Monday, July 4, 2011

The Consultations

After our return from China I had consultations with a number of specialists with expertise in dealing with the various options I had for treating my prostate cancer.  I had meetings with the following specialists:

Doctor Eshelman – Radiologist for both seed implantation and external radiology
Doctor Russinko – Specializing in laparoscopic surgery for removal of the prostate
Doctor Oyer – Oncology and internal medicine
Doctor Sieber – urology and urological surgery, cryotherapy
Doctor Del Terzo - urology and urological surgery

Dr Eshelman advised me that I am not a good candidate for seed implantation due to the fact that my Gleason scores are 7 and due to the location of my cancer, which may make it difficult to accurately, place the seeds.  He did say that if I really wanted seed implantation he recommended a combination of both seed implantation and a shorter period of external radiation.  Five weeks instead of the normal seven week external radiation treatment.

Dr Russinko went through the laparoscopic procedure.  The advantage of the lapraroscopic surgery over the open surgery is that the recovery time is quicker, significantly less loss of blood and the robot used is extremely accurate when used in the hands of a trained expert (read this to mean someone who is really good at video games).

Dr Oyer is more of a generalists and he highly recommended that I go with the laparoscopic surgey.  He had the best bedside manners of all the specialists I talked to and we had a very open and frank discussion.

Dr Sieber did more to confuse me than any of the other specialists.  He felt that I may be a good candidate for seed implantation and he recommended that my records be sent to Johns Hopkins in Baltimore for them to review and give their recommendation.  I should have their comments by July 5.

Dr Del Terzo is my urologists and he specializes in open surgery for removal of the prostate.

After all of these consultations I have made the following decisions:

I have eliminated cyrotherapy because this is a relatively new procedure and there is not enough data available to determine long-range effects.

I have eliminated open prostate surgery.  Why go through a major operation that will leave major scars and have a longer recovery time when laparoscopic surgery will accomplish that same thing with more accuracy and less collateral damage.

I really do not want to go through the external radiation process.  The risk of collateral damage is higher and it is a seven-week agenda with treatments every weekday.

That leaves me with laparoscopic surgery and seed implantation.  I am strongly leaning towards the surgery but we will see what Johns Hopkins has to say about me.

There was one last wrinkle thrown into my alternatives.  My wife has a good friend on the west coast, Judy Copanas, who is good friends with the head urologist at the University of California Irvine and she asked me if I would like to talk to him to get his views on my options.  Of course I said yes and last week I had an excellent phone conversation with Doctor Clayman.  Dr Clayman was very straightforward.  He told me that if it were his decision he would go with the laparoscopic surgery and he recommended that I contact Doctor David Lee at the University of Pennsylvania School of Medicine in Philadelphia.  I have since contacted Dr Lee and have a meeting set up with him the first week of August.

That’s were things stand as of today.  The one thing I do know is that I want to get this cancer taken out of my body ASAP.

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