "graduates" some who have even fathered children after treatment. Try that after surgery.


I wish you well.

hopeful and optimistic

lat
just wondering what your numbers are, that is how many cores were taken, how many were positive, what was the gleason and involvement of each.....if the there are are small number of cores with low involvement you may be a candidate for Active Surveilance.

Also did you have a second opinion of your pathology....determining a gleason level is very complicated, and it is a very good idea to have a second opinion by an expert, so that you are not under or over treated.

SV

hopeful and optimistic said:

lat
just wondering what your numbers are, that is how many cores were taken, how many were positive, what was the gleason and involvement of each.....if the there are are small number of cores with low involvement you may be a candidate for Active Surveilance.

Also did you have a second opinion of your pathology....determining a gleason level is very complicated, and it is a very good idea to have a second opinion by an expert, so that you are not under or over treated.

Find the best surgeon in
Find the best surgeon in your area and cut that beast out once and for all. He should have done at least 1,500 surgeries to be considered a great surgeon. Remember this very important detail...you can follow up with radiation if necessary but the reverse is not possible without huge complications. Your doctor will likely have already told you that.

Swingshiftworker

Other Alternatives
I understand the desire of many men just to go in and "cut the beast out" but surgery presents the GREATEST potential problems -- excessive bleeding, infection, ED and incontinence (not to mention issues of medical malpractice) -- and isn't necessarily the best approach for all men.

Frankly, it is also IMPOSSIBLE to cut out ALL of the prostate via surgery and, if the remaining tissue is cancerous, you will still need to get radiation treatment, chemotherapy and/or hormone therapy following surgery.

Depending on the stage of the cancer, various radiation treatments are available that are equally effective in treating the cancer without the need for surgery. These methods include (but are not limited to) IMRT, EBRT, Proton Beam therapy, Brachytherapy and CyberKinfe (Stereotactic Body Radiation Therapy).

If you don't know anything about these alternatives, it would be wise to read about and investigate them to see if they may be better suited to treating your husband's PCa, before chosing the most aggressive and potentially most damaging form of treatment by undergoing surgery.

BTW, it is UNTRUE that you cannot undergo surgery following radiation treatment. This is a myth. Surgery following radiation treatment is more difficult but not impossible. The main reason that surgery following radiation is usually not attempted is because it is considered unnecessary to subject the patient to the substantial risks of surgery if further radiation, chemotherapy and/or hormone therapy will suffice, especially if the PCa has migrated beyond the prostate itself.

The worst thing you can do is to choose a form of treatment for the wrong reasons or based on false assumptions. Whatever you do, just make sure you choose a treatment based on the FACTS that you've read for yourself and heard from proven experts -- not just on the opinions of unknown people on Internet forums (including me) who (whether intentionally or not) may give you false and misleading information.

Verify EVERYTHING before you act! This is the only way you can truly make an INFORMED choice about which treatment to choose to treat your husband's cancer. Good luck!!!

SV

Swingshiftworker said:

Other Alternatives
I understand the desire of many men just to go in and "cut the beast out" but surgery presents the GREATEST potential problems -- excessive bleeding, infection, ED and incontinence (not to mention issues of medical malpractice) -- and isn't necessarily the best approach for all men.

Frankly, it is also IMPOSSIBLE to cut out ALL of the prostate via surgery and, if the remaining tissue is cancerous, you will still need to get radiation treatment, chemotherapy and/or hormone therapy following surgery.

Depending on the stage of the cancer, various radiation treatments are available that are equally effective in treating the cancer without the need for surgery. These methods include (but are not limited to) IMRT, EBRT, Proton Beam therapy, Brachytherapy and CyberKinfe (Stereotactic Body Radiation Therapy).

If you don't know anything about these alternatives, it would be wise to read about and investigate them to see if they may be better suited to treating your husband's PCa, before chosing the most aggressive and potentially most damaging form of treatment by undergoing surgery.

BTW, it is UNTRUE that you cannot undergo surgery following radiation treatment. This is a myth. Surgery following radiation treatment is more difficult but not impossible. The main reason that surgery following radiation is usually not attempted is because it is considered unnecessary to subject the patient to the substantial risks of surgery if further radiation, chemotherapy and/or hormone therapy will suffice, especially if the PCa has migrated beyond the prostate itself.

The worst thing you can do is to choose a form of treatment for the wrong reasons or based on false assumptions. Whatever you do, just make sure you choose a treatment based on the FACTS that you've read for yourself and heard from proven experts -- not just on the opinions of unknown people on Internet forums (including me) who (whether intentionally or not) may give you false and misleading information.

Verify EVERYTHING before you act! This is the only way you can truly make an INFORMED choice about which treatment to choose to treat your husband's cancer. Good luck!!!

First off, read Surviving
First off, read Surviving Prostate Cancer, by Dr. Walsh, who is one of the pioneers in the field. Do your research and you'll likely agree with what you read there. The post above may or may not be correct information/opinion because without an expert surgeon, those possibilities do exist. But find the right man for the job and move forward. The long term side effects of radiation are just not known.

bdhilton

SV said:

First off, read Surviving
First off, read Surviving Prostate Cancer, by Dr. Walsh, who is one of the pioneers in the field. Do your research and you'll likely agree with what you read there. The post above may or may not be correct information/opinion because without an expert surgeon, those possibilities do exist. But find the right man for the job and move forward. The long term side effects of radiation are just not known.

Amen to that

Amen to that

Kongo

SV said:

Find the best surgeon in
Find the best surgeon in your area and cut that beast out once and for all. He should have done at least 1,500 surgeries to be considered a great surgeon. Remember this very important detail...you can follow up with radiation if necessary but the reverse is not possible without huge complications. Your doctor will likely have already told you that.

1500?
SV,

Not sure where you came up with that number of surgeries that a doctor must do to be considered a "great surgeon?" What are you basing that on?

BRONX52

SV said:

Find the best surgeon in
Find the best surgeon in your area and cut that beast out once and for all. He should have done at least 1,500 surgeries to be considered a great surgeon. Remember this very important detail...you can follow up with radiation if necessary but the reverse is not possible without huge complications. Your doctor will likely have already told you that.

1500 !!
Not sure what type of surgeries you're talking about-- open or davinci. If you are talking davinci then 1500 would be pretty high. Considering how long davinci has been around and the number of facilities that actually have the equipment, you'd be doing approx 300 surgeries per year for the last 5 years---. Although I'm sure there are a few who have accomplished this, they are most likely the exception and not the rule.

Swingshiftworker

SV said:

First off, read Surviving
First off, read Surviving Prostate Cancer, by Dr. Walsh, who is one of the pioneers in the field. Do your research and you'll likely agree with what you read there. The post above may or may not be correct information/opinion because without an expert surgeon, those possibilities do exist. But find the right man for the job and move forward. The long term side effects of radiation are just not known.

Long Term Effects Of Radiation
The long-term effects of radiation for prostate cancer are a long-term survival rate EQUAL to surgery and a minor risk of secondary bladder or rectal cancer only slightly greater than the risk of getting bladder/rectal cancer with surgery alone. However, if you have surgery and followup radiation, your risk for secondary cancer is probably about the same.

bdhilton

Swingshiftworker said:

Long Term Effects Of Radiation
The long-term effects of radiation for prostate cancer are a long-term survival rate EQUAL to surgery and a minor risk of secondary bladder or rectal cancer only slightly greater than the risk of getting bladder/rectal cancer with surgery alone. However, if you have surgery and followup radiation, your risk for secondary cancer is probably about the same.

Amen to that…who knows but
Amen to that…who knows but secondary cancers from what my oncologist, surgeon and ever other medical professional I have spoken too is possible from any radiation treatment and from what I understand if you do get them they are 15+ years out…and not everyone gets secondary cancer.

Lets say you do get secondary cancer from radiation 15+ years out…That was more than likely 15+ years more than you thought you were going to live when you first heard you had PCa and started this journey…

mtguy

My input
Selecting a treatment option and then a surgeon to do the procedure is not an easy decisions. There is a ton of info for/against each option and only you can weigh these against your personal concerns and risk limits.

What ever your decision, once you decide a treatment, always try to find the best in the field. The comment above about 1500 surgeries is unrealistic. My surgeon is considered one of the top in the country and has just 1000. He is based in Seattle. My findings was to find one with at least 500.

Other factors to consider for surgery vs radiation:
- is the prostate already enlarged? If so, action may still be required to address it
- I had 3 professionals tell me that they knew of no surgeon that would do surgery once radiation treatment was done. The organs and surrounding area become more of a mess and very difficult to work with.
- In my case, I also had 2 hernias that would have to be addressed with surgery even with radiation. But they were found during the prostatectomy.
- With surgery, there is a pathology report which gives you a pretty good idea of success. With radiation, you will need to wait over time and hope it is working (my thoughts).

Dr Walsh's book was my best source for understanding the beast and options. One area he did not touch on was if the patient is on blood thinners. This will complicate the surgery (as it did for me).

Best of luck to you

bdhilton

mtguy said:

My input
Selecting a treatment option and then a surgeon to do the procedure is not an easy decisions. There is a ton of info for/against each option and only you can weigh these against your personal concerns and risk limits.

What ever your decision, once you decide a treatment, always try to find the best in the field. The comment above about 1500 surgeries is unrealistic. My surgeon is considered one of the top in the country and has just 1000. He is based in Seattle. My findings was to find one with at least 500.

Other factors to consider for surgery vs radiation:
- is the prostate already enlarged? If so, action may still be required to address it
- I had 3 professionals tell me that they knew of no surgeon that would do surgery once radiation treatment was done. The organs and surrounding area become more of a mess and very difficult to work with.
- In my case, I also had 2 hernias that would have to be addressed with surgery even with radiation. But they were found during the prostatectomy.
- With surgery, there is a pathology report which gives you a pretty good idea of success. With radiation, you will need to wait over time and hope it is working (my thoughts).

Dr Walsh's book was my best source for understanding the beast and options. One area he did not touch on was if the patient is on blood thinners. This will complicate the surgery (as it did for me).

Best of luck to you

The more experience the
The more experience the better with the qualifier that the surgeon has excellent stats...My surgeon had over 5000 something like 5500 and is consider one of the best open surgeons in the world…He also does 100% of the open, close and follow-up (still follows up with me…)...I went to Northwestern in Chicago and William Catalona is the surgeon...and I live in Atlanta...

buzzz

bdhilton said:

The more experience the
The more experience the better with the qualifier that the surgeon has excellent stats...My surgeon had over 5000 something like 5500 and is consider one of the best open surgeons in the world…He also does 100% of the open, close and follow-up (still follows up with me…)...I went to Northwestern in Chicago and William Catalona is the surgeon...and I live in Atlanta...

another choice is HIFU
There's another choice no one has mentioned, it's ultrasound. It's been in use around the world for many years and is soon to be FDA approved here, so in your case you might think about waiting. Hundreds of surgeons have learned how to do this new treatment so it will hit the ground running when approved. It's High Intensity Focus Ultrasound, in my case it was a 2 hour treatment, no hospital stay, no cutting, no life altering side effects. InternationalHIFU.com books us outside the country right now, as you can have it done in Canada, Mexico, Bahamas, Burmuda, Dominican Republic by an American urologist. International HIFU is very professional and will be devoted to you, you must send in all the biopsy and reports to get qualified, it's a very impressive business. If you can possibly pay the $25,000. it costs then it is well worth every cent, my PSA is undetectable now!