Newly diagnosed....

yesterday.

He said my "left side is full of cancer".  Mostly number 3 with a couple of 4's - if you know what that means.  He said I was in the "intermediate" category, as 4-5's would be aggressive.

I'm only 48 and consider myself very healthy.  Never smoked, eat right, exercise hard, etc. so I'm a little blown away.  My dad has battled cancers since he was 60 so I've been around it.

I went to Emory Urology in Atlanta.  I chose them over my local urologist because when I went to the appointment I only met with the nurse, and to be honest she scared the heck out of me about my 4.5 PSA.  She even mentioned castration as a treatment!

However, to get in quickly at Emory I had to pick "one of the new doctors".  My biopsy last Friday was awful.  My  hemmorhoids haven't bothered me in years but ever since Friday they're hurting pretty bad.  The urologist has a good education, UCLA medical school, a 5-year residency at Harvard Urology in Boston, etc. and finished a fellowship within the past year. 

Two things worry me about him though:

- During the biopsy, he said my prostate was "small", and that was good, but he left and brought in another doctor he said was "more senior than I to help make sure we get a good biopsy".  The older doctor coached him through the biopsy with the machine. "Turn your wrist left, etc."

- At my second consultation, he sent me to the lab for blood work but when I got there I realized he had given me someone else's lab orders. 

I'll read all the relevant posts tonight and this weekend, but he's recommending the robotic surgery and says he does it "better than most doctors".  I got the sense he deals mostly with bladder cancer, from talking to the male nurse and the Dr. said something yesterday about his experience and bladders and removing the prostate during that surgery.  I'd estimate the doctor is about 35 - 40 or so.  His academic resume looks strong, but I'm worried about how many of these robotic surgeries he's actually performed.

My questions are:  Who are some of the best doctors/clinics, etc. to get a second opinion?  Should I ask for a second opinion from a doctor at Emory?  I've lived in Georgia for 10 years but I think Emory has a good reputation.  I'll go anywhere.  Luckily I have good insurance, a good wife, a lot of frequent flier miles, and a little money in the bank so I want the best.

And, would this (young doctor) give you some concerns regarding this type surgery?

Thanks!

 

YES, YES, YES, bring your results to another, more experienced surgeon and get another opinion.  You want a doc that has done thousands of these.  My boyfriend and I chose a very carefully.  You are young and young guys who have had surgery at the hand of a very experienced surgeon, tend to fair pretty well as it relates to side effects when the cancer is contained.  I listen to my gut.  Your hesitation is telling you something. 

Welcome aboard Healing Well. You found us just in the nick of time.

Get a copy of your biopsy, send the biopsy samples out to get a second opinion and leave that rookie doctor. It is your life he his learning from. Find someone much more experienced. A doctor who is still learning to perform a biopsy does not need to be behind a Da Vinici machine with you being his guinea pig.

Emory is a good hospital, obviously not all the doctors there are.

There are several guys on the forum from Atlanta who can recommend someone else for you.

As was said, you only do this once so you want to be knowledgeable of all your options and find someone to perform whatever treatment you decide who is very experienced.

I was lucky and the doctor who has performed more Da Vinci's than anyone in the world is right here in Florida, Dr. Vipul Patel.

Take some time to learn all your available options, discuss it with your wife and find a doctor you feel good about.


Bill from Florida

How are robotic prostate surgeons ever going to get 300 surgeries under their belt when nobody in their right mind will allow them to operate on them ?? What's it like to be number 10 or number 20?? At 48 years, you want the BEST surgeon you can find..If you can't find that at Emory, then it's off to one of the big cancer treatment centers, Johns-Hopkins, MD Anderson, Dana-Farber, Memorial Sloan Kettering....On the list of the top 25 cancer centers, Emory is #24....Dr. David B. Samadi out on Long Island, NY. is considered by many to be the best Prostectomy surgeon in the world..There are maybe 20 others in his league..I'm sure there will be a couple of true experts down in Florida...

Ask for a copy of your biopsy report and take it with you when you visit other doctors..Also, should you choose an out-of-town surgeon, make sure your doctor at home accepts that and will be willing to perform your post-surgery check-ups. If his nose gets out of joint, you need to find out about that now..Usually there is no problem...

Best of luck to you...

I had daVinci surgery last year and wouldn't have it done any other way. I was in surgery at 2:00 pm and went home the next morning around 10 am after I eat a large breakfast as ordered by the nurse.

Robotic surgery has a steep learning curve. Many papers have been published stating that a surgeon requires anywhere from 100 to 300 robotic surgeries to be highly skilled. For example my urologist did his fellowship and M.D. Anderson and had over 600 robotic surgeries.

My urologist is faculty at a large med school. I had a choice to have my at two hospitals, one is where my urologist has many residents under him and another hospital where he doesn't have any residents. One of my requirements was that no residents take part in the surgery, so I selected the hospital without residents.

As for training, most hospitals have residents that assist in surgeries under the guidance of the surgeon.

Sorry that you must be here..I echo what everyone else said...find another DOC, I used one in my are who has done thousands, and teach's others how to do RALP, but he screwed me up, and I am still having issues almost. Year later, and now am going through SRT, because my PCa is back...get another doc and run from this guy don't let him learn on you! Good luck

Dewayne,

My (original) URO said "we have a brand new Da Vinci machine ... etc etc." I immediately started to look for another surgeon, because hes telling me indirectly that he is NEW to the technology.

I eventually found one who has done hundreds... so Matey, take your time and do your research, ask lots of questions..

take care..

.

Dewayne,

I suggest you do research and consider radiation treatments as they are as effective as surgery for cancer control and generally lessen the side effects of treatment. I was too far advanced for surgery and chose radiation therapy and have done very well. I am suspect of any urologist that is negative about radiation. That tells me they are either ignorant or giving you purposely bad information. Two conditions to avoid.

I am in Atlanta and will provide any assistance you need. My urologist is with Georgia Urology and they have very experienced surgeons as well as doctors that work well with radiation treatments. My uro is from Yale and Albert Einstein Medical School. He was chief resident at Grady. He specializes in prostate work and is about your age. He tailors treatment to the individual and is adept at both surgical and radiologic treatments. He has never indicated to me a bias in either direction. As part of your research, if you need a referral or information regarding my urologist and/or his associates, please let me know. We have many great options for treatment in Atlanta, so you should find doctors that will serve you well.

Please let me know how I might help.

Jack

Dewayne,

If you are considering brachytherapy, (and I suggest that you at least learn more about it), bear in mind that there are 2 types of brachy treatment: (1) LDR (low dose rate), where the radiation seeds are permanently implanted and slowly release radiation over several months; and (2) HDR brachy, where the radiation seed is a much higher dose, and is only temporarily inserted into the prostate for a brief time period.

2 sources of info on LDR brachy are:

www.prostrcision.com/qa/view-all-questions located in Atlanta

and

www.prostatecancertreatmentcenter.com/brachytherapy/why-brachtherapy/ located in Seattle

Two of the best HDR specialists in the U.S. are Demanes in L.A., and Martinez in Michigan, you can learn more at:

www.botsford.org/blog/index.php/2012/07/03/exciting-things-happening-at-botsford-cancer-center/

radonc.ucla.edu/site.cfm?id=443

No matter which form of treatment you choose, it is important to go with the best doctor that you can find, and one that you feel 100% comfortable with.