Prostatectomy surgeons

Try not to worry too much I had a friend who had his prostate removed 3 weeks ago and is doing fine

As to who is the " best", it depends  on where you are. In Australia there is no published information as to who is the best. In the USA you can actually search for the best hostile gal for urology or most experienced urologists.

if I needed a major procedure I would read up on all the options available and consider the experience of the physician offering the service. A physician with a lot of experience in say open ie non robotic surgery is, in my opinion, a better choice than a newcomer to robotic surgery.

do not be depressed 

feel good about taking charge and considering all the options available. Even if some are unavailable where you live.

Be aware of how much time you have to investigate the matter and use the time wisely. Don't rush. 

One of the very best surgeons if you want to come to the US (and you would not be the first) is Dr. Francis McGovern at Mass General Hospital in Boston.

He only does open surgery.  He did my prostatectomy in early December.  One of the things I am most happy about is no incontinence whatsoever which I was very anxious about.

Good luck!

I am in Melbourne Australia, and the doyen of robot-assisted prostatectimies is Mr Daniel Moon who heads robotic surgery at the Epworth Hospital. I had my procedure 9.5 weeks ago at Cabrini Hospital (where he also operates). I was operated on Thursday afternoon, up and walking around the hospital (gingerly) on Friday, and home noon Saturday.  

Pathology tests showed it had not spread to the lymph nodes, as a consequence I am not on any after treatment. I have minimal leakage and this is dissipating as I continue pelvic exercises at home.

If you are not in Victoria Australia just ignore this post.

Hi everyone, I guess I should have mentioned I live in the US. I'm just not thinking straight.

I have done a lot of research and met with 2 urologists, 1 radiologists, and 1 medical oncologist. Had numerous tests (PSA, MRI, biopsy, bone scan). Cancer is 3+3 (which is not considered aggressive) and is isolated to the prostate but very close to or possibly in seminal ducts. Also have almost no stream because of very large prostate so I must do something soon. The options are prostatectomy or hormone therapy + radiation. I really hate both options because of the side effects. I'm in very good health otherwise and only 56. If I wasn't married I would seriously consider not doing anything. Prostatectomy has immediate side effects of incontinence, impotence (which can get better but is never as good as it was), shorter penis, dry ejaculation...everything a man could ever hope for (sarcasm).

Radiation treatment usually doesn't have too many side effects until a few years later and then rectal issues, incontinence, and ED start to set in.

I feel like I just woke up and I'm trapped in a room engulfed in flames. My choices are run across the room through the fire to the door (and get severely burned in the process or avoid the flames by jumping out the window receiving some cuts from the broken glass and injuries from falling 3 stories to the ground. Of course there's active surveillance of just standing there and hope someone comes up with a better rescue plan before the flames take my life. Sorry to be so negative. Just going through waves of depression.

Did I miss your PSA readings? The most important aspect of PSA tests is the doubling time, obviously the longer the better. You should also mention your DRE results. I am 57 but if I had a Gleason of 3+3 and a PSA doubling time of around two years I would not have opted for treatment. The most important clinical test is the Gleason score and yours is very low so please try and be rational - the outcome is excellent for 3+3 patients. Everyone is knocked sideways by the 'c' word but when you start to do some research you realise that your initial fears are largely unfounded.

​All the best 

Thanks everyone for your caring words and thoughts. To answer Barney & David's question, my first reading was 18.5, 2nd was 18.3, last one (a month after biopsy which can influence the score) was 13.5. I'm drinking mineral water with pure cranberry juice. I don't know if the biopsy, or the mineral water/cranberry juice (or something else) caused the score to drop. The doctors just dismissed it as probably due to the biopsy. Regardless, all three are still considered to too high. They all said my situation is more of a concern because not only is my PSA high, but the location of the cancer is near or possibly in the seminal gland. So taking a active surveillance approach is risky. To make matters worse, I have a very large prostate which is making it difficult to pee.

So I have to take some action just to resolve my urinary issues (before my bladder becomes more stressed) and even though my Gleason score is considered low at 6+6, the location of the cancer is of concern.

If I do radiation therapy, I must do hormone treatment first to reduce the size of the prostate but that has its own side effects including the possibility of developing breasts (which happens a few years later, not immediately while taking the drugs). And there are studies that hormone therapy also contributes to impotence after 5 years.

Also, those who do radiation experience impotence issues and bowel issues at about the 5 yr mark. However, they have much less issues with incontinence. (This info. is just from the studies I have read).

A prostatectomy rarely causes any bowel issues but does cause immediate issues with incontinence and impotence (which can come back if the nerves are spared but it is never as good as prior to the surgery.

My feeling is there is still no good solution for men. Just the choices between the lesser of two evils and everyone must pick their poison. I think some men just do whatever their doctor has recommended. But for me, I'm having great difficulty deciding from which cup to drink.

Sorry, Gleason score is 3+3=6.