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looking for skilled surgeons in my area

pablolo
Posts: 4
Joined: Aug 2014

hi. i'm new to this board.  I live 50 miles north of boston and am trying to find alist of skillful urologic oncologists who have performed at least 1000 da vinci robotic prostatectomies.

hopeful and opt...
Posts: 2326
Joined: Apr 2009

Dear Pablolo,

I am sorry for the diagnosis.

In order to better help you, please share the details of your case, that is what promoted the biopsy, psa history, numer of cores taken in biopsy, how many positive and gleason score(s). Any other diagnostic tests or second opinions, your age, etc.

The above questions are asked to determine if surgery is appropriate, for treatment, or another active treatment, or even active surveillance. Best to look at the horse before the cart.

Best

pablolo
Posts: 4
Joined: Aug 2014

i have a gleason score of 6(3=3) from a twelve core biopsy. my psa was 1.95.  my staging? is t1cn0m0. i am 67 

hopeful and opt...
Posts: 2326
Joined: Apr 2009

A gleason 3+3=6 is a non aggresive cancer. Various institutions have criteria for "active surveillance with delayed treatment if necessary> Generally less than 2 of 12 total cores that were sampled that are positve with less than 50 percent involvement, that is less than 50 percent of the core that is positive.  A PSA of 10 or less. None , or minor bumps found in a digital rectal exam. 

If the above criteria happens in your case you are a candidate for this valid treatment decision that I for one have been doing since March 2009, 5 and 1/2 years. It is very possible that your disease will not progress and you will not need an active treatment tsuch as surgery that can have very significant side effects.

I suggest that you visit with an expert in Active Surveillance.

Please feel free to click my name on left in the blue panel to see what diagnostic tests I have had, and information that you might find useful

 

 

CC52
Posts: 103
Joined: Nov 2013

pablolo,

I agree with hopeful...please, with what you've told us of your results you may be a very good candidate for active surveillance. Take some time to research and get other opinions. Trust your doctor and the advice you are given, but the decision should be yours.

Best wishes - CC

rch
Posts: 79
Joined: Nov 2011

Pablolo

Sorry about the diagnosis but please do not panick or rush into treatment decisions yet. You have plenty of time to research. I'm just wondering however, what prompted a biopsy with a PSA < 2.0 , age 67 and a normal DRE? How many cores and what % core were positive? I would strongly urge you to get a second opinion on the slides from Johns Hopkins ( $ approx 250) , turn around time less than 2 wks. How's your overall health ? Please check with your Urologist if you're a candidate for active surveillance. There are well accepted national guidelines for this. I am 69 and on AS past 3 years. My PSA which started out with 4.0 , 3 years ago has been hovering between 3.8 and 2.6 past 3 years. The last one is 2.6. I have had 4 biopsies over the past 3 years ,GS 6 (<1% in 2 cores) . But the last 2 biopsies were either ASAP or no definitve dx of cancer ( per Johns Hopkins). I check my PSA every 6 months and not going to have another biopsy for another 2 years unless PSA velocity warranted it sooner. But once again each case is different and you are the final judge for yourself.

Josephg
Posts: 287
Joined: Jan 2013

Hi Pablolo,

Welcome to this board.  You will find a wealth of knowledgeable folks, people who are living with prostate cancer, who are open, honest, and more than willing to provide infomration on their own experiences, and who also offer advice from the 'patient' perspective.  I am relatively new (3 1/2 years) on my prostate cancer journey, and I have found the advice and companionship of the folks on this board to be absolutely invlauable.

You live in my general area, based upon your 50 miles north of Boston comment.  My recommendation to you is, if you have not yet received a second opinion, contact Dana Farber Cancer Intsitute in Boston and make an appointment.  In my opinion, they are one of the best 'anchors' in the Boston area to dock up with to help manage your cancer care.  If any follow-up procedures are recommended, they will provide referrals to surgeons and other specialists at Brigham & Women's Hospital for you.  This is the process that I followed, and I could not be happier with the attention, care and treatment that these providers afforded to me.

At Dana Farber, my Oncologist is Dr. Channing Yu, and he specializes in prostate cancer.  At the time of my original cancer diagnosis, he gave me my options, and after my selecting the robotic prostatectomy path, he referred me to a doctor at Brigham & Women's Hospital who had performed over 2200 Robototic Prostatectomies.

So far, I've had a robotic radical prostatectomy, artificial sphincter implant, and combination hormone and radiation treatments.  I have posted my experiences related to these procedures and follow-up on this board for you and anybody else to read.  Currently, I am sitting with a PSA <0.01.

I wish you be best of luck on your journey.

Josephg

 

Swingshiftworker
Posts: 1013
Joined: Mar 2010

Why are you looking for a surgeon, when your prognosis is such low risk?  At age 67, with a Gleason 6, PSA 1.95 and T1c Stage, you have many more options.

As I often recommend to men like you, you need to do some research before selecting a method of treatment.  Surgery is usually the option 1st offered to prostate patients by urologists because it is what they know how to do but it is also the potentially worst choice in terms of the risks of ED and incontinence, as well as the standards risks associated w/surgery.

Please read an earlier post that I wrote to another patient in your situation here for further details: http://csn.cancer.org/node/281432#comment-1457722

Good luck!

 

Boston64
Posts: 2
Joined: Aug 2014

Hi Pablolo,

I had an MRI after a biopsy gave me a GS of 3+3=6. My PSA of 7 was much higher PSA than yours. The MRI showed a much more serious, t3b cancer. MRI's are producing images that have more clarity lately. You might want to have one.

Good luck.

 

 

 

 

pablolo
Posts: 4
Joined: Aug 2014

Thank you all for your support and advice. I am on active surveillance after getting a second opinion on my pca. I am scheduled to get a third and final opinion in mid october at MGH with Dr. Dahl and a team of specialists. My dad had prostate cancer and 3 uncles on my mother's side had pca. My latest psa was 1.95. my previous one was 1.4 my dre was normal (non palpable). again, my 12 core blind biopsy showed 4 cores positive.  1%, 5%, 15% and 30%. I have been self educating and feel fine. I will have a psa every 6 months and my first multiparametric 3t mri next May followed by a color doppler ultrasound targted biopsy.

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