Recently diagnosed, doctor says can take time to make a decision and research doctors. How do I research doctors?
Went to Sloan Kettering for a second opinion but they do not accept my insurance. Looking for suggestions of urologist that has performed surgery at least a couple times a week not a couple times a year.

Located in Central New Jersey

Recently diagnosed, doctor says can take time to make a decision and research doctors. How do I research doctors?
Went to Sloan Kettering for a second opinion but they do not accept my insurance. Looking for suggestions of urologist that has performed surgery at least a couple times a week not a couple times a year.

Located in Central New Jersey

I'm sorry you have had to join our club, but it's members are great! :) I'm glad to hear you are taking some time to research your options and doctors. So many of us feel a need to rush to a decision, and that can cause big problems for prostate cancer patients down the road. As the carpenters put it, it's smart to "measure twice and cut once."

Have you decided on surgery, or are you open to considering all options?

If you are limiting your options to surgery, are you considering only open surgery or also DaVinci robotic surgery, or laparoscopic surgery?

How far from the New York/New Jersey area are you willing to go, or do you want to stick to the greater NYC area?

You might try contacting Sloan Kettering again, explaining the insurance obstacle, and asking them for recommendations of expert surgeons in other institutions in the New Jersey and New York City areas.

We are limited as to web sites we can recommend on this board without getting special permission, but we can recommend Government websites. One wonderful site is PubMed, the site of the online version of the US National Library of Medicine, and you can find it at www.pubmed.gov. If you enter "radical prostatectomy" in the search box, you will get 8,647 hits, a bit many, but if you activate the Limits feature and check the "abstracts" box and only studies in the past five years, you will get 3,489 hits. (By the way, the service is free, unless you count what we pay as citizens in taxes to support the National Institutes of Health.)

Now these are research studies, and you are probably wondering why you would want to look at them. Well, you can often find at least one senior, very experienced surgeon in the group of authors. Click on the group of authors and you will see their affiliated institution and get point of contact information. You can quickly eliminate those that are out of your geographic area, and contact some of the remaining ones. To narrow the search, you can also plug in institution names, as in " radical prostatectomy AND Memorial Sloan Kettering ", which yields 115 hits as of today. Often the surgeons are listed last in the authors lists. (I posted more about using PubMed (Public Medicine) about Christmas.)

It can take some work, but its one way of generating leads.

Take care,

Jim

tex,
you're not too far from baltimore? brady urological institute has their phone numbers on the website like they all do. like most places, these very experienced guys have a few clinic days each week; to my surprise i got an appointment for a second opinion consultation very quickly. their people who answer the phones can tell you the insurance particulars. they were very well organized and quite a smooth operation -- which i guess i hadn't expected from such a huge and well known outfit. but upon second thought, i guess that's how they got that way, huh? :-) anyway, it worked for me. good luck and keep posting.

Sorry to hear that you are joining our club...

Since I'm "only" familiar with robotic LRP surgery you could try a web search for my surgeon...

He's featured in a live webcast of the robotic procedure if you do a search for "crozer keystone health system live webcast"...

Obviously, robotic surgery is not the only type of treatment. There's many other treatments besides robotic surgery that may be suitable for your staging level. For example, one of our forum members had proton beam therapy that sounds very promising.

Maybe others will add their comments.

Recently diagnosed, doctor says can take time to make a decision and research doctors. How do I research doctors?
Went to Sloan Kettering for a second opinion but they do not accept my insurance. Looking for suggestions of urologist that has performed surgery at least a couple times a week not a couple times a year.

Located in Central New Jersey

You didn't mention your age, PSA, or Gleason score, which could help us
who've gone through this offer some thoughts. I was initially going to have
robotic surgery but later read about proton beam therapy, a specific form of radiation that's only done in a few places. It offers advantages over other forms of radiation in that there is much less damage to healthy tissue.
After speaking with quite a few former patients (about 7,000 prostate patients have been treated since 1990, the majority at Loma Linda in California) I cancelled surgery and have been very satisfied with my choice of a non-invasive treatment.

If you have an open mind, buy and read a book entitled You Can Beat Prostate Cancer by Robert Marckini. (You can read a lot of user comments on the amazon website after searching for the book, now one of the top sellers on prostate cancer on that website.) Or do a search on proton on this board and read some of my other posts. Most docs don't mention this as an
alternative- and nearly all the patients are self-referred. I went to Jacksonville, Florida (University of Florida Proton Therapy Institute). It does take a time commitment of brief weekday treatments over a two-month period. If you have any questions, I'll respond. Not to say this is for everyone and surgery is not-- but at least reviewing all the options is worthwhile given all that's at stake.

Thanks for jumping in there, daff!;)

I knew I could count on you!

:angel:

Thanks for jumping in there, daff!;)

I knew I could count on you!

:angel:

I think there are only a few of us that put their two-cents worth in.
It would be nice to hear from others that seem to read the posts but
stay on the sidelines.

Welcome to the club you didn't want to join. ;)

If you're interested in robotic surgery you can go to the Intuitive Surgical website and click on "Locate a daVinci surgeon". I entered "Urology" and "New Jersey" and got a list of 21 surgeons. This tells you nothing about their experience or results, but it gives you a starting point for research.

Alan Strumeyer, MD Urology Millburn NJ 07041
Isaac Yi Kim, M.D. Urology New Brunswick NJ 08901
Bhalla Rahuldev, M.D. Urology Newark NJ 07103
Domenico Savatta, M.D. Urology West Orange NJ 07052
James A. Saidi, M.D. Urology Glen Ridge NJ 07028
Robert P. Caruso, M.D. Urology Bloomfield NJ 07003
Ayal Kaynan, MD Urology Morristown NJ 07960
Lee Pressler, M.D. Urology Morristown NJ 07960
David Saypol, MD Urology Morristown NJ 07960
Dr. Joseph Steinberg Urology Morristown NJ 07960
Perry Sutaria, M.D. Urology Morristown NJ 07960
Marc Greenstein, M.D. Urology Somerville NJ 08876
Marc Colton, M.D. Urology Denville NJ 07834
Gregg Zimmerman, M.D. Urology Denville NJ 07834
Mutahar Ahmed, M.D. Urology Hackensack NJ 07601
Mike Esposito, M.D. Urology Hackensack NJ 07601
Ihor Sawczuk, M.D. Urology Hackensack NJ 07601
John Scheuch, M.D. Urology Hackensack NJ 07601
Dr. Pedram Ilbeigi, D.O. Urology Paramus NJ 07652
Victor Ferlise, MD Urology Toms River NJ 08755
Raul O. Parra, M.D. Urology Camden NJ 08130

Best of luck - and keep us updated on your progress.

I've started a new thread about robotic surgery coming of age. Jim

You've gone to the right place as Sloan-Kettering is the foremost cancer center in the world. Having been successfully treated there myself, I've referred many friends and acquaintences who have all experienced excellant outcomes. Finances should not interfere with receiving the best treatment for a potentially lethal disease such as prostate cancer.
The financial affairs office of Sloan-Kettering will arrange payment plans if they're out of your network and most insurance plans pay the bulk of costs even out of network although the deductibles and co-pays can be quite high. These are the costs which can be arranged through payment plans with Sloan's financial office represenatives. Don't allow yourself to be forced to accept second tier treatment or Drs. After all what is more important at this time?
Sorry you've been forced into membership in our fraternity but determination, persistence and tenacity can at least enable you to access the best resources available.
The chief of the minimally invasive prostate surgery (Robotic) dept. at Sloan is Dr.Bertrand Guillenneau who developed the procedure in France and brought it here to Sloan. He has performed more robotic prostatectomies than anyone else and has trained most of the earliest american practitioners who went to France to learn it. Recent innovations and improvements with the DeVinci equipment and technique have produced results comparable to the gold standard open procedure performed by the best open surgeons. These improvements most often originate at Sloan or compable institutions such as Well-Cornell NY Presbyterian Hospital, Brady-Urological Center, etc.
So if it were me and it once was, I wouldn't settle for anything but the best no matter what the cost or effort. Good Luck and don't give up. Fortunately with Prostate Cancer you've got some time to make arrangements unlike open heart surgery where you're denied that opportunity.

Having lived in northern NJ most of my life and having served for several years as a trustee of a major hospital here, I'm familiar with several of the Drs listed and know several patients operated on by these DRs through support groups and other means. There are good Drs with moderate experience performing robotic surgeries in NJ with most having performed in the hundreds and averaging at best maybe fifty a year. There are great Drs in NY at the foremest centers who have performed thousands of robotics and are doing upwards of 4-8 a week. These top robotic specialists in NY do nothing else leaving the other urological surgeries to other specialists whereas the NJ surgeons don't have this luxury and perform all manner of urologic surgery as their patients require. Thus the NJ surgeons in our best hospitals such as Morristown and Hackensack are more generalized in urology whereas the NY surgeons are more sub-specialised concentrating on a single procedure. They have this luxury due to the high volume of cases coming to places like Sloan from all over the world.
The same is true of other sub-specialties such as colo-rectal surgery. My wife was recently advised by our NJ gastro-enterologist to consider colon-resection surgery for diverticulitis. He referred her to the best colo-rectal surgeon he knew in northern NJ and in NY, both specialising in the laporoscopic colon resection. The excellant colo-rectal surgeon in our area (who incidently operated on me for hemmorhoids several years ago-don't ask) had performed around 500-600 laparoscopic resections. He foresaw some possible complications in my wife's case due to certain anatomical conditions. The NY surgeon who is chief of colo-rectal surgery at one of NY's leading teaching hospitals has performed several thousand laparoscopic resections, lectured on the procedure all over the world and has developed a specific technique to deal with my wife's anatomical "complication" which he's seen and successfully handled a few hundred times.Therein lies the difference between the excellant local surgeon and the truly great sub-specialist who can afford to limit himself to one sub-specialty and consequently has seen more variations and complications and developed ways to deal with them.
Fortunately both surgeons agreed my wife really didn't need surgery at this time and could continue to treat her mild diverticultis attacks medically. But if she should ever need surgery we know where we would go.

Please consider Dr. Ash Tewari at NY Presbyterian Cornell-Weil Medical Center in NYC. He is highly experienced (I believe he performs 9 robotic surgeries per week), humble and extremely compassionate. In addition to excellent numbers with respect to the primary mission of getting rid of the cancer, he has been very successful with a relatively new procedure which improves the odds against incontinence. Dr. Tewari performed my husband's surgery on August 9, 2007 and we cannot say enough good things about him, his staff and the facility in general. For the record, my husband is 57 years old, PSA 1.62 at diagnosis, Gleason 6 before and after surgery and he is presently neither incontinent nor impotent. His life is totally back to normal. Certainly, every case is different but since you live only a short distance from NYC I would highly recommend contacting Dr. Tewari's office to see if they accept your insurance. Best of luck to you!

Please consider Dr. Ash Tewari at NY Presbyterian Cornell-Weil Medical Center in NYC. ...

I don't see how a patient make a wrong decision going to either of these doctors. :angel: Dr. Tewari was the DaVinci robotic surgery presenter at both the 2005 and 2006 National Conferences on Prostate Cancer. (Technically, the 2006 conference was billed as the International Conference on Prostate Cancer.) DVDs of both talks are available.

Jim

Daff
Thanks for your comments on my listing. My Gleason is 6 and Stage is T1c. Out of 12 cores they found cancer in one. I am 60years old. I know it is possible that I may never need to do anything but the thought of Cancer in my body has, as I am sure you know, made me nervous and concerned.

I am leaning toward surgery, either radical open or laparoscopic.

I have another book to suggest to anyone, written by Dr. Peter Scardino at Sloan Kettering, Dr. Peter Scardino's Prostate Book.

Daff
Thanks for your comments on my listing. My Gleason is 6 and Stage is T1c. Out of 12 cores they found cancer in one. I am 60years old. I know it is possible that I may never need to do anything but the thought of Cancer in my body has, as I am sure you know, made me nervous and concerned.

I am leaning toward surgery, either radical open or laparoscopic.

I have another book to suggest to anyone, written by Dr. Peter Scardino at Sloan Kettering, Dr. Peter Scardino's Prostate Book.

I'm 64, was a Gleason 7 (3+4) and T1c. Also, I had 1 of 12 cores with cancer, just as you did. As I said before, I was leaning towards surgery until reading the Marckini book and following up by contacting lots who had gone through the proton radiation treatments. While you may not need to decide something in the next few weeks, I wouldn't think waiting will make things better.

Daff
Thanks for your comments on my listing. My Gleason is 6 and Stage is T1c. Out of 12 cores they found cancer in one. I am 60years old. I know it is possible that I may never need to do anything but the thought of Cancer in my body has, as I am sure you know, made me nervous and concerned.

I am leaning toward surgery, either radical open or laparoscopic.

I have another book to suggest to anyone, written by Dr. Peter Scardino at Sloan Kettering, Dr. Peter Scardino's Prostate Book.

My "pre-op" staging results were similar. Age 58, Gleason 6, T1c, cores 1/12 positive.

Post-op, after they got all of the tissue to the lab, it changed a bit. Before my surgery I was unilateral low risk. After surgery the pathology report said my cancer was bilateral. Much more cancer than the biopsy showed.

Hope this helps in understanding that pre-op staging is not an exact science. My urologist said that the only time they can be certain about your staging is when all of the suspect tissue is out of your body, in the lab and under a microscope.

Best wishes:)

tex -- there are about a jillion good docs out there. some are prominent in the popular domain -- and for sure this is a popular domain, not a domain of medical professionals. having a celebrity doc, one who is on a lot of web pages, has published books in the popular domain, and so on is cool but you don't ncessarily need those credentials to be assured of having a good, competent doc. just keep looking at experience numbers, successes, peer reviewed stuff, yadda yadda. you'll get there. keep posting; good luck.

Hey tex;

Confused yet?:confused:

Information overload?:dizzy:

Looking back, I beginning to feel very fortunate to have not found this forum until three weeks after my surgery.;)

Hope we don't scare you away!:nono:

Best wishes!:wave:

able, i'm with you. i'm finally gonna say what's bothering me. we've drifted away from supporting each other. [for example, i've gotten well meaning advice here telling me to ditch my doctor at once, etc.] when i came here i found lots of support. i've experience from other support venues for other things. we now resemble one of those pet advice columns in the paper: dear doc: my dog does x, y and z. what should i do? answer -- do a, b and c and get back to me.

now, when there's a newbie posting, we pounce. we can't wait to tell the newbie in no uncertain terms what is exactly the right thing to do. we say: post more test results, i'll g**gle and prescibe for you. i'll tell you exactly what doc and what procedure is best for you. you know what i'm saying.


i'm sure the pendulum will swing back the other way.

i'm sure the pendulum will swing back the other way.

Yes, it will...

At least I hope so...

It's good to take a breather from time to time, sit on the sidelines for a while and make this a spectator sport occasionally...

Thanks for your post and for bringing this to my attention. If my posts had anything to do with irritating you, I apologize. I didn't not try to do it intentionally.

:angel:

Daff
Thanks for your comments on my listing. My Gleason is 6 and Stage is T1c. Out of 12 cores they found cancer in one. I am 60years old. I know it is possible that I may never need to do anything but the thought of Cancer in my body has, as I am sure you know, made me nervous and concerned.

I am leaning toward surgery, either radical open or laparoscopic.

I have another book to suggest to anyone, written by Dr. Peter Scardino at Sloan Kettering, Dr. Peter Scardino's Prostate Book.

Hi again,

I'm responding because you mentioned an awareness of what could be active surveillance hoping that you will be able to defer therapy forever. I don't recall if you gave your PSA, but if it was 10 or below, you could fit the criteria for an active surveillance program.

This is in no way a criticism of the other options you are considering. Indeed, you have the wonderful luxury of choices. I just wanted to make sure you are aware that active surveillance is emerging as a sound option for appropriately low risk men. I'm not sure whether Dr. Scardino mentions active surveillance in his book; of course he is best known as a highly respected prostate cancer surgeon. But he is also a leader of one of the premier active surveillance programs (at Memorial Sloan Kettering in NYC).

I did not want to clutter up this thread with a long post on active surveillance, so I started a new thread a few minutes ago, with Active Surveillance in the title.

Good luck with your research,

Jim

QUESTION: Help me understand, with New York City less than 35 miles away, why are you searching for a prostate cancer doctor in Central New Jersey?

Thank You Bug 52. Dr.Tewari is the world class robotic prostate surgeon whose name I couldn't recall. He's raised the technique to a new level substantially reducing if not eliminating the temporary incontinence side effect often associated with the DeVinci Robotic technique. Now that he's published his results, his innovation should soon be picked up by most of the better robotic surgeons around the country. His statistics are impressive.

So are you going through proton radiation now.
if yes how long from diagnosis till you decided for sure to start raiadtion

tex -- there are about a jillion good docs out there. some are prominent in the popular domain -- and for sure this is a popular domain, not a domain of medical professionals. having a celebrity doc, one who is on a lot of web pages, has published books in the popular domain, and so on is cool but you don't ncessarily need those credentials to be assured of having a good, competent doc. just keep looking at experience numbers, successes, peer reviewed stuff, yadda yadda. you'll get there. keep posting; good luck.

CRS, So where do I find experienec numbers, successes, peer reviews yadda yadda. Is there periodicals to review ore perhaps journals that list this type of information Tex

QUESTION: Help me understand, with New York City less than 35 miles away, why are you searching for a prostate cancer doctor in Central New Jersey?

Able- Actually New York is great. I went to MSK for a 2nd opinion but they are not in my insurance network. What I am trying to do is find a list of urologist who have performed the surgery many times and have had a good success rate. Then compare them to those in my Network. In the end if I have to go out of Network then I will. But first I am trying to find where to go to get this type of information on a surgeon, short of calling every urologist in the tri county.

I was diagnosed in Septemeber. Everyone, including my doctor says do research on the doctors and hospitals. How do I do this.

Sorry but all I do on the computer is e-mail

Welcome to the club you didn't want to join. ;)

If you're interested in robotic surgery you can go to the Intuitive Surgical website and click on "Locate a daVinci surgeon". I entered "Urology" and "New Jersey" and got a list of 21 surgeons. This tells you nothing about their experience or results, but it gives you a starting point for research.

Alan Strumeyer, MD Urology Millburn NJ 07041
Isaac Yi Kim, M.D. Urology New Brunswick NJ 08901
Bhalla Rahuldev, M.D. Urology Newark NJ 07103
Domenico Savatta, M.D. Urology West Orange NJ 07052
James A. Saidi, M.D. Urology Glen Ridge NJ 07028
Robert P. Caruso, M.D. Urology Bloomfield NJ 07003
Ayal Kaynan, MD Urology Morristown NJ 07960
Lee Pressler, M.D. Urology Morristown NJ 07960
David Saypol, MD Urology Morristown NJ 07960
Dr. Joseph Steinberg Urology Morristown NJ 07960
Perry Sutaria, M.D. Urology Morristown NJ 07960
Marc Greenstein, M.D. Urology Somerville NJ 08876
Marc Colton, M.D. Urology Denville NJ 07834
Gregg Zimmerman, M.D. Urology Denville NJ 07834
Mutahar Ahmed, M.D. Urology Hackensack NJ 07601
Mike Esposito, M.D. Urology Hackensack NJ 07601
Ihor Sawczuk, M.D. Urology Hackensack NJ 07601
John Scheuch, M.D. Urology Hackensack NJ 07601
Dr. Pedram Ilbeigi, D.O. Urology Paramus NJ 07652
Victor Ferlise, MD Urology Toms River NJ 08755
Raul O. Parra, M.D. Urology Camden NJ 08130

Best of luck - and keep us updated on your progress.

Kemahsaba
Don't think I thanked you for this list. I appreciate your taking all this time to write this and for the lead on the Website

So are you going through proton radiation now.
if yes how long from diagnosis till you decided for sure to start raiadtion

I completed my treatments just before Thanksgiving. I was initially diagnosed in June but had not made up my mind (had initially scheduled robotic surgery for mid-August) until I had a consultation/visit in August at The University of Florida Proton Therapy Institute in Jacksonville. Treatments began in mid-September-- that gave time for insurance to be confirmed and the various tests they do for planning.

Sorry but all I do on the computer is e-mail

tex;

All due respect...

Wow! :eek:I do not know how someone can possible do this type of research without being completely familiar with search engines and the power of the internet. If you won't learn yourself, you'll need a close friend who is web literate and can help you with the research. Otherwise, ask around and get feedback from friends and relatives who have had prostate surgery or may know someone who has had prostate surgery. A respected urology practice in your neighborhood may also be of great help. My guess, most urology offices in your area probably also practice in NYC and are affiliated with the major teaching hospitals and universities. That's how it is in the suburbs of my region, Philadelphia.;)

Dr. Tewari also wrote a very impressive and comprehensive feature article with color photograhs and graphs of his technique and results in the Nov. 2007 issue of PCRI Insights.It describes in detail his innovative Tri-zonal Athermal Nerve Preservation and Anatomical Reconstruction Techniques. Its probably available on line on the PCRI website.
Its recommended reading for anyone contemplating a Robotic Prostatectomy. If I were currently considering this I'd fly in from anywhere in the country to have him operate on me. After reading the article I recommened a friend to both Dr.Tewari and Dr. Guillonneau for 2 opinions and he was able to obtain an appt with Tewari in one week and Guillonneau the following week. One can't go wrong with either of these world class surgeons surgeons. I think Tewari may have a temporary edge with his newest technique although I'd bet Guillonneau of Sloan-Kettering will catch up quickly if he hasn't already.
Bob

able

I am exaggerating a bit. I do go to some sites but research has been slow and difficult.

I completed my treatments just before Thanksgiving. I was initially diagnosed in June but had not made up my mind (had initially scheduled robotic surgery for mid-August) until I had a consultation/visit in August at The University of Florida Proton Therapy Institute in Jacksonville. Treatments began in mid-September-- that gave time for insurance to be confirmed and the various tests they do for planning.

Daff - Wow you are quick. Good for you, I wish you the best in future PSA's. I think at this point I am leaning toward surgery, or have been that way all along. If you don't mind can I ask you all the speciifcs. Age, Gleason, stage. cores positive. I was tols in September, 2nd opinion in November and going abck for another DRE and PSA in a couple weeks.

i'll look into the proton Therapy but will also try tos chedule another opinion with Tewari in NYC

Bob

Daff - Wow you are quick. Good for you, I wish you the best in future PSA's. I think at this point I am leaning toward surgery, or have been that way all along. If you don't mind can I ask you all the speciifcs. Age, Gleason, stage. cores positive. I was tols in September, 2nd opinion in November and going abck for another DRE and PSA in a couple weeks.

i'll look into the proton Therapy but will also try tos chedule another opinion with Tewari in NYC

Bob

Bob-
It won't hurt to check into another alternative-- at least you'll know you did all
you could before the final selection. Once you've chosen, if you're like me, you won't look back and second-guess what you've done. Along the way, at
least for part of the time, I thought I'd be able to toss a coin to decide- so I
felt great when I made the determination as to what I'd do.
I'm 64, had PSA of 2.9 increasing to 3.9, biopsy results were 1 of 12 cores positive, Gleason 7 (3 +4), T1c.
Please let me know if you have any questions as you continue your deliberations.

tex -- right on regarding choosing something and not looking back. some of the best advice i got was from my neighbor, a doc who of course didn't deign to tell me which way to go. he said just make sure i was very comfortable with doc i would eventually go with -- so comfortable that down the road if things didn't go well i'd not be second guessing myself and the path i chose. he was wise. i eventually found a doc and a treatment i feel 100% good about. i'll not look back. well meaning friends [and posters] gave me unequivocal advice [sorta like: of course here what you should do: x, y, followed by z and you are foolish if you don't] but i was of course not swayed.