Prostate Cancer

[GARYCARL]

I am recently diagnosed with PC Gleason 6; I am scheduled for RP (after careful review of all options)

my question is: How do I find/identify the best surgeon in my area? I just moved across country and don't know anything about the local medical community (Portland Or)
please advise, thanks.

[wrene]

Have you asked your urologist for recommendations? Ask around. Word of mouth is usually very helpful. My husband had his RP in NYC, but we live in NY. Ask the surgeon (when you find one), how many RP procedures has he performed? My husband had a "nerve sparing robotic assisted laparoscopic prostatectomy", which is relatively new but in many cases the best option. My husband is only 55, however, several of his friends (in the same age group), also had prostate cancer and the same procedure was recommended. You might also try to locate a prostate cancer support group, and they may be able to give you some advice as well. Check with local hospitals. I am a nurse, and in my experience healthcare professionals are usally very willing to try to help. Good luck. Keep me posted. If this doesn't work, I'll think of something else.

[GARYCARL]

Many thanks, your input is helpful and much appreciated.

[kdunbar]

Probably your best option is to contact the local Prostate Cancer Support Group. The hospital or your GP should be able to put you in contact. They will have information and experience of all the Urologists in the area.
Good luck,
K.D.

[GenesisJohn]

I agree with the posters, take the time you need to find a young (recent training in the newest procedures, and more sympathy to your desire for optimization of Quality of Life Issues). There are local Prostate Cancer support groups everywhere.

If you have to travel, it's not an issue, it's an overnight in the hospital, and a couple of nights in a motel close to the hospital (the hospital will fix you up with a discounted rate).

You are very wise to choose the robotic RP w/ bilateral nerve sparing. View the U-Tube posts for information from Dr Tew at Cornell-Weil for the importance of utilizing the newest techniques. Google "Da Vinci prostatectomy". Find someone who is really interested in your concerns, not just your money - the newer nerve sparing and bladder neck re-attachment techniques take more time. The U-Tube videos by Dr Tew go into the new changes.

Don't be afraid to switch urologists mid-stream. I did, and it was the best decision I've made in my life (next to marrying my wife). I was dry the day after the catheter was pulled, and actually had sex twice the following weekend. Nothing spetacular, but it was very reassuring that I hadn't lost it. I'm 65, PSA 5-7 for five years running, chronis prostatitis. Gleason at post RP biopsy 3+3, NO positive surgical margins, no other evidence of cancer spread . According to the Sloan Kettering prognosis calculator, I have a 99, 98, 98, 97% chance of being cancer free at 2,5,7,and 10 years. The piece of mind is incalcuable.

RP is the ONLY way you get the real skinny about what is going on in there. The DA Vicni give the surgeon the ability to see (6-12 magnification, and ability to stick the tiny camera everywhere). But, don't let anyone talk you into the more conventional RP. That is still very serious surgery.

EVERYTHING ELSE besides RP is a shotgun blast into the dark, based on an educated guess. And the robotic RP is no more invasive that the seed implant w/ associated side effects, especially if they want to add hormone ablation. Google "Lupron Victims Network". You WILL be miserable for the time you are on Lupron, and the time it takes for the effect of the injection to wear off.

I WAS going to go the Brachy route advised by my much older urologist, who also talked me into a 4- MO Lupron Depot shot. Believe me, the Lupron was MUCH worse than the entire RP. I recovered quickly from the RP, but six months later I'm waiting for the Lupron SE to wear off. They HAVE changed, instead of intense hot flashes all night (and no sleep), I now have those - plus I'm cold w/chills all the time. I take the change as a good sign . . .I've lost the urge to step in front of a truck (yes, severe depression is another Lupron side effect).

My previous urologist was trying to shoehorn my 89 gram prostate into his Brachy protocol. ("We can lase a piece of it off"). Actually, the worst part of the Robotic RP was downing that gallon of bowel cleanser the day prior to the procedure -the rest was a walk in the park.

Check the cancer support sites, they will agree that robotic RP is becoming the preferred method of treatment. Previously they touted Brachy as the best way to go. The problem with Brachy and everything else except RP is that you will be looking over your shoulder the rest of your life.

Now, I just have to wait for the Lupron to wear off. I have ALL the side effects associated with a castrate testosterone level. Google "low testosterone"


Good luck to you and let us know how you made out. Feedback to our annecdotal experiences will facilitate others in what is a very complex decision making process.