Welcome to the club, Randy, that no one wanted to join.  Though it sounds
like you spent a considerable time in our application process.

First, you need to find out all that is available to you and make an
informed decision as to treatment.  At 58 with your numbers, you have the
pick of the lot.  There is nothing that you can choose that is all that more
effective than anything else.  Knowing what I know about it, if I were 58
and healthy, especially if I lived in Texas, I would choose Robotic
Laproscopic Radical Prostatectomy (RLRP).  But, Bev, et al., will give you
very good reasons to consider seeds and/or external radiation.

You can post your questions here, but the first best place to find some
answers is to by Dr. Patrick Walsh's Guide to Surviving Prostate Cancer.
It's getting a little dated and you won't find robotic LRP in it, but it is
a great resource.  Also check out www.Phoenix5.org, the premier website for
prostate cancer.

Regarding 20 surgeries a year?  I think not.  Find a more experienced
surgeon.  You have a good uro.  He found your cancer while it was in its
infancy.  Thank him for that and get someone else to cut on you.  You need a
specialist who knows his way around a prostate if you ever want to have sex
again.

Twenty a year? Ok, he might be wonderful doing those 20 but I think I'd like
to have someone who does a whole lot more. This is a field that has changed
quite a bit in the last few years and so has the equipment they use. You
want someone using the latest greatest equipment who has been trained on
that equipment. Do some research and decide how you want the prostate cancer
to be treated. TX is a big state but it has some great doctors and
hospitals. Don't be afraid to search the internet for doctors and hospitals
near you.
Hang around here and you'll discover some of the treatments for PC.
Bev

Randy,

I'm 9 weeks post op and also 58 with same , 2 biopsies before the found the
Pca, Dx Gleason T1c etc.  The uro who made Dx did only 20 a year also.  I
faced the same dilemma of trying to find the surgeon who did the most RP's.
Actually considered traveling to a bigger burg than Tucson (approx 800,000
in the metro area)

Suggestions:  See if there is an USTOO http://www.ustoo.com/ support group
in SA, attend meetings. My local guys are great (2 groups in town and a 3rd
at the university)  Try the department of urology at the U of T San Antonio.

I resorted to calling the 3 largest hospitals head surgical nurse and asking
which doctors did the most RP's and I got names, but not numbers of RP
(don't you just love this litigious society we live in - sorry attorneys!)
and then I just started calling and asking their front desks.  Before I
found my surgeon I remembered that we had worked for a gynecological
oncologist some years back so I called him and he turned me on to the local
guru.

I guess the bottom line is network, make calls, talk to fiends who may have
friends who are doctors or have good relationships with doctors.  Once I got
past the initial frustration I found I had people (sometimes strangers and
doctors of friends) calling me with recommendations and once the vote was in
my surgeon was the most recommended.  Your surgeon is out there. Once you
find him/her the battle is over the rest is a walk in the park, even with
Foley!

Also in that everybody is different get a second opinion from your surgeon
and talk to a radiation guy also.  There are many paths.

Good luck keep us posted.

Tony in Tucson

Here's one resource for finding physicians.  It gives
a number of suggestions for people to ask and places
to look.

  http://cis.nci.nih.gov/fact/7_47.htm

As for 20 per year, I don't know whether that's good or
not.  It's a little less than one every two weeks.  For some
doctors, that's probably enough to maintain high proficiency.
For others it may not be.

Some doctors doing 20 RPs per year may also be doing
a hundred other surgeries - so their surgical skills are very
high and in constant use.  Others might be doing just RP
and no other surgeries - so they are, maybe, less into it.

If you really like the doctor otherwise, perhaps 20 per
year is not a problem.  If you have doubts about him for
other reasons, perhaps 20 per year adds to those doubts.

I know that's not helpful, but I'm not sure what else to say.

   Alan

Hi Randy...On Don Cooley's website, he has a page with contact names
of men with PCa listed by city / state.  I saw 2 for San Antonio when
I took a look.  The page also describes their stats and Tx.  They can
probably give you some good info on docs in your area.  The starting
page is at

http://www.phcagroups.org/grushl.htm

Judging by your stats, you certainly have low-risk disease and may
have what is termed low-voulme ar "insignificant" disease.  If so WW
may be something to at least consider in the mix of other Txs you are
considering.  It's been shown that maybe 25% of the men with low-risk
disease don't progress, the number would be higher amongst those with
low-volume disease.  Active WW would involve changes in stress level,
diet, exercise, etc, along with frequent monitoring.  You'd probably
also want a good color doppler early on to make sure that none of the
PCa is close to escaping the prostate.  WW, while free of the
morbidities associated with more traditional Tx, has it's own side
effects.  They are primarily psychological.  Just like some people
have an "I want it out" mind setand select surgery, it takes a certain
kind of mind set to practice WW, knowing that there is cancer present.
The question, "if I start with WW and switch to treatment later on,
have I lost anything" has yet to be answered.  Experiments are in
progress and hopefully data will appear in the next few years.  I am
not advocating WW, just its consideration along with the other Txs, I
had RP myself...Best wishes and good health, Ron

Randy:

I'm new to this group (about 20 minutes new).  But, I too am in San Antonio,
and have also just been diagnosed with PC.  (PSA - 12.3; Gleason - 6 (3+3);
T1c).

The urologist I'm seeing, says he does does 1-2 RPs a week.  But as much as I
like the guy, I'm still seeking a second opinion.  Besides, I'm still
researching this stuff and trying to compare the different treatment options.

Fortunately, my brother is an OR nurse here and knows some of the local docs
and has a good contact network.

Chuck