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Boston Area Help / Robotic/Laparoscopic Urologist /Ongologist

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Prostate Cancer
Is Robatic/laparoscopic or Proton Best?
Robatic - 0.0% - 0 votes
Proton - 100.0% - 1 votes
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Posted 8/27/2009 8:41 PM (GMT 0)
Looking to consult with an Urologist / Ongologist around the BOSTON, AREA. Wondering if any of our group knows or had experience with an Urologist / Ongologist who is good and well experienced with Robotic / Laparoscopic and "tissues / nerve-sparing" prostate procedures (very important to me). Thanks in advance. Just got the news. I am 57 very active and my diet is 98% animal fat free for the past 30 years. No medical problems at all. PSA 3.4 biobsy 3 out 12 3+3's all. Gleason 6. Also I am open to "open Surgery" if found to be better.

Post Edited (GTA) : 8/31/2009 2:52:39 PM (GMT-6)

Posted 8/27/2009 9:14 PM (GMT 0)
GTA,
Welcome to the site. You will get a lot of information and opinions on this site. I'm one of the few that didn't have surgery.
With your initial stats, low psa and G6, you will have a very high probability of a very favorable outcome regardless of the treatment you choose. Quality of life issues and side affects should play an important part of your decision and the doctor you choose will probably matter more than the treatment you choose.

Carefully research all options as to their normal side affects and determine if you can live with them. My advice is to seek opinions from a radiologist, a brachytherapist, a surgeon and a prostate oncologist to get a good idea of all the treatments available. You have plenty of time and since this will affect your quality of life for the rest of our life it's worth the time and effort.
I'm sure those from the New england area will have some recommendations for you.
Johnt
Posted 8/27/2009 10:54 PM (GMT 0)
Thanks John.
What I read in different respectable publications (unbiased) and different leading school hospitals that a man in my age group, with good health, surgery would be best and survival without PC would be in the highest percentage, about 95 to 98%. But I am taking your advice and I will be seeing all the specialists you mentioned. Like everyone of us, I just want to get it done and get on with my life. Like you advised I will do my homework and hopefully get the best specialist to help me. Thanks again and God bless. GTA
Posted 8/28/2009 2:36 AM (GMT 0)
Welcome to the site. With your stats all methods have roughly the same cure rate. Boston Mass General hospital has a Proton radiation machine. You may want to include a consultation there in your due diligence plan. Take your time. Don't rush a decision. G6 is a slow growing cancer.
Posted 8/28/2009 4:16 PM (GMT 0)
My husband just had surgery at the Brigham with Dr. Jerome Richie and his team.  Dr. Richie only does open RP but has a colleague (Dr. Hu I believe) who does the robot.  Dr. Richie was very open in explaining pros and cons of both approaches - indeed of all approaches - and was helpful in encouraging us to take time to make decision. 

In terms of care - found that the Brigham took great care of both husband and me.

Most important to think through the long haul - whatever option you choose will result in side effects and these are the things that provide the biggest challenge especially if you have not had any symptoms prior to dx.  That said, well worth it to head for those zeroes!

Best to you.

Posted 8/28/2009 5:29 PM (GMT 0)
I had Dr Ali Moinzadeh at Lahey Clinic. He's done hundreds of them.

Posted 8/28/2009 6:04 PM (GMT 0)

Thanks Geebra,

I will add a Proton consultation with MGH, Boston. I understand all procedures have their advantages and side effects. I want a procedure that will free me of "biopsies" and additional radiation and many Dr's visits. My 3 positive cores of 2 cores each were about 1.6 mm and only 5% involved, I wonder if I could be a candidate for  Proton ?

Posted 8/28/2009 6:19 PM (GMT 0)

Hi SieWife Thanks for replying,

You and your husband must have done a lot thinking about choosing "open SURGERY" instead of other procedures. Can you share with us why the open Surgery vs. the ROBOTIC ?  I hope your "Hubie" doing well, my best wishes to both of you. thank you again for sharing your thoughts. GTA

Posted 8/28/2009 6:31 PM (GMT 0)

Thanks Letsky for sharing your Dr. with us. Sharing your experience with Dr. MoinZadeh before and after your procedure will be very helpful for guys like us in the Boston Area. A little history about your PC would be very important to us as well. By replying to us we know you care and want to help,  as we all should. Thanks again and best wishes.

Posted 8/28/2009 9:02 PM (GMT 0)
Dear GTA -

We were convinced that we were going to do the robotic surgery until we met with Dr. Richie.  Think you will find overall that whichever procedure doctor does most (Dr. R has done thousands) is the one that that they advocate.  That said, Dr. R did not advocate for one over other except to make the following point:

- open allows the surgeon to feel the tissue.  Prostate cancer tends to be "sticky" in feel and there is no feeling with a robot and thus no ability to tease out the nerves or to feel if it has spread.  He thinks you can spare nerves more easily with open.  He ended up sparing about 60 percent on one side and all on the other.

I come from a family of surgeons so to hear about the feel and the look was something familiar and comfortable to me personally so that made us feel better with this option.  Longterm studies do not show huge differences.

Dr. also recommended that we read Patrick Walsh's book Surviving Prostate Cancer and that continues to be hugely helpful.

Best in your decisions - keep us posted!

Posted 8/31/2009 8:41 PM (GMT 0)

Hi SieWife,

Thank you very much for sharing your decision with us which gave us a clear and simple explanation to why "open". Thank you also about the recommendation of Dr. Walsh's book which I ordered after reading your Post. I am leaning towards surgery but I will be consulting with other specialists as well. I will. for sure, share my experience with our group. I did look up Dr "R" and found out he is one of the top prostate doctors in our area. Thanks again, and best wishes to you and your husband. Hope he is doing well.

Posted 9/8/2009 9:50 PM (GMT 0)
Hi Siewife

Patrick Walsh's book "Surviving Prostate Cancer" 2008 edition, is a book every family should have on hand. My wife asked me to make sure I thank you  for recommending the book. We both wish you and your husband the best. Thanks, GTA

Posted 9/12/2009 2:41 PM (GMT 0)
Hi GTA,

You are your wife are most welcome - just wish you weren't on this journey!

My hubby just returned from 6 week follow up appt - all restrictions removed (can't lift anything heavy for 6 weeks is biggest one) - happily went out and took down some dead branches and did other yard work he has been wanting to do.  Incontinence is getting better all the time - he is on the right track.  Awaiting PSA result and will post what I hope will be 0 :)

Hope things are going well with you and you are reaching closure on your decisions.  Best to you

Posted 10/5/2009 11:53 PM (GMT 0)
Hi Siewife,
I am glad to hear that your husband is doing well and doing some yard work. Hope his PSA results was satisfactory. I am almost at the end of my research. I will be meeting with 3 different specialist together for the final consultation. I will let you know my final decision. Take care and best wishes to both of you. GTA
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