Re: Getting Performance Statistics on Surgeons and On...

[Guest guest]

Jim,

Check out s Hopkins in Baltimore for surgery. They are very experienced, conservative and top rated. I choose them but at the last minute they canceled my surgery since I had some minor chest pains. I was found to have an 80% blockage in the right arterial artery even though I was cleared for surgery. My heart doctor was even surprised and had to put in a stent. I plan on returning to JH for surgery in a few months. Several of my friends have gone there with excellent results. Sloan is also very good. Stay away from small town hospitals. They just don't have the experience and really want to pay for their DaVinci machines.

Larry

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

[Guest guest]

>>>

Stay away from small town hospitals. They just don't have the experience and

really want to pay for their DaVinci machines.

<<<

AMEN !!!

It takes a while for a surgeon to accumulate 200 robotic prostatectomies he

needs to become competent. And it takes a " high-volume practice " to deliver the

1-2 surgeries _per week_ he (or she) needs to keep up his skills.

The da Vinci machine is worth something around $1 million. It has to pay for

itself -- that is, _you_ have to pay for it. The pressures to market robotic

surgery are intense. In a small practice, they're _very_ intense.

It's expensive to track patient outcomes, and there are no generally-accepted

standards for " urinary problems " or " sexual problems " or " recurrence " .

Whatever your doctor says:

.. . . a) unless his results have been published, you shouldn't

.. . . believe him, and

.. . . you may not achieve his " typical " outcome.

There's a wide range of post-surgical outcomes, and even the best surgeons have

patients who have severe side-effects.

To declare bias: I had an open prostatectomy, and my story is posted on the

YanaNow website:

http://www.yananow.org/Mentors/C.htm

>

>

>

>

> Subject: Getting Performance Statistics on

> Surgeons and Oncologists

> To: 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 others

>

> Please 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 reply

> Try to change the title if the content requires it Yahoo! Groups Links

>

>

> (Yahoo! ID required)

>

> _ProstateCancerSupport-fullfeatured _

>

(http://us.mc807.mail.yahoo.com/mc/compose?to=ProstateCancerSupport-fullfeatured\

)

>

> .com)

>

[Guest guest]

Many thanks for all who responded to my posting. Carl sent me the comparison

chart of treatment options, which is reassuring, and Chuck wondered why I'm

considering treatment in view of the fact that my last biopsy didn't even show

cancer. I've had cancer since 2004 and had decided that when the time came for

treatment I would have the seeds at Seattle Prostate Institute. Seattle is

about 300 miles from where I live. After a big rise in my PSA I thought it

likely that I would be needing immediate treatment. I was highly stressed and

couldn't resolve the matter quickly with another biopsy because of prior

commitments. When I am in that state I don't make good decisions. Because a

friend had a bad outcome from the seeds, I thought I needed to re-evaluate my

prior decision about what course of treatment to take. Even though the biopsy

did not show cancer this time, there were a lot of atypical cells, which in

previous biopsies ultimately became cancerous. Based on the assumption that I

will eventually face treatment, I want to get the decision thought through while

I'm in a rational state. My thanks again to all who responded.