Surgeon appointment for Robotic Prostatectomy: Questions to ask?
Tomorrow I will have an appointment with a surgeon for possible robotic surgery (prostatectomy).
59yrs old
Gleason score 3+4=7
One positive core 1.6cm
Acinar adenocarcinoma
PSA 6/12/23= 4.24
PSA 12/12/23=5.13
BPH on Finasteride
Prostate volume =34cc
Previous surgery double hernia repair more than 10 years ago.
What questions should I ask to make an good decision on treatment?
What should expect from him as far as they can offer?
What will be a red flag, that clearly tell me don’t trust your prostate to this surgeon?
Any advice or suggestions will be greatly appreciate it.
Interested in more discussions like this? Go to the Prostate Cancer Support Group.
I would not trust any surgeon who guarantees an outcome. I do, however, believe that a surgeon who shares their previous patients experiences and their track record shows a surgeon who follows up with his/her patients post op and demonstrates a level of confidence in their ability. It’s another data point to help you make your decision vs just qualitative feedback from a chat group.
Don’t believe any surgeon who gives you his batting average on ED and incontinence. I went to the “biggest” name in NYC - a man who advertises total potency and continence after the procedure. I have NEITHER almost 5 yrs out but I don’t really him for that since I know everyone is different and we all react differently. But I DO blame him for advertising something that is blatantly false.
Ironically I didn’t go to him for his advertising - I went because of the vast number of procedures performed and the fact that people the world over flew into NYC just to have him operate….go figure….
Here is a link describing the procedure:
https://pubmed.ncbi.nlm.nih.gov/33067016/
Basically, it preserves anatomical structure and results in much quicker return to continence in the data provided.
Praying for a very speedy recovery and complete healing and NO more cancer! Hugs to you!
If you don't mind my asking, what is the Hood technique?
why i decided for the same procedure with same results. I too am clean 4 1/2 yrs now. Hoping no reoccurrence. But I have been reaching out. I had nerve sparring robotic surgery but I am incontinent and impotent. Although I dont work at either. I am following this site. Good luck.
I am 71 yo. Just completed RP currently day 9 post op. I had a urologist I had great confidence in and who had 12 years experience in robotic surgery. For good measure I also got a RO consult. Journey started when I was
Having BPH symptoms but PSA was 30. Biopsy showed G 4+5=9 and MRI and PET scans negative for Mets. Just got
My pathology back and clear margins, negative seminal vesicles and nodes. I feel
I made
The right decision as now I know and don’t have to wonder about
Microscopic spread. Will see how my PSA does and take it as it comes. Good luck!
Thanks for the details. Mn281 had great suggestions of what to ask the surgeon. I suggest you check them out if you haven’t already done so.
I’m glad to see that you’re getting care through a center of excellence and that they’ve been thorough and pragmatic with their diagnostic approach. From all appearances, you’ve got what many people would characterize as low risk disease and have a number of possible treatment options besides RP available through UF. These include HIFU and TULSA-PRO. It is my understanding as a layman that both of these procedures carry a lower risk of ED and incontinence than RP yet both leave the door open to multiple salvage treatments such as RP, RT, ADT, and Chemotherapy should the primary treatment fail. You’re a young man and if your sexual health is important to you you’d do well to consider asking your surgeon if either of these treatments would be appropriate for you.
Best wishes for success on your journey to be cancer free.
Thanks Robert
To answer your questions:
All procedures through College of Medicine/Urology/Oncology Dept University of Florida
MRI before Biopsy Multiple parametric.
Biopsy guided fusion
13 cores,12 normal, 1with 3+4 lesson.
Decipher test= low risk
my condition was very similar. gleason 3+3 , one of twelve with cancer, but my PSA was 1.2. Margins were clear. Mine was not considered immediate. I elected for the Robotic nerve sparring surgery. My doctor was with local hospital with his own practice. I started a thread "life after prostate cancer" and many have asked me why the surgery. My Dr said his numbers were 85% success both incontinence and impotence. I had no other issues and active. I fell into the 15% on both. Four and half years later I think maybe I stopped the cancer but I need to figure out the future. so asking now is a good idea. My Dr was a typical I am smarter than you type of guy and bristled at the fact I googled my information. That should have been a clue. I think all the suggestions on here are great ones. I did watch about 5 full surgeries on the internet. I thought it was interesting.