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Posted 3/25/2014 3:37 PM (GMT 0)
Small update Just was able to secure an appointment with Scardino at MSK in 2 weeks rather than having to wait for Eastham until end of April. The waiting, as Tom Petty put it, is the hardest part! Tewari appointment tonight
Posted 3/25/2014 3:44 PM (GMT 0)
Jim.. I did look at other options and have talked with a radiation oncologist. Given the Gleason 7, PNI and my age (46) my wife and I decided that surgery is the best option (for me). We are still educating ourselves and forums liek this have been very helpful. Appreciate the input
Posted 3/25/2014 6:56 PM (GMT 0)
Hatter...good job. It wasn't clear that you had consulted other disciplines and I have glad you have. That's simply due diligence. A couple of other thoughts since you are continuing with your education:

1. There is a thread at the top of our forum for newly diagnosed patients...hopefully you have had a chance to review this: www.healingwell.com/community/default.aspx?f=35&m=2652250

2. If you have not read them, a couple of excellent books are Dr. Walsh's,"Guide to
Surviving Prostate Cancer" and Dr. Scholz', "Invasion of the Prostate Snatchers".

3. It's always a good idea to get a second opinion on your biopsy slides from an acknowledged expert like Dr. Bostwick or Dr. Epstein.

Good luck,

Jim
Posted 3/28/2014 1:14 PM (GMT 0)
So I met with Tewari and his people this week and I have to say I was not entirely impressed. He is a very nice guy, very caring, wanted to know about me etc but I certainly did not get the feeling the other people really cared much. Nurse I saw first told me how the Mt Sinai Urology department was in shambles prior to Tewari arriving and she had only worked withhim for 6 months. Then the scheduler tried to get me in to surgery at the end of April. When I asked " isnt that a bit soon?" She told me all Gleason 7,8,9 are rush jobs.

Wife calls day later and gets an entirely different story. We did not schedule with him (yet) and will see what happens at Sloan April 9
Posted 3/28/2014 1:51 PM (GMT 0)
hatter... Sorry, to read of your less than impressive impression of Dr. Tewari's staff. It appears this is all too common in this field. The business side of this thing is going to leave you feeling disillusioned.

Bottom line, though, is... Can Dr. Tewari do the job? If you like him he's the most important part of this equation. I have a feeling the staff of the guy, or guys, you end up seeing won't be too much different.

Sounded like from your initial post you had a preference for Eastham from the get go. I'm hopeful your visit there goes better than the one with Tewari.
Posted 3/28/2014 3:01 PM (GMT 0)
My husband and I met with Tewari and Eastham. Tewari told my husband to get the surgery within 3 months of the date of biopsy. Eastham told him to get it done within 6 months of the date of biopsy. My husband had 7 out of 12 cores positive for cancer, with 6 cores G6 and one core G7 (3+4). He waited a little over 3 months. Tewari was right. When Tewari did the surgery he found that the cancer had escaped the prostate. Tewari got all of the cancer and saved 75% of my husband's nerves.

IMO the only person who should tell you specifically, based on your biopsy results, how long to wait after biopsy to get surgery is the surgeon, not the scheduler. Tewari left NY Presbyterian about 6 months ago and a lot of this staff followed him; some remained behind. So I'm sure that he has people on his current staff who have not been with him long-term.

As far as I am concerned, the most important thing is what happens in those lonely moments when the surgeon is behind the robot (or behind the knife in Scardino's case as he does open surgery), making decisions about how to cut.

Now the other doctor that you are meeting with, Peter Scardino, has a reputation as one of the best surgeons in the country. I don't think you can go wrong with anyone at MSK, especially Scardino. My husband had his surgery 17 months ago and there are probably rising star surgeons at MSK that we did not know about at the time of my husband's surgery.

Of course you should use the surgeon and the hospital that you are most comfortable with. If you choose Scardino, you are using a surgeon with an impeccable reputation for excellence.
Posted 3/28/2014 3:45 PM (GMT 0)
Inchoation you are right someone told me the other day "You want the best player in the game". I think my choices are solid so Im now looking at "gut feel".

Also a question for the group. Am I doing myself, physically, a dis-service by trying to delay the surgery until, say, June? I'm trying to juggle the home life and also drop some lbs and get in good shape before the surgery. being a 4+3 with PNI , Im wondering if that is ok?
Posted 3/28/2014 4:08 PM (GMT 0)
Hatter
I believe you are doing the right thing. 60-90 days won't make a big difference and getting in better shape is the thing to do. I loss 20 lbs. between DX and surgery. By the way, I loss another 8 lbs the week after surgery.

Good luck in the coming weeks.

Bill from Florida cool
Posted 3/28/2014 4:20 PM (GMT 0)
Hatter, that's a pretty loaded question! The only thing I did was to get any essential heavy lifting out of the way. I'm in "normal" shape for my age I guess, bit of a gut maybe. My surgery went fine and so far everything seems to be on the minimal side ie pain, discomfort. Just had the catheter out today and haven't filled a pad in 7.5 hrs. So that's my story having did nothing.
Cheers, Doug
Posted 3/28/2014 9:31 PM (GMT 0)
Not sure it's the same for surgery patients, but I started on ADT to start weakening the cancer and prevent further growth while I waited for treatment to start.
Posted 3/31/2014 12:30 AM (GMT 0)
Hatter,
Your post about Tom Petty's song "The Waiting" made me smile. That song has gone through my mind a lot these last 2 years. Waiting for biopsy results, waiting for "The Decision" about treatment, waiting for surgery, waiting for pathology report, waiting for post-op PSA results, waiting for next PSA test and now, waiting for recurrence.

Bill from Florida cool
Posted 4/9/2014 11:50 PM (GMT 0)
Brief update. Had meeting today with Scardino at MSK but unfortunately he had the flu so met his partner..guy named Dr Behfer Ehdaie. Really liked him but can't find much info on him. Have Eastham appointment April 28 which I will keep as well since I still think with his experience he is the right guy for me. MSK and Sinai to me were worlds apart and I will be having the surgery at MSK. Just a matter now of who.

Had PSA tested and it jumped from 7 (August) to 11.5 (today). sad
Posted 4/10/2014 1:32 PM (GMT 0)
Hatter
I had open RP at Johns Hopkins due to my Gleason 9 situation. There was no need to stay in Baltimore after surgery. I flew back home with catheter and had it removed by local urologist after 13 days. No complications. Surgery by an expert is usually a no brainer and high volume teaching hospitals have the whole thing down to a science as most of their patients are from out of town.
Bob
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