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Looking for NYC Doctor for Radical Prostatectomy

Posted , 11 users are following.

sharpcut
sharpcut

My name is Keith Nice to meet all of you I have read quite few of your comments and I am grateful for your responses to people in need ! I would like to ask you some questions if ok with you I hope ! ?  Here is my background 

I am 59 excellent physical shape  my PSA . 4.6 . My Father had prostate cancer but and had his prostrate removed and lived for many years after and died of  a series of strokes 

I had  12 biopsies done  on 6/5/18 . 8 out of 12 showed cancer involvement

Here is Pathology Report

Right Base Needle Biopsy

1.)Adenocarcinoma of Prostrate Gleason Score of 7 . (3+4) . involving 40 % of tissue 

comment:  Perineural Invasion is identified    (from what I can tell this is not good)

Right Mid Needle Biopsy

2.) .

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 50 % of tissue 

comment  2 out of 4 cores involved by Tumor

High Grade Prostatic Intraepithelial neoplasia (HGPIN) is also present . ??

Right Apex Needle Biopsy

3.) 

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 75 % of tissue 

Left Base Needle Biopsy

4.)  

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving less than 5 % of tissue 

Left Mid

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving less than 5 % of tissue    2 out of 4 cores involved by Tumor

comment  a rare atypical gland is seen in a third core .   ??

Left Apex  Needle Biopsy

6.)  

Adenocarcinoma of Prostrate Gleason Score of 6 . (3+3) . involving 10 % of tissue 

My questions are .   What does this mean ?  especially the comment  Perinueral invasion is identified ?   I am leaning towards Removing my Prostrate but do not have any leads for a qualified Surgeon in the NYC area 

Do you have any recommendations ??  Very Grateful for your help and input 

Thank You . Keith 

0 likes, 41 replies

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  • Triplets
    Triplets sharpcut

    Posted

    Hi Keith from another Keith.   Perineural invasion basically means cancer cells were seen along or tracking the nerve canal in the prostate gland so potentially could move out 

    your Gleason though shows the cancer is low grade at the moment but in view of your Dads history I suggest you get an appointment with a urologist and there must surely be a good one not that far from you 

    My inclination would be to remove the prostate but obviously you must see an good urologist 

    cheers and good luck Keith 

  • anthony70342
    anthony70342 sharpcut

    Posted

    Have you inquired @ Memorial Sloan-Kettering Cancer Center in Manhattan?  From past experience for my Dad, they had GREAT doctors.  Visit their website.  
    • sharpcut
      sharpcut anthony70342

      Posted

      Thank you .  a friend who works there actually suggested I look elsewhere ?  Not sure why but He said he was not happy with the Dr that treated his brother for Lymphoma !!  I know crazy but that is the truth .  May be a one off
  • rocketman42
    rocketman42 sharpcut

    Posted

    I'd ignore your friend if I were you.

    Look into James Eastham or Vincent Laudone for surgery and Michael Zelefsky for radiation oncology.

    No place better in the world.

     

  • Davey22
    Davey22 sharpcut

    Posted

    You could see an expert in this field of robotic prostatectomy. His name is Dr. Vipul Patel in Celebration Florida.

    Check out his website

     

    Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

    • n-mac
      n-mac Davey22

      Posted

      I was prepared to travel anywhere in the USA to find the very best, and in the end did so.  I ruled out Dr. Vipul Patel very early from my list of options after I learned from some research that he does something like 6 RALRPs per day, which IMO is far way too many.  I decided that I want my surgeon to be in tip-top state of mind and attention when operating on me, and not weary and worn out.  Plus, I found good reason to be concerned that it may not necessarily be only Dr. Patel who'd be running the robot for 100% of my RALRP. All in all, everything (website included) came across as way to much commercial, marketing, and high volume production line.

    • anthony70342
      anthony70342 n-mac

      Posted

      May I recommend contacting Dr. Sangal @ Cancer Center Treatment Center of Phoenix, AZ?  IMO he is one of the BEST oncologists around or should I say that we've have dealt with.

    • richard98806
      richard98806 n-mac

      Posted

      Guarantee that 1 Dr couldn't perform 6 per day. That would be 12-18hrs of surgery. You know he is only overseeing most of the surgeries. You do want a surgeon with many successful surgeries under his belt but this situation seems like a teaching hospital. As a matter of fact my surgeon did his robotic training there.

  • charles61038
    charles61038 sharpcut

    Posted

    Keith, you have many people in this forum that can offer their advice and their experiences. I was diagnosed a little over 2 years ago. The cells found were the adenocarcinoma which I understand from my urologist is a non aggressive type and slow growing - which is good. You have other things going on too and I'm not sure how aggressive the rest of the findings are. Do yourself a big favor and do lots of research on your situation. There are websites where you can plug in your numbers i.e. PSA and Gleason score and it will give you treatment options that would be good. There are many treatments available and you should explore them. Radiation, Cyberknife, Brachytherapy, to name a few. If you can, ask your doctor what he would do if this were his situation, or one of his dad. What ever you decide, make sure the doctor has performed that procedure many times successfully. I researched options and had the Brachytherapy. I also considered Cyberknife. If you would be a candidate for these, they are much less invasive that the radical prostatectomy. But if that is the best treatment option for you - then do research for a good doctor. Maybe even a second opinion.

    Keep us posted on your decision. Good luck to you.

    • sharpcut
      sharpcut charles61038

      Posted

      Thank You Charles  I sent my report to Dr Epstein Pathologist at John Hopkins . for a more detailed second opinion . This was suggested by another helpful chat group . 
  • hopeful65
    hopeful65 sharpcut

    Posted

    Keith,

    I highly recommend Dr. Vincent Laudone at Memorial Sloan Kettering 

    All the best to you

    • sharpcut
      sharpcut hopeful65

      Posted

      Thank You  very much  I assume this recommendation comes from experience !  thanks
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