Northern California Kaiser Surgeons - Any recommendations?

sallyspencer1 said:

Looking for Northern Ca Kaiser surgeons :open or robotic
Hi,
My SO was diagnosed May 2010 with Stage T2b (Gleason 3=4=7; PSA 5; three of six positive cores) and is pretty sure he wants to go the surgical route. He/we are scheduled to interview five Kaiser surgeons including Drs Hsu, Martinez, Rosenbaum and Chan who have been mentioned on this thread.

Can you let us know who you ultimately chose and how it went for you? He is also considering open RP although his urologist only recommended robotic. The latest JAMA study on the post-surgery life style differences makes him want to explore that alternative as well. Did you consider the open route?

Many thanks and hope you all are doing well.
Brien and Sally

Hello there. I am sorry for
Hello there. I am sorry for the diagnoses. I chose Dr. Hsu and he perfmered traditional or non-robotic LRP. My surgery was on May 8, 2009. I am extremely satisfied with the results. I found Dr. Hsu not only to be exceptinally knowledgable about his field, I was also touched by his personal approch and sincere care.

I had considered open, but once I talked to Dr. Hsu, I chose LRP. I wish you a successful outcome and learning experince as you go thrugh this life challenge.

sallyspencer1 said:

Looking for Northern Ca Kaiser surgeons :open or robotic
Hi,
My SO was diagnosed May 2010 with Stage T2b (Gleason 3=4=7; PSA 5; three of six positive cores) and is pretty sure he wants to go the surgical route. He/we are scheduled to interview five Kaiser surgeons including Drs Hsu, Martinez, Rosenbaum and Chan who have been mentioned on this thread.

Can you let us know who you ultimately chose and how it went for you? He is also considering open RP although his urologist only recommended robotic. The latest JAMA study on the post-surgery life style differences makes him want to explore that alternative as well. Did you consider the open route?

Many thanks and hope you all are doing well.
Brien and Sally

Advice on N Ca surgeon
My SO is about a week behind you in the process. We talk to the Urologist (Dr Hagey in Walnut Creek) today about treatment options. We are concerned about his qualifications and would really appreciate any information you obtain in your interviews. How did you schedule them? Kaiser seems very unwilling to schedule appoints beyond standard ones.

BELESSA said:

Hello there. I am sorry for
Hello there. I am sorry for the diagnoses. I chose Dr. Hsu and he perfmered traditional or non-robotic LRP. My surgery was on May 8, 2009. I am extremely satisfied with the results. I found Dr. Hsu not only to be exceptinally knowledgable about his field, I was also touched by his personal approch and sincere care.

I had considered open, but once I talked to Dr. Hsu, I chose LRP. I wish you a successful outcome and learning experince as you go thrugh this life challenge.

thank you
for your comments. Dr Hsu was very kind and knowledgeable. But said he only does robotics now. Glad you had good results.

Best,
Sally

sallyspencer1 said:

Looking for Northern Ca Kaiser surgeons :open or robotic
Hi,
My SO was diagnosed May 2010 with Stage T2b (Gleason 3=4=7; PSA 5; three of six positive cores) and is pretty sure he wants to go the surgical route. He/we are scheduled to interview five Kaiser surgeons including Drs Hsu, Martinez, Rosenbaum and Chan who have been mentioned on this thread.

Can you let us know who you ultimately chose and how it went for you? He is also considering open RP although his urologist only recommended robotic. The latest JAMA study on the post-surgery life style differences makes him want to explore that alternative as well. Did you consider the open route?

Many thanks and hope you all are doing well.
Brien and Sally

Northern CA Kaiser
Sally, I see you are newly into this search for the best choice.

I live in your area and am a Kaiser member so I've been investigating this for a few years, but, as yet, have not had a positive biopsy. Still, I have a long history of being around and very aware of NorCal Kaiser and PCa. Father and two close friends have been treated and I have read heaps over the years.

The most recent friend had one of the first robotic surgeries in Walnut Creek and came out just fine, but it was prior to my most recent biopsy and he said his doctor had left the region so I don't have his name.
You seem to have the main guys names.

The machines in Walnut Creek and elsewhere are so new, and spread between the various surgeons, such that no one has "high" numbers so far. I don't think anyone is doing more than 2 a week, if that. Most far less since the machine is used for more than just prostate surgery.
My friend was one of the first 10 or 20 with his surgeon but everything went very well. Too scary for me, but he didn't give it a second thought.

I initially saw a doctor in Walnut Creek, but didn't feel comfortable with the way they were going to handle my biopsy so I switched to Oakland with a doctor I was very satisfied with and who was going to do the biopsy personally.
Now, if I had a Gleason 6 or 7, what would I have done?

I may have chosen Drs Hsu, or Rosenbaum, but I tend to think I would have given slightly more consideration to the seed treatment that they do in Roseville.
All NorCal brachy treatments are done in Roseville. A bit far to go, but they do them over and over and over and over, at that location. I don't know the precise numbers, but it would seem the team and doctors there have more experience with that procedure than do the Bay Area doctors with robotic surgery.

You are new into this process of searching for the best treatment. I have been investigating this for years and after some time I believe I would now lean to brachy.
I don't know the specifics of your situation. Your age, percentage of each positive core, etc.
As you indicated, you aren't in a huge rush and you shouldn't be.

Don't get 100% stuck on surgery until you have given yourself some considerable time reading the more recent studies on brachy. They seem to indicate there is no advantage from surgery over brachy depending on individual circumstances.

BTW, I have had two friends who have had robotic surgery in the past 3 years. Both are doing well, but most people do have side effects. The one who had his surgery at Kaiser Walnut Creek was back in early 2008. From what I remember, they only just began robotic there in 2007. Sounds like no one is doing more than about 1 robotic surgery per week and it will just take time for the numbers to climb up there.
I don't entirely understand the numbers, because I would have assumed a urological surgeon would be doing more than one PCa per week. I think I may be wrong with that assumption. In fact, I have read in several places that the true number of annual prostate surgeries that the typical doctor, who is doing a prostatectomies, is doing is way way less than one per week. Less than one per month.

Look at this for a real world view of the numbers for typical surgeons.
NOT what you would think, if you hadn't read this article.
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"“The research was published in the December issue of The Journal of Urology. Andrew Vickers, PhD, Associate Attending Research Methodologist in the Department of Epidemiology and Biostatistics at Memorial Sloan-Kettering Cancer Center, led an analysis of data on radical prostatectomy, the surgical removal of the prostate for men with prostate cancer. Of US surgeons treating prostate cancer patients in 2005, more than 25 percent performed only a single radical prostatectomy that year and approximately 80 percent of surgeons performed fewer than ten such procedures."
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Heck, I wouldn't want someone to change my oil if they did it so seldom per year.

I always think back to when I use to spend entire winters in ski resorts. Only when doing that and skiing 6 days a week did I realize out poor one's skiing is when you only come up a few times per year for a few days.
In fact, a few times where we would take off even 4 or 5 days, we'd need a couple hours just to regain our form when we got back on the slopes.. Makes irregular surgery seem scary.
Perhaps Kaiser needs a Jiffy Lube team doing the surgery, or some teens who practice with their joysticks for hours each day.

That quote is from the following article
http://prostatecancerblog.net/?p=1861

Take a look at that article.

I don't think they like to discuss numbers at WC because they know so many patients are looking for 250+ and they simply don't have anyone up there yet.
On the other hand, how else do they get up there without doing numbers 25 thru 200.

If you investigate the seed program at Roseville, ask them how many they do weekly up there. I would like to know.
In fact, please keep us informed about anything you discover in Nor Cal Kaiser since many of us are in that system and that is really our only choice.

Sounds like you are about 4 to 6 weeks into your investigation. Keep reading. I believe your views of the various choices may change. Still, you may go with the surgery.

BTW, I have to believe the majority of PCa surgery patients at Kaiser Nor Cal are getting open prostate surgery. Recent studies indicate the outcomes of that treatment are as good as robotic.
I do see why Hsu would only do robotic now, because he sees where the trends and demand is going.
I suppose you've read his bio.
http://www.permanente.net/homepage/kaiser/doctor/thomashsu/
Seems quite impressive except he doesn't yet have the robotic numbers but has lots of experience with laparoscopic.

OK...keep doing your research and let us other Kaiser member know what you find.

Remember one thing. Both my friends who have been treated in the past 3 years are now doing fine. BTW, my father who did not have surgery, lived 25 years after diagnosis and died of other causes. You should do fine.