Center of Excellence questions/recommendations for CA resident

I live in the Bay area. When I was diagnosed with prostate cancer, I sought many opinions-Stanford, Cal Pacific, Johns Hopkins, Massachusetts General. To quote a Mass General doctor: "We have excellent surgeons but there's no point in traveling to Boston when you have UCSF so close." He was right--UCSF is a center of excellence for prostate cancer if any place deserves that designation. I had an RP with Dr. Peter Carroll and return there regularly for follow up. I strongly suggest you go there for a consultation.

I was diagnosed gleason 3+4 =7 PSA 4.1. At age 60. I decided to wait to do anything after doing much research. As my PSA increased over the next 5 years to 10, Idecided to have the Robotic Prostatectomy. I chose to use Dr. Ahlering at U C Irvine. I did have to pay more by using him, but my health was worth it. Here is a little bit about him:
Dr. Thomas Ahlering is a highly regarded surgeon in Urologic cancers. He received his medical degree at St. Louis University School of Medicine, followed by a residency in urology at the University of Southern California in Los Angeles and a two-year fellowship in urologic oncology under the clinical training of Dr. Donald G. Skinner. Following his training he was the Chief of the Division of Urologic Oncology at the City of Hope (1986-1992) when he was recruited as Chief of the Division of Urology at UC Irvine in 1992-2002. His years of experience in treatment of prostate, bladder, kidney, and testicular cancers has placed him as one of the original America’s Best Doctors since his selection in 1994. He has received local, national, and international recognition for his expertise in urologic oncology, particularly in the development of Robotic radical prostatectomy with the da Vinci robot. He has performed more than 2500 such surgeries, including the first robotic prostatectomy surgeries in Southern California, Denmark, Australia, and Canada.

Thank you for an excellent recommendation. https://thomasahleringmd.com/meet-dr-ahlering/#:~:text=Specialty%3A%20Urological%20Cancers-,Dr.,the%20clinical%20training%20of%20Dr.
How are you doing post surgery?

To add some additional thoughts for the OP:
-There are many excellent, experienced surgeons who perform robotic prostatectomies...many are at University teaching hospitals .
-You might consider robotic surgery over open surgery. Robotic surgery generally requires a shorter hospital stay, results in lower blood loss and smaller incisions with reduced pain and with equally good or better outcomes.
-You can travel to Mayo, Hopkins, LA, or other areas of California and I'm sure you'll find excellent care. But you are fortunate to have one of the very best institutions for prostate cancer treatment nearby and , all else being equal, it's advantageous to be close to your surgeon for follow up. You really should at least visit UCSF. They are at the cutting edge (pun intended)in this area. They have pioneered new drugs for PC, the PSMA test (an imaging test to pinpoint prostate cancer), the CAPRA score to evaluate prostate cancer risk, and many other discoveries which now have been adopted by other institutions.
-I have met prostate cancer patients at UCSF who traveled thousands of miles just to be treated there.
-UCSF also has a peer support program for patients (any patients-not just UCSF patients) or prospective patients (415-885-3693). You can be referred to an experienced patient who had a similar diagnosis and similar treatment to learn about their experience. I am a counselor in this program and have spoken to many patients about my own experience. There are also support groups where men get together either in person or virtually to exchange information. There are several in the Bay area.
-Just my additional 2 cents!
Good luck!

I also endorse UCSF as a center of excellence.

Hi, My husband had Dr. Peter Carroll do his surgery as well. Just wondering about your 'regular follow up'. Since the removal of his catheter there have been no follow up appts. Only PSA tests. They have never suggested he come in for anything. TYIA

I assume it's actually good news...that your husband's PSA remains undetectable and there was no need for further treatment. My PSA began a slow increase after surgery and eventually reached the detectable level (0.2) . This happens about 30% of the time. I had additional testing followed by hormones and 37 radiation treatments. I had multiple consultations with Dr. Carroll during this time to discuss treatment options, referrals to Radiologists, Oncologists and other issues.

Follow ups wouldn't be with the surgical oncologist unless there were a need for retreatment. You might want to follow with an oncologist for help with any side effects. I have heard that physical therapy and/or medications can be helpful. Echoing brownsf good news that your husband's PSA hasn't alerted the need for appointments.

Anyone have there cancer treated at university, California San Francisco? UCSF

I met with a radiation oncologist at UCSF and he is recommending SBRT with a total of 38 Gy radiation over just for treatments

I am Gleason 3+4. Localized prostate cancer. So he is not recommending any additional treatment. No brachytherapy boost or hormone treatment

Total dose radiation seems low to me. I hear that something closer to 50 Gy is more curative

50 GY and over are more likely to damage the urethera. ADT would sensitize the tumor cells to the radiation. Protocol with MRI guided SBRT is 40GY in five treatments. It sounds like you are in very good hands at UCSF. If you haven't had genetic testing for the tumor, that could add guidance. Most are using decipher. But, I think it is good to get second opinions satisfied or not. It is fairly easy with zoom and with the prevalence of Epic and its
access to your records. I can recommend Hoag, City of Hope Lennar, and UCLA for second opinions.
Best wishes