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Need to pick: surgery in Jan or April?

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Posted 12/11/2007 4:19 AM (GMT 0)
I have a situation that I'd like to share with you.

I just saw one of the top robotic surgeons in the Phila area. He has performed over 1200 procedures. However, his first available appt for surgery isn't until mid-April. I saw another surgeon who may not be "the best", but is also a highly-qualified surgeon. He has performed over 400 procedures. I was able to get surgery scheduled with him for late January.

Just curious......if you were in this situation, would you wait until April and have your surgery done by the more well-known surgeon, or go ahead and have it done earlier by the other surgeon?

Your thoughts?

Posted 12/11/2007 4:53 AM (GMT 0)
How much more skilled is a guy who has changed 1200 tires than one who has only changed 400. Granted, there is a difference, but I wouldn't think a lot. Now if it was 1200 to 40 or even 400 to 40 I would think about waiting. There are DiVinci surgeons who are preforming successful surgeries after only a few under the eye of other surgeons. Some are performing surgeries with only 5 surgeries supervised. That's my take, but you have to make the decision that is right for you. Good Luck and God Bless. Uncle Dan
Posted 12/11/2007 11:32 AM (GMT 0)
Phillysub,

I think one of the more important criteria is your gleeson score.
If any other possible health issues are all the same now versus later,
 -AND your score is a 6, I'd personally go with the doctor and facility 
  I felt most comfortable with.  There are many subtleties to your choice.

A higher gleeson score might encourage me to move to a surgeon
    with a good rep and 400 daVinci procedures  - and 90 days sooner.

Another important question, how many "open" procedures has the each surgeon done? 
This type of expereince - or the lack thereof, cannot be discounted.

I also personally would be cautious of a surgeon that got to 1200 in record time.
(At what and whose expense was this experience accrued?)


Waiting itself might be good or bad for your personal situation.
These are just a few issues that come to mind.
Schedule both while you decide!

God Bless You!

CCedar
ICTHUS!

Posted 12/11/2007 2:24 PM (GMT 0)
I agree with Cedar that your comfort level is the right measure not necessarily what we on the forum suggest. Your Gleason, PSA and DRE should all be considered. If I was making the decision a positive or suspicious DRE would have me going with the Janaury date. Also a Gleason of 7 or more would also have me deciding on January. A Gleaosn of 6 with a high PSA may also move me toward the January date. As you can see in my signature my PSA was 4.3, negative DRE and a Gleason of 6 in 1 of 10 samples. I waited three months for my surgery. I would suggest you ask both surgeons what are their complication rates. They should be able to tell you incontinence and impotence complication rates. A motto on this forum is knowledge is power so find out all you can then go with your comfort level.

Tamu
Posted 12/11/2007 2:34 PM (GMT 0)
Philly,
Cedar makes some good points about your PSA. It seems to me that 400+ surgeries should give you a level of comfort in the surgeon's skills. I know in my case I wanted the cancer removed as soon as I could get it done. Another factor to consider, minor maybe, at least it was for me is how I wanted to spend my recoup time. I decided if I was going to be laid up I would rather do that when the weather in upstate NY was cold and nasty. I was looking forward to Spring activities and wanted to be feeling well enough to participate by April.
Good Luck what ever you decide!
Best,
Mike
Posted 12/11/2007 2:37 PM (GMT 0)
We agree with Tamu and the others on this - your numbers are the big factor as well . . gleeson; PSA; etc.

To us, a surgeon with a less number of surgeries, but still a significant number as in your 400 guy, may still be at a stage where he is just a tad more cautious. . . . and therefore may have the same success rate than the one with 1200.

Ask the questions about incontinence rates, and complications. Sometimes the impotence factor depends on what part of the prostate the cancer is . . .in our case, one nerve was totally wrapped around where the cancer was growing, wasn't spared, so impotence in a case like this had nothing to do with surgeon skill.

Keep us posted.

;o) Linda & Bob
Posted 12/11/2007 3:59 PM (GMT 0)

Philly--You've gotten some excellent advice from others to mull over.  I didn't find this forum until after I had surgery and think I may have done things a little differently if I'd had been here shortly after my diagnosis, although everything turned out fine.

One thing to keep in mind as well, is that numbers are, well, numbers. There is a local surgeon in our area who has high numbers, but is not considered the best to do the procedure. If you can get some insider information (not always easy to obtain) about who is best in your area, that may help you in your decision.

Posted 12/11/2007 4:17 PM (GMT 0)

Philly,

I went to Cooper Univ Hosp-had robotic surgery Oct 3, 2007-would stronly recommend them, I wanted the cancer out and feel good, surgery was very easy, no pain, still dribble alittle and have ED problem-but starting to get some felling down ther-so I just have to have patence-God bless

fredg

Posted 12/11/2007 9:29 PM (GMT 0)

philly,

Again, great advise from everyone.  You have to be comfortable with the surgeon.  I just had my done by a surgeon @ the NJ Cancer Institute in New Brunswick that has "Just 300" under his belt.  What made my wife & I comfortable was that we grilled his nurse before we met him.  She does all the follow-up on his patients and she had nothing but praise for him & his work.

Everyone is different and has different results.  At two weeks after surgery, I am @ 1 pad a day with some minor stress leakage, am taking 50 mg viagra a day toget the blood flow back.  Except for a restriction on heavey lifting I am leading my normal life (just being aware of the better control needed to be contenent)  driving, shopping and walking like before.

Be comfortable with the surgeon and get yourself in shape while you are waiting for the surgery.

Wayne

Posted 12/11/2007 9:37 PM (GMT 0)

njiceman said...

 At two weeks after surgery, I am @ 1 pad a day with some minor stress leakage, am taking 50 mg viagra a day toget the blood flow back.  Except for a restriction on heavey lifting I am leading my normal life (just being aware of the better control needed to be contenent)  driving, shopping and walking like before.

Wayne

Wayne--It's good to hear that you are doing well post-surgery!  Take care and hang in there...Tim


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