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Posted 10/22/2006 8:14 PM (GMT 0)

As the subject says I have recently been diagnosed with prostrate cancer.  As you all have gone through I have more questions than answers at this point although my Urologist took time on the last visit to explain what has occurred, my treatment options and what can be result from each option.  He had been very non-commital till that time in visits but did recommend the Da Vinci as my best long term solution.  I have been reading this forum for a few days and see all the wonderful responses.

I am very blessed with a wonderful support team of family, friends and a loving God.  Still there are times when I am alone in my head and I have to fight what I call 'Pity Parties'.  This occurs eventhough I remind myself that it is early diagnosis and confined so treatment should give great hope.

A couple questions I would like to present at this time (am taking a bunch to my Urologist tomorrow).

1.  At this point am looking to Da Vinci but my Urologist has not mentioned anything about an Oncologist.  Is such a visit necessary?

2.  I am in the Omaha Nebraska area and wonder if there is anyone out there in this area that can share hospital and urologist/?? that they would recommend.

Mac

Posted 10/22/2006 8:58 PM (GMT 0)
open, Lap or robotic assist, brachytherapy or radiation, even Proton are all possibilities for you Mac. Check on the Davinci.com web site to find which Docs in your area are recommended by the makers of the robot. The list is by no means complete but it is a good start.

It's all about the skill of the surgeon and the right treatment for the clinical stage of your cancer. With a low PSA & moderate Gleason score, you have a little time to decide so take a breath or two and make a decision that you will be happy with. Good Luck, Vickie
Posted 10/22/2006 9:15 PM (GMT 0)
Dear USMC Retired:

Many of us believe that selecting the finest surgeon out there in terms of experience and credentials is the most important factor for obtaining a successful surgery with minimal to no long-term side effects. I searched the country for my surgeon. I did not restrict just to the immediate home area. I chose to select my surgeon, not the procedure. You will find that the experts specialize in one procedure or the other, not both. Here's my short list of surgeons after my research:

open Procedure: Partin at Johns Hopkins Baltimore; Scardino and Eastham at Memorial Sloan-Kettering New York

Robotic Laparoscopic: Kawachi at City of Hope, Duarte, CA; Menon at Henry Ford Hospital Detroit.

Check your insurance and determine which of these docs are in your network.

Partin operated on me. Excellent surgeon with excellent results. I flew home three days post surgery. No problem.

All of the urologists listed above have extensive experience and outstanding credentials. I am sure others out there can share their knowledge with you as well.

Finally, I don't think you need to consult an oncologist at this time, unless you want to discuss alternatives to surgery.

Good luck.
Posted 10/22/2006 10:07 PM (GMT 0)
Welcome to the club you never wanted to join. My PSA was 4.3 and 5 of 12 biopsy Gleason 6 CT and Bone Scan Clear. I think that makes us pretty similar. I didn't see how old you are. If you are realatively young under 65 even up to early 70's from what I have studied, surgery is the way to go. Everything I read about radiation bothered me, especially since the surgical techniques have improved so dramatically in the last seven years. My feeling was with surgery is the rotten prostate is no longer in my body and if the cancer is contained in the gland then in theory it is gone with the prostate. I had the Davinci 10/12/06 very little problems and the catheter is coming out tomorrow. Selecting the course of treatment is what you will need to decide. Getting the right doctor is important. I prayed a lot and was guided to where I ended up. My first Uro was in his 60's and was not going to do a lap or robotic procedure as he is going to retire.  I'm not so sure the number of robotics they have done is as important as the surgeons competency, skill, desire, and age. Yes, age I wanted someone that has played a lot of video games and doesn't have a phobia about computers like an old guy like me. I had two doctors, mine has only done 4 robotic and the other doctor that was in the surgery at the same time has done over 80. My doctor is I'm guessing to be in his early 40's and has done a ton of prostectomies and is young enough to pick up on new technology very quickly. The second doctor with him looks like he is 12 years old. I think he is in his 30's. I felt very secure and confident with them. You mention you have a loving God. No matter how it plays out, you  are going to be just fine because you know where your strength lies..
Posted 10/22/2006 10:37 PM (GMT 0)
Hi Mac,

I don't see any reason that you need to see an oncologist, and as others have suggested the experience and skill of the surgeon is the most important criteria used to select your procedure. I was 60 when diagnosed with early stage PCa, and because I live in the Washington DC area I had virtually every posible option available to me. After much researching we desided on the DaVinci robotic procedure because it was the least invasive, offered the quickest healing time, and is ideal for patients that are early diagnosed with PCa contained within the gland. Furthermore there are 3 top rated facilities and many excellent surgeons in the Baltimore/Washington area. So good luck with your research, and keep those question coming.

Glen
Posted 10/22/2006 10:39 PM (GMT 0)

Welcome Mac. I think you will find a wide variety of advise and experience here. If you take your time and search around, you'll find tidbits that you'll need regardless of the treatment you pursue. Personally, I feel like my faith has been a large part of the journey and continues to be a great comfort. Best of luck!

Posted 10/22/2006 11:50 PM (GMT 0)

Hi Mac and we welcome you to the board as well,

I'm not sure it is the procedure so much as it is the doctor.  We also believe though that surgery is the best chance for cure if your PC is in the early stages.  Just make sure your doctor is very very experienced in whatever procedure you choose.  Don't hesitate to ask for a second opinion or even a third until you feel comfortable with your decision.  We would also suggest that you read books on prostate cancer to educate yourselves as to what choices you have.  Dr. Patrick Walsh's "Guide to Surviving Prostate Cancer" has been mentioned often on this board and we found it extremely informative and helpful. 

Lastly the thing we would tell you, that we wished someone would have told us, is to start practicing kegal excercies right now this minute.  It will help to regain urinary control sooner.

It sounds like you have caught it very early while it is still CURABLE.  You will know what is the right choice and become secure in your decision after you educate yourself and as Swim said, you have time and should take the time to do this.

We wish you all the best,

Posted 10/23/2006 12:00 AM (GMT 0)
I would check out University of Nebraska Medical Center.
Posted 10/23/2006 12:01 AM (GMT 0)
Hi Mac,   Welcome friend…..   This is a wonderful forum where true feelings can be shared and understood.   So ~ you make sure to stay with us and let us help you through the “dark” moments….   We have been where you are… and this will be a comfort to you.....knowing you are not alone and will never be alone.  We help you clear away the clouds that cover the beautiful sunshine....so it will shine on you!  Positive thinking is the best cloud pusher there is!!      As God carries you during the “toughest times”…. We are here to take your hand and help you on to the next stepping-stone.   This is a new journey for you and it is best traveled with friends.   So give us your hand ~ any time day or night and we will help guide you over those slippery ~ wobbly stones!!!   Depending on your age and *health….   *Retired Marine….   *Need I even ask!!!        I agree that surgery is the best option…in most cases… We all have our own journeys that are shared here and looking back at past postings…. Even 12, 13, 14 pages back…will help gain knowledge about this new path you are on.  Follow their journey from 1 st PSA to recovery/healing period…. And beyond.     There is so much knowledge in this forum….   Once You gain Knowledge… about this cancer and the steps it takes to cure it!!!! You gain Power.   Once You gain Power… it will take the fear away.   And Your decision will be easy to make… Always remember… Your decision will be the right decision for you.   We will keep you close in thoughts and prayers as you begin your journey.   In Friendship ~ Lee & Buddy   "GOD Bless You"   It's a little prayer "GOD Bless You"... but it means so much each day, It means may angels guard you and guide you on your way.                                   ~ author unknown ~  
Posted 10/23/2006 1:19 AM (GMT 0)

Hey mac,

Welcome to a club that understands what you are going through.  My Gleason is the same as yours and my PSA was 4.3.  If you have looked at the Partin Tables you will note that we both have an 80% chance or better that the cancer is confined to the prostate.  While that is comforting it is that other 20% that keeps you awake at night plus the potential complications.  I know what you mean about the support just cannot crack that internal feeling of loneliness that comes with the PCa.  In fact, that is why I get more out of those on this forum then I do my own family. 

As others have mentioned your decision does not have to be made quickly and it gives you time to research and understand all of the options.  If you have not found it yet go to www.yananow.net and read the "Mentor Experiences".  They are catergorized by type of treatment.  I found reading all of the experiences helpful although the ones that have had it tough does not do your morale any good.  The point is that the results depends upon the skill of the surgeon or doctor that provides the procedure.  In my case I will be having a Da Vinci a week from Wednesday.  My first query into surgeons for this procedure came up with the names that have already been mentioned.  I was open to traveling anywhere for the right surgeon.  While not published as much as other surgeons I selected my surgeon located at Vanderbilt University in Nashville.  He is about 2 hours from my home, has done over 3,000 of the open type of RP's until 3 years ago when he began to exclusively do the Da Vinci.  He has done over 800 of the Da Vinci's in the 3 years with excellent complication rates.  I believe that a university based medical center provides the best and latest technology.  Certainly Menom, Partin, Tewara all have been noted in publications and on the Internet. 

As to needing an oncologist I do not believe that is necessary unless you just want an opinion from one of treatment options.  I have been somewhat surprised by the difference in approaches taken after the initiaol finding of PCa.  In many cases the next step is an MRI and/or a bone scan.  When I asked my surgeon about this he told me that it was not warranted in my case with a stage of T1c since it was caught early and the only way to know if it has gotten out of the prostate is the post op pathology analysis.  I have been comfortable with that approach.

Take hope in that it was caught early and your faith God's grace will see you through.

Tamu

Posted 10/23/2006 12:13 PM (GMT 0)
Good morning, Mac. Glad you landed here - you'll discover much and, in turn, share your own experiences, which is very important. The first place we consulted was an oncologist (after urologist) and received quite a sales pitch. However, he left out some very important issues and with further research we opted not to pursue. But that is only because we had other options. Some do not. We discovered daVinci and, like many, opted for the shortened recuperative time and have a strong history with robotics and their capabilities in the right hands. In addition, had we not elected surgery, would never have known there was some cell escape, which would have only been detected (probably) by removal and a pathology report.

The process of getting to the decision, however, does leave some down times. They, too, will pass (or come and go - mostly go). Stay in good spirits as best you can and keep researching, asking, and reading. And, remember, everything you learn can be shared with the next person coming along.
Posted 10/23/2006 1:56 PM (GMT 0)
Hi Mac!
I too would like to wish you well in your journey. I stumbled upon this forum, just last week, while researching Prostate Cancer and it's the best thing that could have happened. My husband had his laproscopic prostate surgery on September 27, 2006 and continues to improve daily.

He's not the researcher in the family so I do the digging on the internet for this stuff, but he too knows the value of this wonderful group of people. As a wife, I have concerns of my own and have found great confort, support and information right here.

Our original urologist did only open surgery, so that was his recommendation at first visit. Thankfully, Bob's brother having had his prostate surgery just one year (almost to the day of our diagnosis) was adament about checking out a less invasive method. We asked for a referral to a laproscopic surgeon and ended up with the very same doctor as his brother. We are so glad we followed big brother's advice.

In my understanding, when they feel you are a good candidate for one of the removal techniques and that the cancer is contained, a visit to an oncologist isn't necessary. Then after removal, if pathology shows any spread whatsoever, the oncologist would be the next stage.

Good luck Mac, and please keep visiting us and keeping us posted. The support and caring wishes really make a big difference.

;o) Linda & Bob
Posted 10/24/2006 12:22 PM (GMT 0)
GreenAcres,
Saw you post on another thread about going with a second doctor and how he had a wealth of information about himself and a pdf that became you Bible. Would you provide the web site?

Meeting with current urologiest next Tuesday (31st) and want to have plenty of questions. We have pretty much decided on the Da Vinci but want to make sure there are no regrets.

Thanks
Mac
Posted 10/24/2006 1:14 PM (GMT 0)
USMC, here's the direct link to the pdf file. (I hope it's OK to post this here). It is full of helpful info detailing the da Vinci procedure, what to expect before, how to prepare, recovery, kegels, post-op, etc.

http://www.prostatecenterofaustin.com/Docs/davinci.pdf

Good luck - making that decision and then waiting to meet and schedule is never easy.

I might add that the only reason we raced to an oncologist first was that we knew nothing about surgical procedures other than our own perception of turning into a doddering, dribbling, sexless old fool. That, as we all know, is perfectly silly, but still a belief held by many. Thanks to newer techniques, we all know - and are proving - otherwise!
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