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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2004Friend in Toronto with PCA
Hi Group, My friend in Toronto has been diagnosed with PCA. He has elected to undergo RPCA. His is seeing a urologist, Dr. Casey. I find that Dr. Casey says he does 50 of these procedures per year and estimates that he and his partner have done 1,000. Is 50/year enough? Heather have you ever heard of this urologist? Chuck H. >Subject: Friend in Toronto with PCA >From: chuck@chuck.com [quoted text clipped - 3 lines] >Hi Group, My friend in Toronto has been diagnosed with PCA. He has >elected to undergo RPCA. RPCA? That's a new one, what is it? >His is seeing a urologist, Dr. Casey. I >find that Dr. Casey says he does 50 of these procedures per year and >estimates that he and his partner have done 1,000. Is 50/year >enough? Not too good- mine did about 200 RRPs a year. >Heather have you ever heard of this urologist? > >Chuck H. > Hi Group, My friend in Toronto has been diagnosed with PCA. He has > elected to undergo RPCA. His is seeing a urologist, Dr. Casey. I [quoted text clipped - 3 lines] > > Heather have you ever heard of this urologist? Hi Chuck....... No......there are 5 million people in the Greater Toronto Area and a lot of urologists. Ask him which cancer hospital this guy works at.......assuming that he does. We have several excellent general hospitals. But the two I am referring to are the best in Canada.......Sunnybrook Hospital's Regional Cancer Centre, where Ron went.......and Princess Margaret Cancer Hospital......where my brother-in-law went. Both had radiation, btw. Ron had HDR plus EBRT......Ray had EBRT. RPCA?? We call them the same as you do......RP, LRP, etc. I am in a city of 200,000 adjacent to Toronto and Ron's urologist (Dr. Ibrahim) told us he gets 2.5 days per week in the OR.....so 3-5 RP's theoretically. Computing that, he would do about 200/year. And that is just one urologist in Brampton. We were very happy with him.....but he gave Ron the equal option at 71 of surgery or radiation......in fact, he recommended radiation and sent us to an oncologist of our choosing for a second opinion (he said radiation). We got the third and final opinion at Sunnybrook with Dr. Loblaw, radiation oncologist......and went with him for the HDR treatment. Mention this to your friend because it is the first hospital to do this in Canada and they have been doing it for 3 years now. Plus they do seeding and I would assume that Princess Margaret does too. Both of them are excellent hospitals and he can be referred to either. If he wants to contact me......no problem. Write me off List if you want. heatherfig at rogers dot com. Cheers.....Heather I don't remember what Doc Walsh says, but I imagine doing an RRP 25% on one of every four days you work should be a good average.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .3 .4 .8 EBRT 05-07/2002 @ 47 PSA .3 .2 .2 .2 .3 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .1 Lupron 7/03, 8/03, 12/03 > Hi Group, My friend in Toronto has been diagnosed with PCA. He has > elected to undergo RPCA. His is seeing a urologist, Dr. Casey. I [quoted text clipped - 5 lines] > > Chuck H. Thanks Steve. I really hadn't thought of it that clearly. I guess it's OK. Chuck H. >Hi Group, My friend in Toronto has been diagnosed with PCA. He has >elected to undergo RPCA. His is seeing a urologist, Dr. Casey. I [quoted text clipped - 5 lines] > >Chuck H. We know Dr Casey well. He works out of the Male Health Centre in Oakville... I had NO idea he did RP's. Chuck, tell your friend to question every piece of information he is given. We were told Gleason 9, Gleason 7 by the second lab and Cleveland confirmed the 7. We were also told NOT to bother with a biopsy because of my husband's age, 48, lack of family history and because of his healthy appearance. And the first doctor we saw was actually backing out of the office to another appointment when he gave us the news. We were also told not to bother trying the US as OHIP probably wouldn't pay for it. I love being Canadian but sorry, folks, I am disgusted with our health care system, and the individual power each doctor holds. Heather, I'm so glad you had good experiences here at home, but quite honestly, we faced nonsense at every level with the exception of our family doctor and the people at OHIP. Lee Lee Lee Lee thanks for that bit of information. Trying to help out as best I can.... One interesting note about Canadian health care system. I was born in Winnipeg so I can mouth off. Sorry Heather but here comes another horror story. Last night my wife spoke to a friend of hers in Winnipeg whose granddaughter had a seizure the other day. The first appointment they could get was in June. This is the grandmother who could not even get an x-ray for three years for knee pain. When the surgery was finally done in the fourth year it was found that she had no cartilage in her knee joints so it was bone on bone. Painful I'll bet. No decent rehab either so she didn't really do that well. Compare that to friend in Denver who had the surgery on both knees with excellent postop rehab and no issues. Sorry had to get that off my chest again. Chuck H. OK, Westerner......my turn, grin. I am sorry to hear that the knee lady is being treated so badly, and also the young girl. But didn't they take the granddaughter into Emergency and get a referral from there to a neurological specialist? And why on earth didn't the grandmother insist on an earlier appt.???? You know that the health care system is *Provincially funded* and run. Ontario has a far better system than a lot of the other provinces. A friend had her knee replaced about 5 years ago and I believe she only waited some 2 months for the surgery, which they tried to talk her out of because she was only in her early 60's. Rehab was good.....she was 'bone on bone' too, but caused by running marathons in a large part. I have never, ever, personally had a problem with getting serious medical attention, except for SARS. And even then, we were in and out of hospitals in full gear. Had Ron needed immediate surgery, he would have had it. That never stopped. I could tell you some personal horror stories too.......due to medical incompetence and stupid doctors!! I have fired two of them for improper care. (translation = they didn't have a clue.....but I did). I have found that I need to research everything medical to make sure I am not given a wrong diagnosis or medication.....I am allergic to many of the meds. In fact, two specialists (some 30 years ago) *offered* to testify in court if I chose to sue an idiot of a doctor for malpractice.....I didn't have to ask, but I didn't bother.....working in law for so long had taught me that it would be a long process that most likely wouldn't get me anywhere. 4 years ago, I found a new family doctor (we do get a choice), and then got referrals to the proper specialists. We now have top notch docs and I have absolutely no complaints. But you have to learn two things...... 1. Doctors are not *Gods*......(Paul being an exception, of course) 2. Speak up (bitch and complain in essence) and get things done right. Example: I just reamed out my dentist for problems with both him and his staff not returning my calls re surgery I had, and he was very apologetic and is reducing my bill due to the added problems they caused me. (long story, not relevent) But I am beginning to realize that I am getting 'testy' in my old age (G). Actually, I have always spoken up and let ordinary people or doctors know if I feel something is wrong. I can just write it off to 'old age' now....LOL. And guess what.....they have all not only thanked me for bringing stuff to their attention, but have corrected the problem. Every damn time!! (see my picture in the Toronto Star in March where I took on the Federal Gov't. re long waits for passports, grin........a week later they announced they were opening 22 more offices....now THAT was a good thing, grin) Cheers.....Heather (who takes on docs, the Cdn. Gov't, and 400 lb. sumo wrestlers, grin) > Lee thanks for that bit of information. Trying to help out as best I > can.... [quoted text clipped - 14 lines] > > Chuck H. > <snip>I could tell you some personal horror stories too.......due to medical > incompetence and stupid doctors!! I have fired two of them for improper [quoted text clipped - 23 lines] > long waits for passports, grin........a week later they announced they were > opening 22 more offices....now THAT was a good thing, grin) Your experience(s) are not shared by everyone in Ontario nor Canada. There's thousands in various areas/cities who cannot even find a family doctor. And "speaking up" gets one "fired" by the doctor. They don't care. They want "5-minute patients" so they can push more through per hour, since they get paid per visit (not per hour). I had to say that Heather because you paint such a wonderful picture here of healthcare in Canada and it's not that way for everyone ! (do want to add that for heart or cancer related matters, they do seem to have very good care). J > Your experience(s) are not shared by everyone in Ontario nor Canada. > There's thousands in various areas/cities who cannot even find a family doctor. > And "speaking up" gets one "fired" by the doctor. > They don't care. > They want "5-minute patients" so they can push more through per hour, since they get paid per visit (not per hour). >>> I had to say that Heather because you paint such a wonderful picture here of healthcare in Canada and it's not that way for everyone ! (do want to add that for heart or cancer related matters, they do seem to have very good care).<<< Not about to disagree with anything you say......I take my chances and speak up.....it rarely backfires. But you are right about our shortage of doctors. I just found out from a pharmacist that the *new family doctor* was NOT taking new patients at that time......or now. She told me I was very lucky to get in with him. I didn't know that at the time and simply asked him if he would take us on......must be the red hair, or some such. (G) Oh......and Dr. Yong-Set limits the patients he sees per day....he doesn't like to be rushed. A rarity, I am sure. The previous one triple-booked and a 2-hour wait for a 5 minute appt. was normal. Yuck!! Cheers.....Heather This doc sounds like gold.....don't tell anyone about him or others will try to get in. I have a PPO here with United Health. The PPO plans allow anything from almost anyone. It is more expensive but what a lucky break that I have it. It's the only reason I work at home because my company provides it free to me and I pay something like $100/month for my wife. Chuck H. > opening 22 more offices....now THAT was a good thing, grin) > ... [quoted text clipped - 5 lines] > get paid per visit (not per hour). > ... Many of us in the U.S. belong to Health Maintenance Organizations, or have insurers, that give us the same assembly line style of medicine. I once had a knee problem. The orthopedic surgeon they sent me to had a half a dozen examining rooms. His assistants would take a patient into each one, get a history or whatever and leave him there. The doctor then went from room to room, examining each patient, speaking briefly to him, then moving on to the next room, dictating his notes into a pocket tape recorder as he walked between rooms. The time he spent with each patient was literally only about 60 seconds. And you should have seen how fast he did my knee operation! The fact that I was in pain for 10 years thereafter may have seemed to him a small price to pay in order to get 4 operations done per day, or whatever he was doing. I have no doubt that he was the low bidder when the HMO went looking for specialists. Socialized medicine has its drawbacks and excesses. But capitalist medicine ain't perfect either. If we could find a way to inject more professionalism, and more patient concern, into the profession, then maybe either system would work better. Alan Hi Heather: Our friend with the knees tried to get x-rays. She couldn't even get another orthopedic surgeon, in Manitoba you don't dare leave the doctor you are with. You need to be interviewed with the new one to see if he will take you as a patient. The little kid with seizures went to ER and was given an appointment. It was the same thing with my late father-in-law. He needed Doppler ultrasound of his carotid arteries and was given a six-week appointment. I phone the ultrasound doc (used to work with him) and got him in the next day. But it continues like that. Too scary. I think that folks in the USA who want Canadian-style health care do not understand that each province is different with Manitoba being the worst (imho). In B.C. you have to see the GP before you can see a specialist. That includes an ophthalmologist. My wife gave the doc such a scathiing argument about that when we lived there. She needed an eye doc and her GP wanted her to come in first. What a rip-off. Anyhow....it continues.....I think my friend will be in good hands. He has a surgery date and he is just trying to tough it out. Chuck H. Hi Chuck..... I don't disagree with anything you are saying. I did get the new family doctor to take us on before firing the old one. And I *interviewed* him because I felt we had to be *compatible*. I had seen him twice before and liked him. This fellow was doing the walk-in clinic that night and diagnosed me in 5 minutes......turns out the medication I needed was the VERY ONE the now-fired family doctor had taken me off. So I had put up with a year of on and off abdominal pain due to his inability to diagnose a simple case of bladder inflammation....not infection. Tell your wife I also reamed out the docs when I needed a referral for the eye doctor. I now go to an optometrist. Yes.....you have to have a referral for every darned specialist, and you also have to see the specialist once a year or get a new referral. Our system ain't perfect, but so far I have survived. (G) You and I both know that it is "who you know" that counts. And it used to be thru my Dad that we got fast-tracked. (a doctor) Luckily you knew someone who could get the Doppler faster. Unfortunately.....often you have to "know someone" or be related to a doctor, to be fast-tracked. And that irritates me as well.....but I guess I am a bit too altruistic, for lack of a better word. Best.....Heather in Ontario > Hi Heather: Our friend with the knees tried to get x-rays. She > couldn't even get another orthopedic surgeon, in Manitoba you don't [quoted text clipped - 15 lines] > > Chuck H. I suspect, as have all things socialistic, all national health care systems run along a continuum between "going down hill" to "crashed an burned". SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .3 .4 .8 EBRT 05-07/2002 @ 47 PSA .3 .2 .2 .2 .3 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .1, .1 Lupron 7/03, 8/03, 12/03, 4/04 > Lee thanks for that bit of information. Trying to help out as best I > can.... [quoted text clipped - 14 lines] > > Chuck H. Pessimist!! This national (I hate the word *socialistic*) health care system has been in existence since the very early 50's......and is still humming along. It may have its drawbacks at times, but it is free....no two-tier system yet. However, they are trying to bring that in. We get this 'free' treatment by paying for it thru pay cheque deductions and taxes.....not to mention lotteries.....all of our lives. I can live with that!! Beats dying coz you can't afford to get treatment or losing your retirement savings in order to pay for it. Heather..... > I suspect, as have all things socialistic, all national health care systems > run along a continuum between "going down hill" to "crashed an burned". [quoted text clipped - 17 lines] > > > > Chuck H. Thanks. You made my day! I hate it when you just ignore my pokes. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .3 .4 .8 EBRT 05-07/2002 @ 47 PSA .3 .2 .2 .2 .3 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .1, .1 Lupron 7/03, 8/03, 12/03, 4/04 > Pessimist!! > [quoted text clipped - 32 lines] > > > > > > Chuck H. ROFL!! You love to push my buttons, don't you. And it works most times. Blasted dry sense of humour!! <g> But I am not taking on a Big Guy like you other than verbally!! Watch out......now that I know your game, chuckle. Heather > Thanks. You made my day! I hate it when you just ignore my pokes. > [quoted text clipped - 37 lines] > > > > > > > > Chuck H. Correct. It is so unbelievable that you can die in this country if you have no health insurance or not the "right" kind. When I was an ultrasound tech in L.A. I remember having to deny someone a study because they had no insurance. It happened only once but because I felt it was important, my colleague and I did the study without logging it. I then took it to a radiologist who phoned the result to the referring physician. Only happened once but it sure underlined the issues. I love living here but there are some issues that beg to be addressed but we are too busy spending money to rebuild a country that we just bombed nearly into oblivion. Of topic so won't go further. Chuck H. --------snip We were told Gleason 9, Gleason 7 by the second lab and > Cleveland confirmed the 7. We were also told NOT to bother with a > biopsy because of my husband's age, 48, lack of family history and [quoted text clipped - 14 lines] > > Lee If you don't mind Lee Did your husband have RP or LRP in Cleveland and did you in fact get OHIP to pay for some of it? thanks; newly diagnosed and looking at options >If you don't mind Lee >Did your husband have RP or LRP in Cleveland and did you in fact get >OHIP to pay for some of it? > >thanks; >newly diagnosed and looking at options He had the LRP, which is the reason we went to CCF, and OHIP paid for it all. It wasn't the easiest thing in the world.... it took a lot of pressure and a lot of work. But when you;re in that kind of mental state, you do everything and anything :) L > He had the LRP, which is the reason we went to CCF, and OHIP paid for it all. It wasn't the easiest thing in the world.... it took a lot of > pressure and a lot of work. But when you;re in that kind of mental > state, you do everything and anything :) Know that feeling well, Lee. That is why I stated that you have to fight or speak up. We were about to book an MRI in the US when they lifted the SARS ban in the Brampton hospital. SARS held us up....not the medical system. And I will say that all of the doctors did their best to get Ron the tests and treatment as quickly as possible.....but you know what it was like here a year ago. As an aside, my sister's husband also had Pca at the same time and the four of us were part of a CBC Montreal documentary on coping with SARS....never saw it tho. This film company was travelling to Vietnam next for another part of the documentary on killer viruses. Besides, it was dubbed in French.....wouldn't have understood myself, grin. Just another one of those 'flukey incidents' that my life seems to be full of. (G) Heather Wow, Heather, I can't imagine having to ANYTHING with a hospital during all the SARS stuff! You know, you should call CBC and they'll send your a copy of the show for probably $40 or something... it would be fun to see even if it's in French! Yes, you're right. There is no room for complacency on the part of any patient, here or south of the border. When we were waiting for the final go ahead from OHIP, it was pretty close to the wire. August as well so people kept taking vacations just when we needed them. And we'd booked the operation date in Cleveland before we got the OK. We were actually on the 401 driving towards the border when the final word of approval came! So I took the call, and just said to hubby, "Keep on driving.... it's a go." Neither of us ever said or speculated on what we would do if it hadn't been approved! Ahhh, we can laugh about them now. Lee >Know that feeling well, Lee. That is why I stated that you have to fight or >speak up. We were about to book an MRI in the US when they lifted the SARS [quoted text clipped - 11 lines] > >Heather That's a scary result to have an abnormal PSA and no one cared. This same friend many, many years ago had to go to the US for back surgery because he just could not get OR space because of no anesthesiologist so was forced to go the US, OHIP did pay for it though. Chuck H. |
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