I have just been diagnosed with prostate cancer. I am 63 years old in relatively good health. PSA 5.8 Gleeson score 3+3=6. Cancer was 5% or less found on both sides of the prostate.

I am in the information gathering mode now and have virtually ruled out an open prostectomy and also probably radiation, mainly because if the cancer does reappear then the surgery that had to be performed I understand is quite difficult.

I am going to see Dr. Tewari at New York-Presbyterian next week and Dr.Guillinneau at Sloan Kettering the following week.Dr. Guillinneau is a laproscopic surgean and Dr. Tewari is a robotic laproscopic surgeon.

Any advantages of one over the other ?

I have spoken to 2 doctor friends who both had robotic surgery done by Dr. Menon in Detroit, the pioneer in robotic surgery. Aside from the inconvenience of going to Detroit is their any advantage of not having the surgery done their ?

Has anyone had any experience with either Dr. Menon, Dr. Tewari or Dr. Guillinneau ?

Thank you

My neighbor 71yr old male had surgery done by Dr. G. at Sloan Kettering last year, his gleason score was a 6, I cannot remember what his psa was maybe a 7 or so. He has had no problems to speak of post op, he was back to playing tennis again 6 months or so after surgery. He went for the laparscopic type due to it is minimally invasive.


Hope this helps,
A.

Lawny:
I had the robotic radical laparascopic prostatectomy with Dr. Tewari in NYC in may, 2005. He is a wonderful surgeon, and in fact, studied with Dr. Menon in Detroit.
The care given to me at NY Presbyterian was great, and follow up blood tests and care were also great.
I am planning to go back for a follow-up test next week, when I am in NYC.

Ken in CA

Robotic surgery advantages:
1. Less catheter time
2. Less bleeding
3. Comparable results to open IF you have high volume surgeons at high volume centers.
4. More magnificantion and ability to visualize the surgical field.
5. More rapid recovery
6. One day hospital stay
7. No hand tremor

Disadvantages of robotic surgery:
1. More expensive
2. More difficulty sewing the urethra to the bladder neck for some surgeons
3. More expensive
4. Longer surgery
5. More anesthesia risk due to length of surgery

Those are considerations for me, though the more general choice of surgery was made due to simpler follow up (PSA if it remains at -.1-+.1 range), definite staging of the cancer since the actual prostate is removed and can be seen by a pathologist, the ability to have radiation after surgery if there is recurrence. Though radiation is improved, it is necessary to shoot the beam through the anus and rectum to reach the prostate. This can cause damage. The number of treatments is also an issue for some.
Each person has to make their own choices, of course, and the multiplicity of treatment options reflects the varying health of patients, financial conditions, personal choice, cancer stage, etc. Unfortunately, it also reflects that there is no, single treatment that is universally considered the best.