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Schaeffer or Zagaja in Chicago ?

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Prostate Cancer
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Posted 8/8/2018 7:52 PM (GMT 0)
I’m recently diagnosed with 4+3, low volume disease. Have visited with both Dr. Ed Schaeffer at Northwestern and Dr. Greg Zagaja at Univ. of Chicago. Both meeting were really good and believe these are two of the best in Chicago....any thoughts ?
Posted 8/8/2018 8:05 PM (GMT 0)
I don't have any familiarity with either doctor, but they're both surgeons, correct? If you're looking beyond surgery you have the Chicago Prostate Cancer Center near you and they have a great reputation for brachytherapy (seeds). I would think it would be worth a visit to have a contrast to a surgical perspective. Good luck to you!
Posted 8/8/2018 8:51 PM (GMT 0)
Hello, Harrison and welcome. I'll second what Michael said and also suggest that you consult with experts in HDR Brachy and SBRT. There are many ways to cure you and you'll want to get educated in all of them so you can make this critical decision with the best info available.

Jim
Posted 8/8/2018 9:11 PM (GMT 0)
Arica Hirsch - Advocate Lutheran (SBRT)
Brian Moran - Chicago Prostate Cancer Center (LDR brachytherapy)
Posted 8/8/2018 9:35 PM (GMT 0)
Welcome to HW.

Research all your options.

Keep us updated on your progress,
Andrew
Posted 8/8/2018 10:02 PM (GMT 0)
You picked the exact 2 I would have recommended. My husband had surgery with Zagaja in February of 2017. Top notch surgeon.
Posted 8/8/2018 10:39 PM (GMT 0)
I would think Catalona is the top surgeon in Chicago - no?
Posted 8/8/2018 10:53 PM (GMT 0)
Yes but I think he only does open. I was going to switch our after care to him because our insurance was going to drop the University of Chicago but they ended up working the contract out at the last minute so we stayed with the UofC. I was looking forward to meeting him though.
Posted 8/8/2018 10:54 PM (GMT 0)
Catalona certainly is a giant in the field...but in his late 70’s now, not sure if he still operates. Schaeffer is the relatively new head of the Northwestern Urology dept.....he came from John Hopkins. I liked him...interested in others view point ?
Posted 8/8/2018 11:40 PM (GMT 0)
Perhaps he doesn't take patients anymore. So what if he only does open? One gets equivalent results - the experience of the surgeon is the only thing that matters and Catalona is by far the most experienced. They finally did a randomized study:

"Urinary function scores did not differ significantly between robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy... Sexual function scores were not significantly different ... Equivalence testing on the proportion of patients who had imaging evidence of progression revealed that the two groups were not significantly different.

/www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30357-7/fulltext
Posted 8/9/2018 12:12 AM (GMT 0)
We never really looked at open although it was tempting only because we're in Chicago and do have access to Dr. Catalona. The reason we didn't is because I was under the impression that with RP there is less blood loss and a faster recovery. We were just more comfortable with robotic overall.
Posted 8/9/2018 12:19 AM (GMT 0)
Harrison, welcome to our little club that none of us wanted to join--but found incredibly helpful after we did.

To expand on the 1 sentence replies---

There are multiple treatment options--and surgery is only one of them. It is wise to talk to experts in the other treatments about their recommendations. It's simple surgeons know about surgery. What a surgeon tells you about radiation therapies is about as useful as a plumber making recommendations about putting a roof on your house. The plumber may know a few good roofers...but he's out of his expertise.

PC is unusual in that it is typically diagnosed by a urologist--and almost all urologists are surgeons. So they recommend surgery. Please do avail yourself of the tremendous expertise available in the Chicago area and consult with the other experts that have been suggested to you. PC is nice in that you do have time to do the research and come to a reasoned decision that is right for YOU.
Posted 8/9/2018 2:57 AM (GMT 0)
J&D-

That is very true - the peri-operative outcomes with robotic are better - but that is a very minor outcome. Catalona says that haptic feedback is important and only possible when actual hands are involved.
Posted 8/9/2018 3:16 AM (GMT 0)
I had HDR Brachetherapy at Loyola with Dr Harkenrider in June of 2017 in Chicago. I thought he did a good job. PSA went from 6.8 to .9 so far. I had a possibility of EPE and HDR can go outside of the capsule wall to get the cancer. I would recommend that you get an MRI to see where the cancer is even if you are low volume. Gleason 7 (3 + 4) was my diagnose as well. I joined the Loyola NCAA tournament bandwagon after that. I need to get a t-shirt or something next I go back there.
Posted 8/9/2018 5:13 AM (GMT 0)
Catalona may be a giant in the field but my results with him were far from ideal. His nerve-sparing technique wasn't. Cancer returned in about 9 months. Continence issues plagued me until I got PT prior to the start of proton treatments. Now I'm in PT again trying to recover continence after that treatment. There is no such thing as a free lunch but at least in my case, Catalona's pitch didn't pan out. I don't know if he's still doing surgeries but I don't buy his arguments for open surgery anymore.

I have a friend who went to Zagaja about a year before I was diagnosed and had a great outcome.

I wish I had known about and talked to Zagaja and Moran. I would have been able to make a more informed decision. But I got panicky and make a hasty choice.
Posted 8/9/2018 1:54 PM (GMT 0)
Dr. Tim Hollister, worked with Zelefsky before opening in Wilmette, Metro-Chicago Surgical Oncology, did my lymph nodes. Smart and helpful, free with time.
Posted 8/9/2018 10:43 PM (GMT 0)
I second Dr. Tim Hollister, he is a wonderful radiation oncologist, he performed my husbands treatments and it was a breeze even with Lupron. Dr. Hollister is compassionate and answers all questions in terms that the patient can understand. I am a nurse and I went with hubby to most of his treatments and 1:1s with Dr Hollister I watched his "bedside manner" and his ability to make my hubby understand his options and possible side effects. He also gave tips on how to avoid these awful side effects from radiation and lupron and we listened. As a nurse who has for 30 years listened to Drs talk to patients, he is by far one of the best. After our first meeting with him I knew that I had to have him for my hubby, and jumped through hoops to accomplish this. My hubby currently experiences no side effects his PSA was 0.2 6 weeks after radiation, and is probably lower now.
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