Go with local prostectomy surgeon or pursue big center 2.5 hours away

His name is Alex Zacharias. He’s with Aurora in Grafton(262-329-8100)where he performs the surgery(an excellent facility) and also has an office on Good Hope Road(414-352-3100). I live in Slinger and the drive to Grafton was well worth it. I still have followup appointments with him twice a year. Hope this is helpful

I have a cT3b diagnosis, so not that relevant to your less serious case. I started out by seeing a community urologist. I then transferred my care to a urologist at the NCI designated cancer center in the nearest big city to where I live. I then transferred back to the community urologist. Both urologists were proposing to do the same type of perineal biopsy and I chose the one who would do it 2 months earlier than the other. Once I had the biopsy result, I went back to the NCI designated center.

Since my biopsy interpretation was cT3b, suddenly the NCI urologist found he could accelerate my care. Once he saw the biopsy report he gave me an appointment one week later. This is the guy who thought 2 months delay in getting the biopsy in the first place was nothing to be concerned about.

My experience with this urologist was somewhat difficult. I saw him and he scheduled surgery. But when I read his clinical note after that appointment, it became clear that he did not believe surgery was the best option for me. Although during the appointment, he had insisted I see a radiation oncologist prior to undergoing surgery and I had agreed to this, in discussion he had stated that as the outcome of having surgery or radiation in my case were very similar it was up to me to choose.

Yet in bold type in his clinical note, he wrote "Despite my recommendation for radiation treatment given his age and high risk disease... the patient would really like to proceed with surgery"

I wrote him to say please refer me to anyone other than you at your facility, as I can't have a doctor who is not levelling with me.

I do appreciate that I was able to find out what his recommendation was though. It appears he thought that by making sure I agreed to book an appointment with a radiation oncologist prior to surgery, this was sufficient to convey to me that he was actually recommending radiation instead of surgery.

I then looked up and studied the clinical note left by my community urologist after he saw my biopsy report. This guy, during the appointment, had also said radiation or surgery, the outcomes are similar, its up to you to choose, and he had scheduled surgery. His note was clear: "if we do proceed with surgery there is a high chance of biochemical recurrence and needing radiation postoperatively", and that during discussion, he had "wanted to be clear that this may be a multimodal approach".

I concluded that both urologists were not that enthusiastic that the surgery they had scheduled would turn out well. I saw the radiation oncologist at the NCI designated center, and the one in the community that the community urologist referred me to. I eventually agreed to a plan proposed by the RO at the NCI designated center. He is still investigating details about my case which can modify his treatment plan. I am still investigating alternate choices and alternate treatment centers that can offer these choices.

Anyway, I thought I'd report my experience. I found that the community surgeon and the surgeon at the center of excellence both had about the same level of surgical experience. The community guy established some level trust beyond what I felt with the center of excellence guy. I chose to agree to radiation at the center of excellence as I found the RO to be someone I could respect and trust, who had more experience and more resources at this disposal than the community RO I saw, although I liked and respected her as well.

I could sum up what I wanted to convey by saying try to understand what the doctors you are seeing actually believe is best for you. It seems to be difficult for some of these people, however brilliant and accomplished they are when doing or choosing the treatments they offer, to communicate what they actually think to their patients.

Definitely the big center and if possible a center of excellence. Having someone highly skilled (2000+ RARPs) is crucial for side effects.

I had my RRP performed by a local urologist surgeon in Barrington Il. I truly think that it was a mistake for me. I should have gone to a center of excellence first. It is a 2 1/2 commute for me to go into Northwestern in Chicago. My oncologist is Dr Vanderweele and I would highly recommend him. But I have also heard good things about the GU Oncologists at the University of Chicago. You have cancer, see a GU Oncologist.

Sorry, ‘one or two a month’ isn’t nearly enough if you want the best chance for success; and 100 surgeries is like you trying out for the London Philharmonic after a few piano lessons.
Drive, get a room, do whatever you can- but please try to get this done RIGHT the first time. Side effects from bad surgeries are life-altering!
Phil

Go CCOE - just one of many benefits - your post-surgery pathology show some surprises that might require a follow up plan. You're going to want expert pathology and expert treatment plan. the CCOEs have seen it all.

I had mine done by a local surgeon in the Milwaukee area. I selected him after talking with another surgeon(whom was terrible) and a center of excellence in Illinois(that refused to give me any financial details). My surgeon is named one of the top urologist surgeons in Wisconsin. He has done over 1,000 procedures. The care and detail given before the surgery was second to none. After surgery I had no problems with the catheter and ZERO incontinence issues, even to this day 2 1/2 years since my surgery. My pathology report came back with a higher risk G score compared to my biopsy(done by a different urologist), but my PSA is still < 0.01. Still praying everyday. If you would like his name drop me a line. Best wishes🤞🙏

Northwestern has a really great prostate cancer center of excellence. I definitely think you would be better off going there. The American Cancer Society can arrange for housing for low or no cost, Go to their website and search for it. There are other groups that also can you get housing for cancer patients?.

You would be better off going to a doctor that does the surgeries Continuously.

Recovery from prostate cancer surgery is pretty Quick. After seven days, I went back to work full-time, but I was 62 and in great health. Not everyone recovers that quickly.

Start Kegels now. Set up appt with physical therapy and ED months in advance, even before your surgery. Typically, they are all super booked. PS You might think you know how to do kegels but most of us dont. Get a good PT.