Northern California Kaiser Surgeons - Any recommendations?

Paraplu
Paraplu Member Posts: 37
edited March 2014 in Prostate Cancer #1
Hi guys, am visiting my urologist next week (March 2nd):

I am very thankful for all your comments and advice on a previous post. Now my question is a bit more specific:

I have Kaiser Insurance and am wondering :
- which surgeons you can recommend within the Kaiser network.
- which surgeons to avoid within the network
- Any recommendation for a specialist outside the network in or around San Francisco

Thanks again so much to everyone,
Paraplu
«1

Comments

  • tetech
    tetech Member Posts: 8
    Kaiser
    Dr. Gohar 310-517-3185 at Harbor Kaiser in so ca is great and can do da vinci. Ask for a so ca medical record number and a referral.
  • Paraplu
    Paraplu Member Posts: 37
    tetech said:

    Kaiser
    Dr. Gohar 310-517-3185 at Harbor Kaiser in so ca is great and can do da vinci. Ask for a so ca medical record number and a referral.

    Thanks
    Thanks, I will bring that up Monday when I talk to my urologist
  • rolf5
    rolf5 Member Posts: 5
    Surgeon Recommendation
    Dr. Dale Kunihira, locted at Kaiser Homestead Campus performed my radical prostatectomy. He did an outstanding job and my side effects were minimal. He is very careful and deliberate. He also served as Chief Urologist at Kaiser. I would recommend him without hesitation. Good Luck.
  • Paraplu
    Paraplu Member Posts: 37
    Found the one!
    Ok, had my daVinci Robotic surgery at Kaiser in Walnut Creek a week ago. Dr Martinez from the San Francisco urology dept did the surgery and I am amazed. He is the greatest!

    Only a week later, back to walking, to work, healthy and fit and YES erections already, even with my catheter still in. WOW
  • RRMCJIM
    RRMCJIM Member Posts: 149
    Paraplu said:

    Found the one!
    Ok, had my daVinci Robotic surgery at Kaiser in Walnut Creek a week ago. Dr Martinez from the San Francisco urology dept did the surgery and I am amazed. He is the greatest!

    Only a week later, back to walking, to work, healthy and fit and YES erections already, even with my catheter still in. WOW

    excellent
    I am glad to hear it all went so well for you Paraplu. I also have Kaiser here in So Cal. I am told by my Dr that he also takes a long time to do the procedure. Not in any hurry, they only schedule 2 per day. He is aware of my concern to save all the nerves he can, at my age 54 I need them,,,lol I am confident I picked the right Dr for me. I hope for your continued success. Keep us all informed.
    Jim
  • Paraplu
    Paraplu Member Posts: 37
    RRMCJIM said:

    excellent
    I am glad to hear it all went so well for you Paraplu. I also have Kaiser here in So Cal. I am told by my Dr that he also takes a long time to do the procedure. Not in any hurry, they only schedule 2 per day. He is aware of my concern to save all the nerves he can, at my age 54 I need them,,,lol I am confident I picked the right Dr for me. I hope for your continued success. Keep us all informed.
    Jim

    Good luck
    Good luck Jim, do they have a robot in SoCal or are you coming up to Walnut Creek?
    Theo
  • RRMCJIM
    RRMCJIM Member Posts: 149
    Paraplu said:

    Good luck
    Good luck Jim, do they have a robot in SoCal or are you coming up to Walnut Creek?
    Theo

    da vinci in so cal
    Hi Theo, yes they have one here in So cal. They say it is at the West L. A. hospital. I looked it up, it looks more like it is in Beverly Hills. They even have valet service for patients on day of surgery, go figure, only in L.A....lol I looked on line at the facility and it looks very nice. They have apts of sorts w/kitchenettes for the longer term patients, during treatment, so families can stay together during this time. Thanks again for sharing with us all.
    Jim
  • Paraplu
    Paraplu Member Posts: 37
    RRMCJIM said:

    da vinci in so cal
    Hi Theo, yes they have one here in So cal. They say it is at the West L. A. hospital. I looked it up, it looks more like it is in Beverly Hills. They even have valet service for patients on day of surgery, go figure, only in L.A....lol I looked on line at the facility and it looks very nice. They have apts of sorts w/kitchenettes for the longer term patients, during treatment, so families can stay together during this time. Thanks again for sharing with us all.
    Jim

    Good news
    Great, sounds like you guys have the upscale Kaiser model. Also glad you can stay 'close' to home and don't have to come up to San Francisco (which isn't too bad though).
    Check out my posting ' There is good news' as I write about my very positive experience with this beast.

    Jim, let me know if you and your wife would like to call us to talk through this. Our situations have been so similar.

    Good luck,
    Theo
  • dswanman
    dswanman Member Posts: 2
    Paraplu said:

    Found the one!
    Ok, had my daVinci Robotic surgery at Kaiser in Walnut Creek a week ago. Dr Martinez from the San Francisco urology dept did the surgery and I am amazed. He is the greatest!

    Only a week later, back to walking, to work, healthy and fit and YES erections already, even with my catheter still in. WOW

    your surgeon
    Paraplu,

    was Dr Martinez a Kaiser DR out of Kaiser san fran location ? Arturo Martinez ?

    thanks

    ds
  • Paraplu
    Paraplu Member Posts: 37
    dswanman said:

    your surgeon
    Paraplu,

    was Dr Martinez a Kaiser DR out of Kaiser san fran location ? Arturo Martinez ?

    thanks

    ds

    Kaiser
    Hi ds

    Yes, that's the one. Any experience with him? Can I answer any questions?
  • dswanman
    dswanman Member Posts: 2
    no experienceancd looking
    no experience with him and I'm looking for a person within Kaiser (should I decide to use them for treatment) that has a LOT of DaVinci experience under his belt, the one person I spoke to so far averages 4 a month since 2007 so in the best case thats 100 surgeries, doesn't come close the 300/3 rule I've read about and I'm not real excited about the numbers he's done, tho I liked him...

    you don't know the numbers that Martinez has done do you ?

    thanks for the reply, sincerely.

    the below link made a lot of sense -on www.prostrate-help.org

    What is an "expert" or "artist"

    http://www.prostate-help.org/artist.html
  • Paraplu
    Paraplu Member Posts: 37
    dswanman said:

    no experienceancd looking
    no experience with him and I'm looking for a person within Kaiser (should I decide to use them for treatment) that has a LOT of DaVinci experience under his belt, the one person I spoke to so far averages 4 a month since 2007 so in the best case thats 100 surgeries, doesn't come close the 300/3 rule I've read about and I'm not real excited about the numbers he's done, tho I liked him...

    you don't know the numbers that Martinez has done do you ?

    thanks for the reply, sincerely.

    the below link made a lot of sense -on www.prostrate-help.org

    What is an "expert" or "artist"

    http://www.prostate-help.org/artist.html

    Dr. Martinez
    Hi,

    Dr. Martinez was the 2nd wave of surgeons to be trained on the daVinci, which brings him to less than 100 surgeries.

    The reason I picked him over the guys who were the first to be trained is the fact that the first wave were young urologists right out of school who may have a great experience on the robot by now but do not have the 20 years of experience of open surgery, laprascopic as well as robotic. I was looking for doctor who could finish the job in case the machine, yes it is a machine driven by software, broke down midway through surgery. I was looking for someone who could recognize an oddity if they saw one while working on me. I was looking for someone who was careful rather than young and wanting to do a number of these a day.

    So I think I found that in Dr. Martinez. He was very understanding, careful, informative, did a great job with nerve sparing on both sides resulting in an erection 5 days after surgery.

    Whomever you decide on, I think there is more to it than pure numbers.
    Good luck.
  • sallyspencer1
    sallyspencer1 Member Posts: 6
    dswanman said:

    no experienceancd looking
    no experience with him and I'm looking for a person within Kaiser (should I decide to use them for treatment) that has a LOT of DaVinci experience under his belt, the one person I spoke to so far averages 4 a month since 2007 so in the best case thats 100 surgeries, doesn't come close the 300/3 rule I've read about and I'm not real excited about the numbers he's done, tho I liked him...

    you don't know the numbers that Martinez has done do you ?

    thanks for the reply, sincerely.

    the below link made a lot of sense -on www.prostrate-help.org

    What is an "expert" or "artist"

    http://www.prostate-help.org/artist.html

    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
  • BELESSA
    BELESSA Member Posts: 6

    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.
  • Swingshiftworker
    Swingshiftworker Member Posts: 1,013 Member

    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

    I am a NorCal Kaiser member
    I am a NorCal Kaiser member and have ruled out surgery for me. I have already changed my health enrollment and will be going w/Blue Shield in order to get CyberKnife treatment at UCSF effective 7/1/10. However, in the process of doing my PCa research, I spoke with Dr. Arturo Martinez in San Francisco and w/ Dr. Raymond Rosenbaum in Walnut Creek.

    Dr. Martinez said he had only done about 50 robotic surgeries, which was not enough experience in my opinion. Dr. Rosenbaum was one of the physicians responsible for establishing the robotic surgery program for Kaiser in NorCal about 5 years ago and has done about 180 robotic surgeries in that time, which is still not that many surgeries.

    In the course of my research, I also read a medical article (which concluded that the success of surgery was primarily dependent upon the experience of the surgeon) that said that doctors with less than 200 robotic PCa surgeries are basically "practicing" on their patients. So, if I chose surgery, I probably would have done more research to find other surgeons with more experience that these two physicians, even if I had to pay for it without insurance coverage.

    There are several very experienced robotic PCa surgeons mentioned on this forum who have successfully treated forum members. Among the other robotic PCa surgeons with much more experience (over 3000 surgeries) that I personally contacted is Dr. Vipul Patel at Florida Hospital - Global Robotics Institute in Celebration Florida. He'll do the surgery for $36k if no insurance is available. This is not a recommendation of Dr. Patel -- just info in case you want to investigate further.
  • EngineerC6
    EngineerC6 Member Posts: 2

    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.
  • sallyspencer1
    sallyspencer1 Member Posts: 6

    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.

    Kaiser appointments
    For making appointments with "robot pool " kaiser docs, Theresa was wonderful.I can get you her number, but try calling the Walnut Creek urology and asking for appointments in the robotic pool. We gave her the names of four docs (all of whom were mentioned on this thread: Hsu, Rosenbaum, Martinez and Chan) and she made the appointments....

    We met yesterday with Dr Hsu in Santa Clara. He was kind, caring and said he had done over 800 RPs, 80 % of which were laparscopic and 20% of those robotic. My math suggets that means somewhere around 160 MIRPs. He said he felt an appropriate "learning curve" was around 40. Seems pretty low to me....Said he no longer does open RPs and feels robotic provides same results with lesser side effects. He recommended we see the three other Kaiser docs but said he would do the surgery in Santa Clara since they just recently got a machine there.

    Scheduling consults with docs who do open RPs was/is more difficult. Lisa does all that scheduling and had no suggestions and seemed less than helpful. Still working on that issue.
    Best of luck - I feel we are still on the learning curve. Since it is recommended to have surgery at least two months past biopsy in order for the organ to revive from that assault, we have time to shop around.
  • sallyspencer1
    sallyspencer1 Member Posts: 6
    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
  • Swingshiftworker
    Swingshiftworker Member Posts: 1,013 Member

    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.

    I had no problems scheduling
    I had no problems scheduling appts w/Drs. Martinez or Rosenbaum.

    Dr. Martinez is in the SF office where my urologist Dr. Thomas is also located. Dr. Thomas just scheduled the appt to see Dr. Martinez when I was in the office and I just called the Urology Dept at Walnut Creek myself to schedule an appt to see Dr. Rosenbaum in Antioch (closer to where I live).

    The only "problem" with scheduling is the lead time for the appt, which was 2-4 weeks, for a "standard" appointment. Really no need for greater urgency, unless you have a late stage cancer. But, if that's the case, I'm sure they'd try to fit you in earlier.
  • RiverRider
    RiverRider Member Posts: 15

    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.
    -------------------------------------------------------------------------
    "“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."
    ---------------------------------------------------------------------------

    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.