Re: Getting Performance Statistics on Surgeons and Oncologists

February 20, 2011

Jim,

You are asking the right questions. What are your PSA, Gleason and

Staging numbers? Assuming they are not out of sight you have plenty of

time to find the right treatment and treatment center. Take your

time. You need to first figure out what the best treatment seems to be

for you; then find out where the center or centers that perform that

treatment are located; and then determine which of those centers has

the best documented results; then you need to have a serious discussion

with yourself to see how willing you are to accept less than the best

results for the convenience of being treated locally.

If your interested I could email you a comparison I recently updated of

eight major PCa treatments performed in the USA (based on average 10

year disease free results; and serious urinary, rectal and sexual side

effects).

Carl

xcpx@...

JimV wrote:

I live in a small town, and the only urology practice is so busy

I'm lucky to get three minutes of the doctor's time. One of the doctors

in this practice does the robotic laparoscopic prostatectomy procedure,

which I think is what I want. I should get another doctor, but I would

rather stay in town. However, I might go to elsewhere for a doctor with

more empathy, especially if the local doctor's record is less than

stellar. How do I find out the performance statistics of my local

doctor or of others who are out-of-town? Do I say: "How many of these

procedures have you performed and, of these, how many ended up with

urinary incontinence, how many ended up with erectile dysfunction, and

how many ended up with bowel problems?" Do I ask the question of the

girl at the window in the doctor`s office or do I have to use my three

minutes to ask the doctor himself? How can I know if I'm being told the

truth? What should I conclude if the answer is that they !

don't keep statistics? Is there an independent source of statistics? .

February 20, 2011

Jim,

Don't rush into surgery. If you haven't already done so, research all the options first. I chose robotic surgery after doing my homework, and I'm very happy with the results, but everyone is different. If you haven't already done so, check out the Prostate Cancer Research Institute website, which has great information on all the treatments, and a process for making a decision, and the Memorial Sloan Kettering website. On the latter, click on "cancer type" and go to prostate cancer. There you will find a calculator into which you plug your Gleason score etc. and it will give you the five and 10 year recurrence-free probabilities for the various treatments appropriate for your scores. Check out the YANANOW.net website, which has 1,000 experiences from men who have been down this path, with all the various treatments.

If you remain certain surgery is the best for you, definitely ask the doctor how many robotic prostatectomies he has done, and how many he does a year. I was advised not to use anyone who had not done at least 200, and was doing at least 50 a year. That might be tough to find in a small town. Perhaos others can tell you of a location where you can check the doctor is telling you the truth, but I don't know of one, though that may be coming in the future.

Mike C.

Subject: Getting Performance Statistics on Surgeons and OncologistsTo: ProstateCancerSupport Date: Sunday, February 20, 2011, 10:40 AM

I live in a small town, and the only urology practice is so busy I'm lucky to get three minutes of the doctor's time. One of the doctors in this practice does the robotic laparoscopic prostatectomy procedure, which I think is what I want. I should get another doctor, but I would rather stay in town. However, I might go to elsewhere for a doctor with more empathy, especially if the local doctor's record is less than stellar. How do I find out the performance statistics of my local doctor or of others who are out-of-town? Do I say: "How many of these procedures have you performed and, of these, how many ended up with urinary incontinence, how many ended up with erectile dysfunction, and how many ended up with bowel problems?" Do I ask the question of the girl at the window in the doctor`s office or do I have to use my three minutes to ask the doctor himself? How can I know if I'm being

told the truth? What should I conclude if the answer is that they don't keep statistics? Is there an independent source of statistics? .------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

February 21, 2011

Jim,

This is the $64MM question. You are told to ask about performance but have no

independent source of data. Medical societies for years have fought forms of

data dissemination as have hospitals. Medicare has accumulated some useful info

on hospitals but it is rather generic.

Unfortunately, the medical community has kept it difficult to get good data and

you will likely need to rely on anecdotal info and noted centers for preferred

treatment, like s Hopkins for prostate.

It is a pretty sad situation in the medical consumer arena but no one either

seems to care enough to correct it. There are various patient rating sites

online like ratemd.com but you will find the comments rather shallow or trivial

for the most part.

Rich L

Green Bay, WI

>

> I live in a small town, and the only urology practice is so busy I'm lucky to

get three minutes of the doctor's time. One of the doctors in this practice

does the robotic laparoscopic prostatectomy procedure, which I think is what I

want. I should get another doctor, but I would rather stay in town. However, I

might go to elsewhere for a doctor with more empathy, especially if the local

doctor's record is less than stellar. How do I find out the performance

statistics of my local doctor or of others who are out-of-town? Do I say: " How

many of these procedures have you performed and, of these, how many ended up

with urinary incontinence, how many ended up with erectile dysfunction, and how

many ended up with bowel problems? " Do I ask the question of the girl at the

window in the doctor`s office or do I have to use my three minutes to ask the

doctor himself? How can I know if I'm being told the truth? What should I

conclude if the answer is that they don't keep statistics? Is there an

independent source of statistics? .

>

February 21, 2011

JimV wrote:

> I live in a small town, and the only urology practice is so

> busy I'm lucky to get three minutes of the doctor's time. ...

I once had a knee operation performed by an orthopedic surgeon

who moved patients through his office in about three minutes

each. He told me he had done 300 of these operations and never

had a single bad result and I'd be walking again in three days.

Well, the operation was a disaster and I limped and was in pain

for ten years. I believe he performed his surgeries the same way

he handled his office visits. Get the patient on the table,

knock him out, cut fast, sew fast, move on to the next patient.

When I called his office afterward to complain of pain and

swelling, he never called me back until I finally called up and

told his receptionist that he better damn well call me back or

else I will take some action. Then he brought me in and

pooh-poohed my problems, telling me they were nothing, no problem

at all. I just needed to wait a while (he didn't remember the

three day promise), I'd be fine.

The doc I eventually chose for my radiation treatment spent a

half hour or more with me on several visits before the final

treatment. She worked hard on follow up care too.

Even if you spend your three minutes asking this doctor what his

outcomes were like, could you believe anything he said?

I recommend going elsewhere.

Best of luck.

Alan

February 21, 2011

Jim – I also live in a small town with no one doing either seeds or daVinci. The local urologist is 120 days out for an appointment so my urologist is 100 miles away and 4,000 feet in elevation as are the two doctors who I’m seeing this week to discuss seeds and daVinci. Go to those who are the big producers! Glen

February 21, 2011

Jim.

I would ask him for a reference patient, perhaps more than one I could talk to.

Don't settle for that confidentiality BS either. If He's competent and

confident he shouldn't have any problem referring you to a prior case. Also, as

others here have mentioned I wouldn't go near anyone who has done less than 1600

procedures. The learning curve is very long with this. Also, to get an idea of

what you're in for, I believe there are actually videos of this procedure on

Youtube.

Lee of Hospital of University of Pennsylvania, had one out there years ago

of a procedure he did in Korea. Dr Lee, I know does about 5 of these a day, and

He is one such physician who has over 2500 procedures to his credit. Other good

Surgeons specializing in RLAP are at Northwestern in Chicago and s Hopkins

in Baltimore. If you go this route, Go For the Best, you only get one shot at

it.

I opted for IMRT/IGRT (Calypso) and am very happy with my decision.

Good Luck.