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Posted 11/5/2011 7:58 AM (GMT 0)
Hi. Partner has been recently diagnosed with prostate cancer and we are looking into laproscopic robotic prostatectomy. We got two names from the urologist who initially diagnosed the cancer -- one being a local doctor and one being someone he respects in California -- but we are trying to research who else does it so we can find the doctor that we feel has the most experience and the best results. We are having a lot of trouble! Came across the name of Dr. Ash Tiwari (sp?) in NYC who helped develop the robotic surgery but no one else. We can travel anywhere for the surgery. Fortunately money is not a limiting factor. Any suggestions how to find a doctor who does this procedure? Thank you! (Gleason score 3+4, 65 years old, excellent health, no ED).
Posted 11/5/2011 10:17 AM (GMT 0)
Welcome to the site... Sorry you have to be here.

What City and State do you live in?

Posted 11/5/2011 11:52 AM (GMT 0)
Grass, there may not be a need to travel any significant distance for a great doctor. Ash Tiwari is in NYC and has a terrific reputation but he is one of many. Once we know where you guys live, perhaps someone can give some advice.
Posted 11/5/2011 4:25 PM (GMT 0)
Thank you for your speedy replies. We are not too far from Chicago, but would rather travel --regardless of cost -- than settle for anyone we think is anything less than cream of the crop! Considering the seriousness and possible outcomes of the surgery, we don't want to be second guessing ourselves later. We want to be sure we choose a surgeon we feel confident in, and who has loads and loads of experience and performs these surgeries very frequently with the best success rates we could expect. Life is so precious, and money can't buy happiness or health, but I am so grateful it can allow us a certain freedom of choice at a time like this... Thanks again forum family! And good luck to all of you out there who are also going through this. I've seen 5 other of my family members go through cancer and I know the road can sometimes be very rocky. God bless!
Posted 11/5/2011 4:34 PM (GMT 0)
Some names that come to mind as having superior results:

Walsh at John Hopkins; Scardino at MSK; Tim Wilson at City of Hope in Ca.

There are many surgeons in this top class and you can''t go wrong if you get any of these.

Posted 11/5/2011 4:55 PM (GMT 0)
A great guy in Chicago is Dr Greg Zagaja at the University of Chicago. I know someone who had very successful surgery with him (no ED no incontinence after 4 weeks). I could put you in contact with this person if you want so as to potentially avoid travel.

My guy in NYC, Dr. Samadi is amazing. Just youtube him.

Dr. Menon in Detroit is one of the best, as are Tehwari in NYC and Patel in Florida.
Posted 11/5/2011 5:05 PM (GMT 0)
Grasshopper,

Not to be discouraging, but going to a "Top Ten" surgeon sounds good, if one can afford it, but it does not guarantee sucess. We have men right here at HW that saw the best of the best, and had less than stellar results. Each body is different and reacts differently with prostate surgery. Incontinence and ED results jump all over the page, from none to severe, despite the level of surgeon. There's a certain toss of the dice regardless of whom you choose for your husband.

You definitely have been given a good slate of "brand name" surgeons so far, sure any of them would be good for your purposes.

Good luck in you choice, but wishing better luck in the results.

David in SC
Posted 11/5/2011 5:06 PM (GMT 0)
Thanks for these leads! I am looking into these doctors now and will continue to check this forum thread for other leads that come in. Personal testimonies by patients who have been treated by these top doctors would also be very interesting. I'll be back!
Posted 11/5/2011 5:23 PM (GMT 0)
if you email me I will put you in contact with the person who used Zagaja in Chicago.

I can also tell you about the amazing experience I had with Dr. Samadi in NYC.

I wasn't willing to travel too much prior to my surgery but you're absolutely right. You got one shot at this so do it right. Looking back I should have been willing to travel and many do.

I also picked a surgeon who wasn't covered under my plan. Used same logic, I had one shot at this and wanted t use the guy I thought would give me the best shot at getting rid of cancer and minimizing side effects. I was blessed to have accomplished all of these (for now at least).
Posted 11/5/2011 11:08 PM (GMT 0)
You might want to talk with Dr. Catalona at Northwestern, in Chicago, though he may do only open surgery. He is VERY experienced and well-regarded.
Posted 11/5/2011 11:38 PM (GMT 0)
I would suggest going to a major center someplace like Mayo, Cleveland, MSK, etc. I found the team approach to treating all facets of the disease suited me. You need to talk to a radiation oncologist, and probably just a pure oncologist.

There are many facets to PC. A good surgeon or oncologist is important, but it also depends on where the cancer is, how aggressive it is, how far along it is, and how your body deals with it.

Steve Jobs could afford the best doctors in the world. I might suggest you slow down a little and read some books, get second and third opinions, and develop a plan, then find the best medical team to handle it.

Welcome to HW, and good luck.
Posted 11/6/2011 1:12 AM (GMT 0)
David, David, David:

Why the same old refrain from you?

Of course there are no guarantees. As most regulars here know, I had a world class surgeon, Dr. Menon. But my cancer unfortunately has progressed. (On the positive side, the surgery went flawlessly and I recovered very well with no incontinence after about 3 weeks).

You seem to keep mentioning this fact, but it is meaningless as we all know there are no guarantees.

David -- do you not think that it makes sense to find the best surgeon possible (obviously within one's financial/travel constraints)? Almost by definition, the best surgeons will have the best outcomes, assuming they take comparable patients.

Take off your blinders, already.

The best advice to one who has decided on surgery to to find the best/most experienced surgeon.

Mel

Posted 11/6/2011 2:31 AM (GMT 0)
Mel, Mel, Mel

Once again, you failed to see my real point.

You said:

"You seem to keep mentioning this fact, but it is meaningless as we all know there are no guarantees"

I wrote my remarks to a new poster, that was inquiring about surgeons. Not the "WE" that you are inferring. Was not writing to those of us that have already had surgery. And I still feel its good advice, the point being, is that picking a "top ten" surgeon is no guarantee of great results or outcomes. No one is arguing about needing a good surgeon with good skills and a good range of experience. I "keep" mentioning it, as you said, to those new to our world, not to the converted, like you and others here at HW.

Then you pour gas on the fire with your blatantly rude remark to me, your words"

"Take your blinders off already"

Considering what I have been through and endured in the name of treatments, that remark made me laugh. I am the last person to have blinders on concerning surgery or radiation. I have been through the mill, and make a good poster boy of what can go wrong, even when you are in good hands. Not to be reptitive, but it just varies so much, patient to patient, too many variables, too many "what ifs". So I didn't appreciate your remark.

David in SC
Posted 11/6/2011 3:19 AM (GMT 0)
The top 10 doctors (surgeons)..Who rates them?? Is there published list? What criteria are used to judge them? Who keeps score? The doctors themselves? If you feel money will make things go better for you, I'm SURE there are any number of doctors who will flock to your side and support your feelings..

Gleason 7 (3+4) that's not too bad...What was his PSA at diagnosis? PSA history? how many positive cores? Yes, the surgeons skill is very important but so are the factors above which the surgeon has no control over..

Good luck to you both...
Posted 11/6/2011 4:18 AM (GMT 0)
fairwind, your answer is kind of the point i was trying to make, not a remark against top surgeons, but against all the unknowns and variables involved
Posted 11/6/2011 4:59 AM (GMT 0)
David:

Yes David you have blinders on.

You continually seem to take umbrage at the concept of finding the best doctors.

Of course there are no guarantees.

If there were, then no rich people would die of PC as I'm sure they have sought out the best.

It's all probabilities.

Now, if money or travel was no object, would you rather consult with MD Anderson or Johns Hopkins or Mayo...or your local specialist? The reality is that money (alias insurance) and travel/convenience are factors.

Fairwind: You raise a good point. I don't know who formally rates the doctors. I don't know who rates the hospitals either. Yet, there are some unquestioned leaders in the field. For example, the institutions I mentioned above. Then there are doctors like the two I've mentioned, Hussein and Scholz. They have been in-demand as speakers. Hussein is a leading researcher. That is certainly evident by looking at publications. She has certainly been a leader in researching new drugs/therapies. Some have just been approved by the FDA and some are in Phase III trials. She is affiliated with one of the top hospitals, Umich.

Scholz has spoken at some of the top PC conventions. He has published a number of papers. His book is actually quite excellent (the chapters written by his co-author, a patient, ran the gamut from weird to excellent). Scholz was Strum's partner for years. Strum and Meyers seem to have a reputation as being top doctors. There are many more -- but actually not that many in terms of being medical oncologists who specialize in treating PC. They are fewer in number.

Seeking the best care seems like a no brainer.

Mel

 

Posted 11/6/2011 5:14 AM (GMT 0)
Mel, there you go again, another insult. I could play that game back with you, but won't take the bait with you. BTW, my oncologist is directly associated with MD Anderson, so do you have a problem with that level of care?

Some of these top-name doctors are such self-promoters, ie. our friend Dr. Spam, who would ever know what the real facts are with their stated number of patients and high numbers of sucess? There is no, one, verifiable source to determine this.

And with many people, I would hazzard to say most common folk (like myself), are limited in their choices by the dictates of their health insurance provider, and the restrictions they place, assuming someone is fortunate enough to still have private health insurance, so the luxury of hand-picking a big-named doctor isn't available to most people. Plus I think this attitude does a terrible discervice to the hundreds, if not thousands, of good, experienced, caring, and local doctors that no one outside a particular area would ever have heard of. There are lots of good surgeons, not just those on somebody's particular short list of favorites.

And not everyone can cope with the logistics and extra expenses involved if one choose an out of area doctor/surgeon, again reality and finances often dictate that.

So drop this silly blinder nonsense off, I find it condenscending on your part towards me. I might not be a genius in these matters, but I am hardly a fool.

David in SC
Posted 11/6/2011 5:39 AM (GMT 0)
David:

Why are you creating a straw man argument.

I said: "The reality is that money (alias insurance) and travel/convenience are factors. "

You said " I would hazzard to say most common folk (like myself), are limited in their t choices by the dictates of their health insurance provider, and the restrictions they place, assuming someone is fortunate enough to still have private health insurance, so the luxury of hand-picking a big-named doctor isn't available to most people."

Are we not saying the same thing here?

It is good advice to suggest that folks seek out the best possible care. If you think that is a disservice to thousands of doctors, then that is your problem. Frankly, most of these same doctors would probably give the same advice.

This will conclude my portion of our semi-annual discussion on this matter.

Mel

 

Posted 11/6/2011 5:58 AM (GMT 0)
Good, because you chose to make this an issue, my original post to the original poster of this thread was directed to a newcomer, not to you in the first place. Put me on "ignore" if you wish, won't hurt my feelings a bit.
Posted 11/6/2011 9:05 AM (GMT 0)
Purg - Scholz and others are out there just as much as the wonderful Samadi. It isn't SPAM, it's information. It's called social media and to the new generation isn't insulting at all.

It's funny, you're quick to point out the lunacy of some when they talk about firing doctors as if it were somehow cool and yet you have a clear issue with what are considered the best guys out there. Of course there are no bloody guarantees in life outside of death and taxes. That is about as obvious as the genuine advantages of going to the best. Look at it this way, would you rather go with a guy who has done 200-400 of these or a guy who has done 1000-3000 of them assuming they both do them by themselves? Would you rather go with the guy who is taught to use the robot by another surgeon or the guy who is actually paid by Da Vinci to train newer surgeons? Would you rather go with a guy who works for a center of excellence and does ONLY prostate robotic surgeries because everyone flocks to him for them or some local urologist who because of location and traffic has to do whatever comes his way be it surgery or just general care for knobrot?

ps - patients are out there to verify the success rate btw. There is a reason people rave about these top guys, their results.
Posted 11/6/2011 9:31 AM (GMT 0)
Mel - David - davidg -> DO NOT POST in this thread again.

You've been warned.

Posted 11/6/2011 3:22 PM (GMT 0)
Somehow, I believe that a surgeon who does ANY procedure, so that he has a record of thousands of procedures, develops somewhat of an attitude of complacency. Most of the time, this harms no one, but how hard is it to pay attention to the p and q of the procedure? I once knew of a neurosurgeon purported to have done more cases of a particular brain tumor than anyone in the world. I had occasion to speak with one of the residents who worked with him. opening and closing were NOT done by the big shot. He ran 3 operating rooms and rotated between. A few minutes on a tumor already exposed, and he was gone. Not hard to "do" a bunch in a hurry.

Take all with a LARGE grain of salt!
Posted 11/6/2011 5:36 PM (GMT 0)
I don't think we told the OP what he/she wanted to hear.....
Posted 11/6/2011 11:34 PM (GMT 0)
I left my uro who discovered by PCa for Dr. Hu in Boston. Out of the hospital in one day, off the evil catheter in about 10 days, continent in about 4 - 6 weeks. Two pairs of underpants helped at work. Dr. Hu had done about 1,100 surgeries two years ago. Good luck. Choose from the best and you have increased your chances all around. No doubt about it. Good luck.
Posted 11/7/2011 4:18 PM (GMT 0)
Hi folks. I'm in the middle of making phone calls now but want to thank you for the info up to date, and I will definitely be checking this thread soon (again and again!) for any and all new info you provide. I am really moved reading not just your responses to my question, but reading about each of you: your dates of surgery and other info at the end of your responses, which is so much more than just numbers. My heart goes out to each of you and your families. Thank you again for looking out for those of us so new to this, looking for guidance. The info you provided has been very helpful, among other things just learning what to look for in a surgeon. Without some of the names of doctors and surgeons you provided, I wouldn't have known where to start. Not sure where the "top 10 surgeons" thread came from. I wasn't exactly looking for such a list, though I think I wouldn't be alone in my curiosity to see such a list, and the criteria it is based on...I figure there could be 100's of top doctors. And probably they are at the so-called "top" urology departments at the "top" hospitals. (Forgive me anti "top" people!) And yes, extent of the cancer involvement in the patient makes comparison of doctors' results trickier, and yes, there are no guarantees in anything. But I needed to start somewhere, and you have all been so helpful so far. More later. God bless!
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