Finding the best hospital and surgeon

Hi. I've just been diagnosed with prostate cancer. Stats in my signature.

My urologist says that with my level of cancer, all options are open, though he said he wouldn't do brachytherapy with a Gleason 7. I don't know which option to choose, let alone which doctor.

Everything I've been reading tells me the best chance for full recovery with minimal side effects will come with choosing the right doctor, regardless of the type of therapy. Experience, lots of experience, is important. This seems especially true for surgery, whether open or robotic/laproscopic. I've also read that the amount of experience by the hospital is important.

The problem is that I can't find data about the experience levels of doctors or hospitals. Internet searches have been fruitless other than finding hospitals advertising their expensive new robotic techniques. Is there a way to find out which doctors and which hospitals have the highest volume of prostate surgeries or other prostate treatments?

I've called multiple urologists' offices, but the receptionists say they don't know that information and that I'll have to come in for an appointment. But I can't even tell which doctors in their facilities do which treatments. I went to one that I thought was with a retropubic surgeon only to find out he only did perineal. I learned a lot, but still want to find out who's "best". I know that won't depend solely on volume, but it could be a place to start.

What part of the country are you ?

That's a tough problem, and one that many of us have faced. First, I think you want to do everything possible to be treated at a center of excellence. Cleveland Clinic, Mayo Clinic, Johns Hopkins and other familiar names are good places to be if you can make it happen. You don't say where you're located, but big cities are better than small towns. You want to find a place that sees a lot of prostate cancer patients.

Depending on where you're located, someone here may be able to refer you to a doc. If not, you may just have to take your best shot and ask lots of questions. If you opt for surgery, you'll want someone who has done hundreds of prostatectomies.

Good luck with your search, and your treatment. Remember that there's lots of great information and support here.

syzygy51 said...

The problem is that I can't find data about the experience levels of doctors or hospitals. Internet searches have been fruitless other than finding hospitals advertising their expensive new robotic techniques. Is there a way to find out which doctors and which hospitals have the highest volume of prostate surgeries or other prostate treatments?

I've called multiple urologists' offices, but the receptionists say they don't know that information and that I'll have to come in for an appointment. But I can't even tell which doctors in their facilities do which treatments. I went to one that I thought was with a retropubic surgeon only to find out he only did perineal. I learned a lot, but still want to find out who's "best". I know that won't depend solely on volume, but it could be a place to start.

You are absolutely right about the frustrations of choosing a surgeon. There are really no rating system and no published statistics comparing their skills and results. So, the only information you can get are: 1) How many surgeries has he performed to date - an indication of how proficient and experience he is. 2) How many surgeries is he performing per week, in the last 3-6 months - an indication of whether he is still in his game. 3) Is he willing to discuss his performance, be it positive margin, incontinence or ED - an indication of how confidant he is. 4) Talk to his patients to see how satisfied are they - again some indication of his skills. 5) Get referral from other doctors. Also, I thought a long queue was good, meaning they must have done something right to have lots of customers.

The bottom line is you have to be comfortable with the doctor and the treatment you select as this is not a one size fits all situation. However, most of us got lucky and have a good outcome.

syzygy51 said...
Thanks for the great replies. I should have given my location, sorry. I live just outside Boise, Idaho. I have family in the Salt Lake City area, and friends I could probably stay with in San Jose, CA or Irvine, CA. My wife could travel with me, but my children, grandkids, and friends are mainly here.

I think if I do radiation that I wouldn't want to travel and be gone that long, but for surgery, I guess I could do anywhere. Don't you have to follow up regularly with your surgeon? That could make for a lot of trips.

I'll try the other ideas. I had gone to vitals and several other rating sites, and while some of the urologists had ratings, most did not and none told me how many surgeries or what type of treatment they offered.

thanks again for the help.

There are some excellent surgeons in Southern Cal and Northern Cal.

Southern Cal: City of Hopes, UCI, UCLA... Call them up and they would be happy to talk to you.

These rankings aren't specific to urology, but if you have access to staying in San Jose you arguably can't do better than UCSF and Stanford on the West Coast. I don't know your insurance limitations. My case is being overseen at Stanford and, so far, I'm pleased with their work.

The important qualification, as others have mentioned, is a surgeon, oncologist, etc. that specializes in prostrate cancer.  A lot of surgeons and oncologist, be they open or robotic, do not concentrate in one field. Much like samster I had my robotic done at the Cleveland clinic by Dr. Stephenson.  The man specializes in PCa, did a fantastic job, and he is easy to talk to.   I am only two hours away, however, you are a little further from Cleveland. Keeping in mind pre-op consults, testing, etc.

Also, many of the treatment centers have a "Hope Lodge" that provides free lodging for those being treated. I have not stayed at one myself, but understand that some, such as Cleveland and Birmingham, AL, are very nice.  They are sponsored by the American Cancer Society. 

The important thing is to find a specialist in whatever treatment you opt for.

Best wishes in your journey, and remember that you are your best advocate.

Mr. Bill