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

Go immediately to a center of excellence. You may not need to be carved up and suffer the related side effects. I would ask for an evaluation to see if your are a candidate for the Tulsa procedure (radiowave ablation from within the urethra). Some here will comment on their experience with the procedure. Some of us have varying levels of buyers remorse because remember surgeons sell surgeries, radiologists sell radiation, and med oncologists sell pills . Do your own homework. A wealth of information exists on this platform .

I think you're asking a good question. I'm not a medical professional nor an expert on this stuff, so take my comment with a grain of salt as I certainly don't know what's best for you. That said, I also had a 3+4=7 that appeared to be contained in the prostate. I was 70 when I had NS RARP in June 2024 at Mayo Phoenix, which was about a 5 hour drive from where I live. I made the drive because it's my personal opinion that it's a very difficult surgery and it just seemed logical to make the effort to find the best surgeon I could find to minimize the likelihood of a bad outcome. The surgeon I was assigned at Mayo turned out to be a long time surgeon (something like 20 years) at Mayo, he had a long list of published articles, and he had great reviews. During the consult I asked if he'd be doing the surgery, or some resident. He told me he'd be teaching during the surgery, but he'd be operating the robot and doing the surgery. I figured he must be pretty good if he's teaching at Mayo. I did ask him what he believed my odds, with him as surgeon, were for incontinence and ED. He told me at 1 year I had a 90% chance of being continent an 70% of not having ED. After surgery I was never incontinent (other than the normal accidents while figuring out the new normal) and at 15 months my ED is gone and I'm fully back to normal. I'm pretty sure a big part of my success was getting a great surgeon (and a good penal rehab program after surgery). So I think (generally speaking) that if someone has the option, then getting a very experienced and successful surgeon is worth the effort, but that's just my opinion. Although you didn't ask, I feel compelled to add that a CCOE like Northwestern would also be a great place to get a 2nd opinion on your specific case and all your treatment options. Expertise really matters when treating prostate cancer, and while I don't know for sure I've read that at Northwestern you'd have access to a multi-disciplinary team review of your case. If it's an option for you, it's possible a 2nd opinion could be done very quickly. Best wishes.

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🤞🙏

Wow-thank you so much for the good advice! My challenge now is to see if my insurance will cover the oncology team at Northwestern ( aldenrobert: not sure that GU Oncologists at the University of Chicago is in my plan or not).

I'm not sure if I start with a doctor or the unit?

It looks it would be the Polsky Urologic Cancer Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital.

The other issue is how long would it take for me to get accepted as a a patient. Looking up Dr. Lee, Ziho, MD
Urology , who appears to be in y plan on a web search. But, it looks like he only accepted two new patients in the past year.

Any advice on how to navigate all this? Always been healthy before this, so new to navigating this process. Thank you all!

Couldn't post links, so this info on Dr. Lee..
Dr. Lee is an Assistant Professor, and the Director of Urologic Male Reconstruction and Robotic Reconstructive Surgery in the Department of Urology at Northwestern University Feinberg School of Medicine. After completing medical school at Sidney Kimmel Medical College at Thomas Jefferson University, he completed his general surgery internship and urology residency at Temple University. He then went on to complete a fellowship in Advanced Robotic Urologic Oncology and Reconstruction at Temple University, followed by a second fellowship in Urologic Trauma and Reconstruction at the University of Washington. Dr. Lee has a particular interest in complex robotic reconstruction of the upper and lower urinary tracts, and has contributed to the development of novel techniques utilizing intraoperative fluorescence and ureteral substitution (with the inner lining of the cheek and intestinal segments) during robotic ureteral reconstruction

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.