I think we have decided

Wife and I met with a urologist (doc B) yesterday. I saw him 2 weeks ago on referral from my neighbor who is a doctor. The original urologist (doc A) who did my biopsy was hell bent on surgery and did not want to talk about any alternatives. When I told my neighbor doctor he suggested I go see his friend (doc B). On my initial visit with doc B he was heavily in favor of surgery. He knows my doc A very well but he set me up with a radiologist so I could see if radiation was something I would want to pursue. Met with the radiologist the day after my visit with doc B.
Wife and talked about all the options after yesterdays visit with doc B. My wife had met doc A on and earlier visit after yesterdays meeting with doc B she said she felt better with doc B.
Looking at scheduling robotic surgery for middle of Sept. The only question now is which doc has the most experience. Doc A practices out a hospital less than 10 minutes away and my have done more procedures but doc B who is attached to a hospital further away has been doing robotic surgery 2 years longer.
Doc B says he has been doing 6-8 surgeries a month for 7 years doc A has been doing them for 5 years and doc B thinks doc A has done more in 5 years than he has in 7.
I guess I need to visit with doc A one more time. I think skills are more important than bedside manner. Doc A doesn't know I've been seeing doc B but he did know I was going to get a second opinion. Doc B said if I went with Doc A since he was closer he would understand.
Too many decisions.
I am in south Florida the 2 doctors are Kahn out of Plantation and Masel out of Hollywood. If anyone has had any experience with either one I'd love to hear about it.

I think Dan is correct, you are lucky to be able to choose between two qualified surgeons. I wish you the best and a lifetime of zeros.

Sheldon AKA Sleepless

Sounds like either surgeon would be a good choice, if you choose surgery. It's not just about how many surgeries are done by the dr, its also about the quality of the surgeries themselves, and the doctor's record with quality of life side effects. Sheer number along shouldn't be a deciding factor.

With your stats, you still should have sufficient time to really decide what method you want to go with. What advice and methodlocy did the radiation people tell you? How would they handle you if you chose them for primary treatment? Would seem like you would have a good shot at "seeding" with your stats, and that it would be much less invasive for you.

Keep doing your home work, as there is no re-play button once you undergo your primary treatment.

david in sc

Ger, sounds like you are very interested in surgery.  However, given that you are in South Florida, I would suggest you high-tail it across the state to Sarasota to the Dattoli Cancer Institute.  They will do color doppler staging and give you a highly experienced and professional opinion about the benefits of seeding and/or radiation.  Please take the time to make an educated decision.

Sincerely,

Tudpock (Jim)

Everyone just wants it out and over with and put in jar and forgotten about. PCa doesn't listen all that well and isn't as simplistic as we are lead to believe. Hope it all goes very well for you and that cure becomes your four letter word when talking about PCa. You will be looking very closely at psa tests, especially in the first year or so as a patient (or should be). It gets easier on you if the numbers stay in the safe range...that is the good news. So, I will end it on good news. All avenues of PCa are represented herein as to what could, can, might happen...be it good or not.

Ger, since you seem intent on "getting it out" this will be my last unsolicited commentary unless you ask me something specific.  Without knowing your prostate size and all of the details of your case I can't know whether brachytherapy alone would be a good choice for you.  But with the stats you have shown it looks like it might be. 

With brachytherapy the visits you are concerned with are minimized dramatically.  Basically you see the doc for analysis/discussion, you have a "volume study" that take an hour or so and is done out-patient, you have the procedure itself which takes less than half a day and is also out-patient.  Then you return in a couple of weeks for a scan for seed placement assurance.

There are long term (15+ year) studies that show brachytherapy to be as effective in curing PCa as is surgery.

That's the end of my sales pitch except to say if you were my brother or best friend I would advise:

1.  Get your pathology re-read by an expert, e.g. Bostwick or Epstein.

2.  Get color doppler staging.

3.  Carefully read the experiences of the surgery patients on HW so that you know what you are getting yourself into.

4.  Strongly consider brachytherapy for the best balance between cure and low side effects.

Tudpock (Jim)

Ger42, For what it's worth, I think you are making the right choice..Your Gleason 6, PSA 3.5 cancer puts you in the 80%-90% full cure group. RLRP surgery expertly done is a far cry from the open surgery of just a few years ago.

My own case, PSA 14, Gleason 9 puts me in a different category but I'm still favoring surgery even though future radiation treatments are a high likelihood for me.

Ger42,

I was not a valid subject for seeds (7 of 12 biopsy cores at 4+4; 2 at 3+4), but age & stats considered, if I had yours, seeds would have been my choice.

David has a good point - taking the prostate out is not always a perfect solution - I required post-DaVinci IGRT to cover what had escaped.

If only I had found it earlier - I don't regret my treatment choice or my selection of doctors, just my timing - years too late for a PSA -