Consult Dr Eastham SK

Hi Thank You for all the wonderful comments helps me sort things out !

I have an appointment with Dr Eastham At Sloan Kettering this Monday I am told his robotic assisted laparoscopic prostatectomy takes 4 Hours which is 2x the time my local Urologist said the same operation would take so I am hoping he is more thorough !! Wondering what other questions are important to ask ? I know he is Dept Chair so He does 4 operations a week . 2 Tuesdays 2 Thursdays Not sure if this surgeon is the right one for me Some Dept Heads are there for a reason better at Politics than surgery Any input is welcome . Thank You . Keith .

I am 59 excellent physical shape my PSA . 4.6 . My Father had prostate cancer at 70 and had his prostrate removed and lived for many years after

BIOPSY REPORT FROM DR EPSTEIN

I had 12 biopsies done on 6/5/18 . 8 out of 12 showed cancer involvement . Gleason 7
1.)Adenocarcinoma of Prostrate Gleason Score of 7 . (3+4) . involving 40 % of tissue

comment: Perineural Invasion is identified

Right Mid Needle Biopsy

2.) .

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 50 % of tissue

comment 2 out of 4 cores involved by Tumor

High Grade Prostatic Intraepithelial neoplasia (HGPIN) is also present . ??

Right Apex Needle Biopsy

3.)

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 75 % of tissue

Left Base Needle Biopsy

4.)

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving less than 5 % of tissue

Left Mid

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving less than 5 % of tissue 2 out of 4 cores involved by Tumor

comment a rare atypical gland is seen in a third core . ??

Left Apex Needle Biopsy

6.)

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 10 % of tissue

RALP takes between 2-4 hours depending on a number of factors. Both docs are right. You URO maybe bit optimistic.

For a list of questions to ask see this thread: /www.healingwell.com/community/default.aspx?f=35&m=2637622#m2647572

What really matters is the skill of the surgeon and how many procedures they've done. 4 a week is a couple of hundred a year, over a number of years, not bad.

You'd be fine with any of the mainline treatments and have every reason to expect that one treatment will be curative.


Andrew

Eastham is among the best anywhere. Did you also talk to Zelefsky about radiation? MSK has an embarrassment of riches. Here are some questions to ask (adapt to your particular situation):

/pcnrv.blogspot.com/2017/12/questions-to-ask-and-not-ask-on-first.html

Also, ask yourself these questions:

/pcnrv.blogspot.com/2017/12/questions-to-ask-yourself-in-deciding.html

Hello Keith and welcome. My first thought was, "have you considered radiation treatments?". These are likely to cure you as well as surgery but with a lower chance of onerous side effects. Having said that I see that you have added a consultation with Dr. Z so it sounds like you are doing a great job of covering your bases.

Good luck.

Jim

Hello Keith and others,

I am a new member here and this is my first posting.
This thread about Dr Eastham at MSK caught my attention and I feel an obligation to chime in.
I had proton therapy for my prostate cancer at Penn in 2012. By Fall 2016 it was obvious that my PSA never bottomed out and was climbing progressively. After an MRI, biopsy, bone scan, exploring cryotherapy, etc. my local urologist strongly urged me to consider a salvage prostatectomy at MSK. Almost exactly a year ago I met with Dr. Eastham. He warned me about all the risks and possible complications I would face, but I knew he was still my best chance for a cure. I was very impressed with his manner and his frankness. We scheduled robotic-assisted laparoscopic surgery for the last Saturday in August. (For the record here, I was woken from surgery 4.5 hours after I entered the operating room.) I remember my anesthesiologist being effusive in his praise for Dr. Eastham's skills with robotic laparoscopic procedures. I was glad to be under his care, even though I have suffered through many of the known complications of the salvage surgery, including very slow healing (9.5 weeks before my catheter was removed), severe bladder neck contracture requiring emergency urethral dilation and recatheterization, more surgery (at Temple) to open the bladder neck contracture which predictably left me totally incontinent, and most recently the implantation of an AUS. I have gone through a lot, but I was well-aware of the risks going in and I accepted them readily. So...did Dr. Eastman cure me? I just got the results from my 4th PSA test since November and it remains in the undetectable range, and for this I am very grateful to Dr. Eastman and his outstanding team at MSK. I have no regrets.
I am not familiar with any other physician at MSK, but from experience there and Memorial Hospital I was left with the impression that it was truly a first class operation compared with my five other hospitalizations.

Dino

I had surgery with Dr. Eastham in June 2018. I was most impressed with him professionally and personally. My surgery lasted over 4 hours. The experience at MSK was outstanding. Completely continent after the removal of the catheter ( day seven ) and still undetectable after one year. I was most pleased with the entire MSK experience.