how do you find an experienced prostate surgeon?

majestymarcia27

My husband was just diagnosed with early prostate cancer (I hope) with Gleason score of 7 (4+3). We live in Cleveland area so have access to Cleveland Clinic and to University Hospitals. The one urologist we have seen so far looks like he is 12 (not really - but very young) and according to his bio, he has only been out of training since 2007.  I am not confident he has had the time to develop the kind of skill at this surgery (whether robotic or open). He was urging that appropriate treatment is robotic surgery to remove prostate. We think surgery is the way to go but aren't convinced that he is the right guy.  When previewing bios of other in town urologists, there seems to be many, many very young ones who have practiced for even less than 7 years. Anyone have ideas about how to choose? I am concerned that even if a doctor tells us he does many procedures a year or in his years in practice, we don't have any effective way to check whether he is giving correct info. The same goes for relating his outcomes. Any help?

 

VascodaGama

The "Leader" and his staff should be checked

Treatment outcomes relate much on the experience of the doctor, the facilities and the staff. Many in this forum recommend DaVinci doctors to have over 500 surgeries done. Here you got a link that may help you in your decision;
http://prostatecancerinfolink.net/tips-tools/pick-surgeon/

In any case, the best outcome starts from previous proper diagnosis and due decisions. Second opinions and knowledge of what one is doing is a must.

Best wishes and luck in his journey.

VGama

Swingshiftworker

Educate Yourselves and Expand Your Search

Why are you just looking for a surgeon?

I presume this is because this was the only option presented to you by your primary physician and/or the urologist you spoke with.  BEFORE you decide on surgery, you and your husband need to educate yourselves about the options available for treatment.  There are many other options available other than surgery AND most of them have less draconian effects on the patient than surgery does. 

The other primary options for a patient w/a Gleason 7 are primarily radiological and include, SBRT - CyberKnife (CK), Proton Beam Therapy (PBT), Brachytherapy (BT) and IMRT - Intensity Modulated Radiotherapy.  Each of these techniques has different advantages (and relatively few disadvantages) when compared w/surgery, which IMHO is the most primative and least sophisticated method currently available.  There have been very significant advancements in the radiological treatment of prostate cancer, which makes surgery essentially unncessary.

Some men just want to cut the prostate out to get rid of the cancer but this POV is more emotional than rational.  The primary risk following surgery is ED and/or incontinence which could be permanent. This risk is substantially reduced through radiological treatment BUT, even if you choose surgery, subsequent radiiological treatment may still be necessary following failed surgery. 

There is still some risk of ED and incontiencne following radiological treatment but less so than surgery.  Other potential radiolgical problems include collateral tissue damage caused by inaccurate radiation delivery.  Of the current methods available, CK provides the most accurent method of radiation deliery and consequently the fewest reported problems following treatment.

Another option is Active Surveillance, which involves active monitoring of the cancer w/o treatment.  The rationale for active surveillance is that most people w/prostate do not actually require treatment; ie. that most men are subjected to surgery and/or radiation treatment unncessarily.  AS is sometimes accompanied by changes in diet and exercise.  You should also research AS to see if that's something your husband would want to consider.

You don't have to believe me about any of this.  Just do your own research.  You and your husband have time w/in the next few months to learn more about this and to choose the option he considers best for him.   So, please don't rush out to remove his prostate surgically before you learn about the other treatment options that are available.

Good luck!

 

hopeful and optimistic

Where do you stand

In order to select a possible treatment you need to know where you stand

A Gleason 4+3=7 is an intermediate level cancer, and can spread faster than a lesser cancer.

MOre information is required about your case since it may be possible that the cancer may have gone outside the prostate and surgery would not be appropriate.

So how many cores were taken

How many cores were cancerous

Of the core(s) that were cancerous what wss the involvement, that is what percent of the core was cancerous

Did the pathology report indicate any thing else going on

Second opinion of the pathology....so that you are not under or over treated it is important to have a second opinion of the pathology by a world class pathologist, one who specializes only prostate cancer. There are are about 6-8 in the world who stand ...bostwich being one of them

What led to your husbands diagnosis, high PSA?, digital rectal exam? etc

Have you had any other diagnostic tests...For example there is a multiparametric MRI using a powerful Tesla 3.0 magnet that can show if the cancer has escaped the prostate, and would be critical in making a treatment decision. 

 

 

 

Beau2

Cleveland Surgeon

Marcia,

You may want to try addressing this question to the guys at the Healingwell prostate cancer site (www.healingwell.com). I believe there are some that had prostate surgery in Cleveland (Cleveland Clinic?).  Sorry I can not help you, I had my surgery in Denver and was not smart enough to look for the best available surgeon. I do think it is wise to ask around (on line) and possibly at UsToo meetings to see who guys in Cleveland recommend.

Best of luck and best wishes. 

majestymarcia27

thanks

I appreciate the responses to my message. and will follow up on the various suggestions.