Can you select your Mayo surgeon?

Posted by larrycurlymo @larrycurlymo, Feb 19 3:33pm

Diagnosed Gleason 6 in 2022 by local urologist. Got a second opinion at Mayo Rochester. Both urologists concurred, and advised that active surveillance was best step. Fast forward to today. Recent MRI showed lesion growth and PSA has risen. Might be facing surgery. I liked the Mayo urologist, but he is young. If I need a RALP, can I request a more experienced surgeon? Can I request one by name? Thank you.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Many young new surgeons are skilled with the new technology. But...older more experienced surgeons have a proven record. How you feel about them makes a difference. The surgeon will be your friend for life. Do you like the person? How is the staff? You may spend more time with staff then the surgeon. How long does it take to get a follow up visit? Good luck. Follow up is very important.

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I researched several at Mayo and if and when I need it I will definitely use Ram Pathak in Jacksonville FL - robotic surgeon - nerve sparing procedure - they also have courtyard Marriott hotel on Mayo campus in Jax - good luck brotha

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Definitely, you can choose your surgeon. Just as important as picking a center of excellence, you need to do your homework on the surgeons and pick the best possible surgeon at the center of excellence you chose. You will need to do your own investigation, just asking Mayo for a their best surgeon does not work - You will get the "all of our surgeons are great" response. For me, I wanted someone that has performed thousands of robotic assisted radical prostatectomies I did not want a surgeon that spends most of his/her time teaching, leading departments, writing books, "jack of all trades" surgeon, etc... I wanted to surgeon that has the most successful experience performing RPs. This also allows for good decision making during the surgery, if complications arise. I went with Mayo-Rochester and chose Dr. Igor Frank. He is an amazing surgeon and also a wonder human being. I did not prioritize bed side manner, but Dr. Frank is excellent in this area.

Best of luck with your journey and I pray all works out well for you!

Jim

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@leedawg

I researched several at Mayo and if and when I need it I will definitely use Ram Pathak in Jacksonville FL - robotic surgeon - nerve sparing procedure - they also have courtyard Marriott hotel on Mayo campus in Jax - good luck brotha

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Wise choice. He performed my RALP in Sept 2023.

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Follow-up questions: We live about 5 hours from Rochester by car. Concerned that if there is a complication after surgery, we will be far from Mayo. Did any of you have surgery at Mayo but received follow-up care with your local urologist? How did that work? Did the local urologist show any signs of displeasure that you did not have him/her perform your surgery? Who did your catheter removal and routine PSA tests? Thanks very much.

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By all means you may choose your own surgeon at Mayo! I am fortunate to live within an hour of Mayo Rochester, so I already had the first step completed: finding a center of excellence.

I wasn’t satisfied with the urology oncologist I was assigned to; after two consultations, before and after the biopsy, I just wasn’t sure if he had the personality that jibed well with mine.

You mentioned that you have seen urologists. Have you fully investigated radiation options as well? I was a Gleason 3+4=7 ( but with a high risk Decipher score of .8) and could choose any treatment from the amazing technological smorgasbord available to us these days. That was great, but so many available choices also made it a more difficult and time-consuming decision. : )

My wife and I watched countless videos and read several books and articles about prostate cancer and recovery. We looked for reputable sources, such as Dr. Scholz @PCRI, info from the prostate cancer foundation (PCF), the latest (5th) Edition of Dr. Patrick Walsh‘s Guide to Surviving Prostate Cancer. Also, we read many reputable journal articles about prostate cancer and relatively recent high-quality studies. Zerocancer.org had good info… Et cetera.

It’s very important to take the time to fully investigate your options before committing. And finding a doctor who has performed a very large number of the kind of treatment procedures of the kind you are looking for.

We looked heavily into the various types of radiation treatments, and homed in on HDR (high dose rate) brachytherapy—tiny radioactive pellets used inside the prostate. We asked the first urologist we’d been seeing for recommendations for a good radiation oncologist (RO) and he recommended a few that he works with. We chose one, and had a meeting with him. (He was kind enough to let us meet via Zoom the morning of our appointment, after our car wouldn’t start!) Again, we felt that this doctor was not right for us.

So we looked on the Mayo website and found another RO and had an impressive interview with him. He squeezed us in to his schedule relatively early, had excellent academic and experience credentials, and was a warm, friendly communicator. We left that meeting feeling very relieved that we had found the best doctor for us.

We told him that we wanted a Decipher test, which looks at your genome and rates the degree of aggressiveness of your cancer. After a few weeks the result came back as high-risk/ aggressive. That really shocked us. Also, we had had earlier followed the advice of a trained volunteer at PCRI and gotten a second opinion (on my Mayo biopsy) from Johns Hopkins. Hopkins had found evidence of “large cribriform morphology,” and we looked that up. It’s controversial and somewhat unsettled, but cribriform is not good and could raise the risk level of your cancer.

The cribriform and the Decipher score made us reconsider our options, and we looked again at surgery, which offered more certainty (following the procedure) that it had gotten all the cancer. This is because they can biopsy the entire prostate after it has been taken out and get a more accurate reading of where are you stand. Whereas with radiation, it can take several months or even a year or two before you can tell if the Pca was fully eliminated. We just didn’t want all of that worry and uncertainty.

So we sought help on Mayo Connect, and got dozens of very helpful replies, among which was a strong recommendation from someone who was very satisfied with his surgeon, both in competency and bedside manner.

This was Dr. Igor Frank. We had a consultation with him and were very impressed. So we decided to go with him. Yesterday we spent the day at Mayo Rochester for pre-op testing, a class, and another meeting with Dr. Frank and his nurse. All were very satisfactory.

So this coming Monday is the big day! I’ll have my surgery at the Methodist Hospital campus at Mayo Rochester.

We’re grateful that we did our due diligence and understood all of the treatment options available, and that we had kept searching until we found someone we felt fully confident about and comfortable with.

I wish you the best of luck as you embark upon your journey through this world of prostate cancer. Onward!

Jim G

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@larrycurlymo

Follow-up questions: We live about 5 hours from Rochester by car. Concerned that if there is a complication after surgery, we will be far from Mayo. Did any of you have surgery at Mayo but received follow-up care with your local urologist? How did that work? Did the local urologist show any signs of displeasure that you did not have him/her perform your surgery? Who did your catheter removal and routine PSA tests? Thanks very much.

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larrycurlymo,

Your surgical team will provide you with detailed instructions for post RP care. My surgeon recommended having the catheter removed at Mayo because it also serves as a sort of check up on how you are doing post-surgery. It just takes a second or two to remove, but they have you drink a few bottles of water and make sure you are able to urinate a few times before they let you leave. I'd recommend staying the night in Rochester just to ensure there are no complications. As for the follow up PSA's they provide you with several options, but none involved going to the Mayo for the test. The preferred option is to have your local GP do it and if that's not an option, they can also mail you a kit to have a sample sent to Mayo.

I recommend having a consult with a couple different surgeons to help with your choice. I was able to get a couple of recommendations and then had Mayo set up consults to help me choose. It was well worth the time.

Good luck with your surgery!

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Great post James, best of luck Monday!

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I had settled on HDR Brachytherapy at Mayo, but met with Dr. Igor Frank while exploring my options. Had I decided on surgery, he would have definitely been my first choice.

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