Prostate Cancer Survivors






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Re: surgery choices & feedback on a couple of doctors in particular

Hi Dave,
Just thought I'd say hello. My situation is nearly the same as yours. I'm 47 with T1c. I was also having cholesterol blood test when the doctor caught my high PSA.
I'm here in Austin, TX and have also been referred to Dr. Fagin. Just curious as to how you were referred to him, especially given that you're in NY?
I've been researching other doctors/hospitals.
The University of Texas MD Anderson hospital in Houston is supposedly the 2nd best hospital in the US for cancer treatment, so I would think if you're coming all the way to Texas, you would be referred to Houston. Anybody mentioned Anderson to you?

Re: Re: surgery choices & feedback on a couple of doctors in particular

Hi Tom -

Welcome to the "mid-40's" club. I guess lucky for both of us the cholesterol thing was looking over our shoulder...

Yes, I did consider MDA (especially when I was thinking proton therapy might be a choice). I met with 5 surgeons (I eliminated the non-surgical options fairly quickly) including Jean Joseph/Rochester NY, Angelo De Rosalia and Po Lam in Syracuse, NY, James Eastham at MSK/NYC and had an electronic exchange with Randy Fagin/Austin.

It was Dr Lam in Syracuse that added Dr Fagin's name to the list. Dr Lam is the "local expert", having done >350 robotic surgeries (if I wasn't willing to travel, Lam would be my choice). According to him (Lam), Fagin is in the top tier of robotic surgeons in the country (he recommended Ahlering/UC Irvine, Guillonneau/MSK, Vip Patel/Orlando, Fagin/Austin & Jim Porter/Swedish Hospital Seattle). The connection between Lam & Fagin? Fagin actually studied at a local hospital a few years ago, I'm sure they crossed paths there (University Hospital, Syracuse NY).

I was *very* direct in questioning each of the doctors on my list (I had a 3-page list of questions for each of them. Their answers/numbers will be different! If there's any doubt, make sure you have them qualify their answers!)

Ultimately, it came down to this for me:

- the decision weight of technology (open vs. robotic) evaporated over time; more important is the choice of the quality & experience of the surgeon - I frankly didn't care if he used hammer & nails if he was good (well - kind-of - you know what I mean...)

- if you have a short-list of "thumbs-up" candidates, then allowing locality to play a role is OK

- As many other's have said (including an Uncle who has been a HUGE help in this process - he was diagnosed & treated last year) - meet with as many surgeons as you can. ONE of them is going to feel right in your gut. Follow your gut.

I can drive to MSK in about 4 hours - AND my local urologist was a fellow with Dr Eastham's group. Dr Eastham has done over 2,000 open surgeries & over 200 robotic surgeries. He's the chief of urology at one of the leading cancer centers in the world. Add to that the meeting with Dr Eastham was "way out in front" in terms of his conversational manner & patience (very comfortable to speak with, he stayed with us answering all of our questions way over an hour until 6:30PM one rainy NYC night). I'm having open surgery with him in <1 month and feel VERY comfortable I've got the right guy for the job.

If there's anything I can do to help you along in your process please let me know. It looks like we are almost "in-stride", but would be happy to help. I do have a friend who works at MDA (administrative) so if you need logistical help let me know (unfortunately they didn't have contacts we could leverage for PCa, but they live there & know the hospital well).