Checking on doctor

I just had a consultation with Dr. Harcharan Gill at Stanford. Said
he's done about 200 RPs, and does two per week.

Anyone been worked on by him?

He said I had an 80% chance of being cured, and 100% chance with
radiation. In the context of the conversation, it seemed he meant
radiation after surgery. Does this make sense to anyone?

Dwight (Doofy)

On Apr 17, 4:32 pm, Dwight <nodamnspa...@yahoo.com> wrote:
> I just had a consultation with Dr. Harcharan Gill at Stanford. Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. In the context of the conversation, it seemed he meant
> radiation after surgery. Does this make sense to anyone?
>
> Dwight (Doofy)

Dwight,

In my opinion, you should run away from any doctor that claims a 100%
cure rate. For a doctor to claim that 100% has already been achieved
shows total ignorance of the literature. No study has ever shown that.
If you check old posts to this group, you will even find (on rare
occasions), some men having an undetectable PSA for 10 years or more
until it suddenly started to rise.

Also, his figures make absolutely no sense. It is generally
acknowledged that early detected PCa's are cured by surgery at a rate
of over 90%. For him to quote an 80% cure rate would indicate that
your cancer is more advanced than the ordinary early detected PCa. If
that is that case, there is no way for radiation to jump the cure rate
from 80% to 100%, since that would only be true if all of the PCa
cells that have escaped the prostate are located in close proximity to
the prostate. Once PCa escapes the prostate, there is no test that
can rule out the possiblity that some cancer cells have travelled far
away from the prostate. Obviously, radiation would have no effect on
any such cells.

Ed Friedman

On April 17, Dwight wrote:

> I just had a consultation with Dr. Harcharan Gill at Stanford. Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. In the context of the conversation, it seemed he meant
> radiation after surgery. Does this make sense to anyone?

I'd be very reluctant to accept such absolutes when trying to outguess
this beast.

Regards,

Steve J

On Thu, 17 Apr 2008 14:32:36 -0700 (PDT), Dwight
<nodamnspamok@yahoo.com> wrote:

>I just had a consultation with Dr. Harcharan Gill at Stanford. Said
>he's done about 200 RPs, and does two per week.
>
>Anyone been worked on by him?
>
>He said I had an 80% chance of being cured, and 100% chance with
>radiation. In the context of the conversation, it seemed he meant
>radiation after surgery. Does this make sense to anyone?
>
>Dwight (Doofy)

100% chance of being cured? I'd suggest following Ed's advice!

Best wishes, Dwight.

Burney
RP in 1995 (age 52)
RT in 2000
ADT (Casodex) 10/06 - 8/07
Latest PSA - 0.18

Dwight,
I am curious why you did not see Dr. James D Brooks.
Stanford Medical University:
RP 1999 (Brooks)
jloomis
"Dwight" <nodamnspamok@yahoo.com> wrote in message
news:633a97a7-dbf3-414f-aac3-ae3860db50e3@a22g2000hsc.googlegroups.com...
>I just had a consultation with Dr. Harcharan Gill at Stanford. Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. In the context of the conversation, it seemed he meant
> radiation after surgery. Does this make sense to anyone?
>
> Dwight (Doofy)

On Apr 17, 2:32*pm, Dwight <nodamnspa...@yahoo.com> wrote:
> I just had a consultation with Dr. Harcharan Gill at Stanford. *Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. *In the context of the conversation, it seemed he meant
> radiation after surgery. *Does this make sense to anyone?
>
> Dwight (Doofy)

Thanks everyone, for your feedback. The 80% sort of shocked me.

Has anyone had surgery from this guy?

On Apr 18, 6:58*am, "jloomis" <jloo...@ocean.net> wrote:
> Dwight,
> * * I am curious why you did not see Dr. James D Brooks.
> Stanford Medical University:
> RP 1999 (Brooks)

This is who Stanford recommended to my doctor for the robotic.
Doesn't Brooks only do open prostatectomy?

"Dwight" <nodamnspamok@yahoo.com> wrote in message
news:633a97a7-dbf3-414f-aac3-ae3860db50e3@a22g2000hsc.googlegroups.com...
>I just had a consultation with Dr. Harcharan Gill at Stanford. Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. In the context of the conversation, it seemed he meant
> radiation after surgery. Does this make sense to anyone?
>
> Dwight (Doofy)

Never heard of him. But, I don't care if he's Patrick Walsh. No one has a
100% chance of cure with RP and/or RT. The best you can guarantee you'll
not die of PCa is if you have RP, then RT, then get hit by a bus.



--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08
Non Illegitimi Carborundum

Yes, Dr. Brooks is a master at his craft.
He would rather do RP by hand. very skilled.
He has done 1000's and several here on this news group.
He is a skilled surgeon, professor, cancer specialist.
Will not operate unless the lab results are promising, and will sew you up
if cancer is found to have spread.
Best of wishes, jloomis
"Dwight" <nodamnspamok@yahoo.com> wrote in message
news:43851004-38fc-4cff-8515-500d90f77440@1g2000prg.googlegroups.com...
On Apr 18, 6:58 am, "jloomis" <jloo...@ocean.net> wrote:
> Dwight,
> I am curious why you did not see Dr. James D Brooks.
> Stanford Medical University:
> RP 1999 (Brooks)

This is who Stanford recommended to my doctor for the robotic.
Doesn't Brooks only do open prostatectomy?

Dwight wrote:
> I just had a consultation with Dr. Harcharan Gill at Stanford. Said
> he's done about 200 RPs, and does two per week.
>
> Anyone been worked on by him?
>
> He said I had an 80% chance of being cured, and 100% chance with
> radiation. In the context of the conversation, it seemed he meant
> radiation after surgery. Does this make sense to anyone?
>
> Dwight (Doofy)

I agree with what the others have said about cure rates. The best spin
you can put on what he said is that he is speaking figuratively but not
quantitatively. If you challenge him on the figures, he may be more
forthcoming.

If I were in your shoes, I would certainly be put off by such a
cavalier response, but I wouldn't necessarily reject using him as a
surgeon. He may in fact be a good choice for robotic surgery. You
have to get some information about that.

What I don't see is why you are insisting on robotic when a first rate
surgeon like Dr. Brooks is available.

On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
(in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):

> What I don't see is why you are insisting on robotic when a first rate
> surgeon like Dr. Brooks is available.

I can't answer for the OP but from what I understand the recovery time from
the surgery is much shorter.

--
Dedman

** Posted from http://www.teranews.com **

Dedman wrote:
> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>
>> What I don't see is why you are insisting on robotic when a first rate
>> surgeon like Dr. Brooks is available.
>
> I can't answer for the OP but from what I understand the recovery time from
> the surgery is much shorter.
>
Patrick Walsh claims that robotic can't replace the benefit of direct
touch by a skilled surgeon. That may be the point Evens is trying to
make, in particular since OP said he's concerned about LT ED. While
recovery time undoubtedly is much shorter after robotic surgery, not
many long term studies exists showing better results.

Dedman wrote:
> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>
>> What I don't see is why you are insisting on robotic when a first rate
>> surgeon like Dr. Brooks is available.
>
> I can't answer for the OP but from what I understand the recovery time from
> the surgery is much shorter.
>

I think it depends on what you mean by recovery. Certainly it takes
longer with open RP for the incisions to heal, but, on the basis of the
little I know, I doubt if the time to regaining continence or erections
is much different.

Dedman wrote:
> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>
>> What I don't see is why you are insisting on robotic when a first rate
>> surgeon like Dr. Brooks is available.
>
> I can't answer for the OP but from what I understand the recovery time from
> the surgery is much shorter.

Yes, but there are other pros and cons. I'd rate the surgery recovery
time as the LEAST important factor unless I just HAD to compete in the
Olympics next month.

I.P.

"Leonard Evens" <len@math.northwestern.edu> wrote in message
news:eeKdnacYnJQ9jZfVnZ2dnUVZ_rXinZ2d@comcast.com. ..
> Dedman wrote:
>> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
>> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>>
>>> What I don't see is why you are insisting on robotic when a first rate
>>> surgeon like Dr. Brooks is available.
>>
>> I can't answer for the OP but from what I understand the recovery time
>> from the surgery is much shorter.
>>
>
> I think it depends on what you mean by recovery. Certainly it takes
> longer with open RP for the incisions to heal, but, on the basis of the
> little I know, I doubt if the time to regaining continence or erections
> is much different.

I wonder if anyone has knowledgeable information about what urologists would
cite as the advantages of robotic surgery besides quicker recovery time and
therefore, I assume, lower surgical risk. Are there any other advantages to
it? Probably we will have to wait until enough of these are done to have a
study comparing the two types of surgery in terms of cancer removal,
continence and erectile recovery.

On Sat, 19 Apr 2008 17:03:06 -0400, "Claude" <claude@hatesspam.com>
wrote:

>
>"Leonard Evens" <len@math.northwestern.edu> wrote in message
>news:eeKdnacYnJQ9jZfVnZ2dnUVZ_rXinZ2d@comcast.com ...
>> Dedman wrote:
>>> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
>>> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>>>
>>>> What I don't see is why you are insisting on robotic when a first rate
>>>> surgeon like Dr. Brooks is available.
>>>
>>> I can't answer for the OP but from what I understand the recovery time
>>> from the surgery is much shorter.
>>>
>>
>> I think it depends on what you mean by recovery. Certainly it takes
>> longer with open RP for the incisions to heal, but, on the basis of the
>> little I know, I doubt if the time to regaining continence or erections
>> is much different.
>
>I wonder if anyone has knowledgeable information about what urologists would
>cite as the advantages of robotic surgery besides quicker recovery time and
>therefore, I assume, lower surgical risk. Are there any other advantages to
>it? Probably we will have to wait until enough of these are done to have a
>study comparing the two types of surgery in terms of cancer removal,
>continence and erectile recovery.
>
Many doctors claim they can see better when doing robotic.

On Sat, 19 Apr 2008 17:03:06 -0400, "Claude" <claude@hatesspam.com>
wrote:

>
>"Leonard Evens" <len@math.northwestern.edu> wrote in message
>news:eeKdnacYnJQ9jZfVnZ2dnUVZ_rXinZ2d@comcast.com ...
>> Dedman wrote:
>>> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
>>> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>>>
>>>> What I don't see is why you are insisting on robotic when a first rate
>>>> surgeon like Dr. Brooks is available.
>>>
>>> I can't answer for the OP but from what I understand the recovery time
>>> from the surgery is much shorter.
>>>
>>
>> I think it depends on what you mean by recovery. Certainly it takes
>> longer with open RP for the incisions to heal, but, on the basis of the
>> little I know, I doubt if the time to regaining continence or erections
>> is much different.
>
>I wonder if anyone has knowledgeable information about what urologists would
>cite as the advantages of robotic surgery besides quicker recovery time and
>therefore, I assume, lower surgical risk. Are there any other advantages to
>it? Probably we will have to wait until enough of these are done to have a
>study comparing the two types of surgery in terms of cancer removal,
>continence and erectile recovery.
>

I think you're right, it's still too early to make reliable
comparisons.
Even though the manufacturers offered him a 'free' robot, the uro who
did my laparascopic RP (basically the same thing but without the
robot) decided against training and turned down the offer to get to
grips with it, preferring instead the closer physical association he
enjoys with his team assembled directly round him (anaesthetist,
brow-mopper, instrument-passer, masseur, teaboy etc). This seems to
make some sort of sense. The robot-assisted surgeon probably leads a
lonely working life in front of his LCD while all those other bods are
cosying up together round the patient.

My guess is that laparascopic (plain or robot-assisted) will gain
favour over time and perhaps completely displace the open surgery -
but it is only a guess. Significantly less operating time on average,
less blood loss, quicker recovery time - whether these advantages are
construed as trifles or not, there's little point in not accepting
them graciously if all other things - curative, rehabilitative - turn
out, after due appraisal, to be broadly equal.

"Claude" <claude@hatesspam.com> wrote in message
news:480a5e0d$0$3356$4c368faf@roadrunner.com...
>
> "Leonard Evens" <len@math.northwestern.edu> wrote in message
> news:eeKdnacYnJQ9jZfVnZ2dnUVZ_rXinZ2d@comcast.com. ..
>> Dedman wrote:
>>> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
>>> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>>>
>>>> What I don't see is why you are insisting on robotic when a first rate
>>>> surgeon like Dr. Brooks is available.
>>>
>>> I can't answer for the OP but from what I understand the recovery time
>>> from the surgery is much shorter.
>>>
>>
>> I think it depends on what you mean by recovery. Certainly it takes
>> longer with open RP for the incisions to heal, but, on the basis of the
>> little I know, I doubt if the time to regaining continence or erections
>> is much different.
>
> I wonder if anyone has knowledgeable information about what urologists
> would cite as the advantages of robotic surgery besides quicker recovery
> time and therefore, I assume, lower surgical risk. Are there any other
> advantages to it? Probably we will have to wait until enough of these are
> done to have a study comparing the two types of surgery in terms of cancer
> removal, continence and erectile recovery.

Most of my information on RLRP comes from this NG. And, all other things
being equal in 2000, if RLRP was available, I would have chosen it over RRP.
However, depending on your definition of "surgical risk", I think that open
surgery might have the nod on that one. As I recall, RLRP involves a much
longer time under anesthetic, which is never good. It also involves a lot
more bleeding. However, RLRP also involves a much better look at the
prostate and the all-important "margins". But, there is no "feel"
whatsoever. So, as to risk, I think it's a toss-up.

As to erectile recovery, I think it might have an advantage as to seeing the
nerves and a disadvantage as to peeling them.

As to continence, I don't think there is an advantage either way.

I am fully prepared to be told I'm wrong; which will educate me and others.



--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08
Non Illegitimi Carborundum

On Sun, 20 Apr 2008 07:08:01 -0400, "Steve Kramer"
<skramer@cinci.rr.com> wrote:

> As I recall, RLRP involves a much
>longer time under anesthetic, which is never good. It also involves a lot
>more bleeding.

No Steve, regarding bleeding, exactly the opposite is the case.

Smaller total incision tying in with less bleeding and faster
recovery.

I believe laparascopic procedures (robotic or otherwise) are faster
too but perhaps less generally, I'm not 100% sure about this. As
example only, my non-robotic LRP took 2.5 hours - average according to
the uro. I've heard of open RP being something of a marathon haul and
I'd be surprised if the average was lower than my 2.5.

<rosbif> wrote in message news:01am04d5k8f3p3t4kqjte3elnuli6avf18@4ax.com...
> On Sun, 20 Apr 2008 07:08:01 -0400, "Steve Kramer"
> <skramer@cinci.rr.com> wrote:
>
>> As I recall, RLRP involves a much
>>longer time under anesthetic, which is never good. It also involves a lot
>>more bleeding.
>
> No Steve, regarding bleeding, exactly the opposite is the case.
>
> Smaller total incision tying in with less bleeding and faster
> recovery.
>
> I believe laparascopic procedures (robotic or otherwise) are faster
> too but perhaps less generally, I'm not 100% sure about this. As
> example only, my non-robotic LRP took 2.5 hours - average according to
> the uro. I've heard of open RP being something of a marathon haul and
> I'd be surprised if the average was lower than my 2.5.
>

That is very good to know. Admittedly, my paradigm was set shortly after
RLRP became widespread. Then, I believe, surgeries were taking up to four
hours. But, again, I could be wrong.

He'sDeadJim wrote:
> On Sat, 19 Apr 2008 17:03:06 -0400, "Claude" <claude@hatesspam.com>
> wrote:
>
>> "Leonard Evens" <len@math.northwestern.edu> wrote in message
>> news:eeKdnacYnJQ9jZfVnZ2dnUVZ_rXinZ2d@comcast.com. ..
>>> Dedman wrote:
>>>> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
>>>> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqnZ2d@comcast.com>):
>>>>
>>>>> What I don't see is why you are insisting on robotic when a first rate
>>>>> surgeon like Dr. Brooks is available.
>>>> I can't answer for the OP but from what I understand the recovery time
>>>> from the surgery is much shorter.
>>>>
>>> I think it depends on what you mean by recovery. Certainly it takes
>>> longer with open RP for the incisions to heal, but, on the basis of the
>>> little I know, I doubt if the time to regaining continence or erections
>>> is much different.
>> I wonder if anyone has knowledgeable information about what urologists would
>> cite as the advantages of robotic surgery besides quicker recovery time and
>> therefore, I assume, lower surgical risk. Are there any other advantages to
>> it? Probably we will have to wait until enough of these are done to have a
>> study comparing the two types of surgery in terms of cancer removal,
>> continence and erectile recovery.
>>
> Many doctors claim they can see better when doing robotic.

And those who do Open surgery claim they can both see better and feel
better what they are doing. The argument for seeing better is that the
fiber optic probles allow for magnified images on the screen. However,
surgeons using the open procedure can, if they choose use magnifying
lens, if they need to look closely at detail, so I don't see why there
is an overwhelming advantage here with respect to visual inspection of
the operation site.

rosbif wrote:
> On Sun, 20 Apr 2008 07:08:01 -0400, "Steve Kramer"
> <skramer@cinci.rr.com> wrote:
>
>> As I recall, RLRP involves a much
>> longer time under anesthetic, which is never good. It also involves a lot
>> more bleeding.
>
> No Steve, regarding bleeding, exactly the opposite is the case.
>
> Smaller total incision tying in with less bleeding and faster
> recovery.
>
> I believe laparascopic procedures (robotic or otherwise) are faster
> too but perhaps less generally, I'm not 100% sure about this.

I think in fact you are 100 percent wrong about that. It is my
understanding that generally laparascopic prostatectomy takes at least
twice as long as convention RRP.

> As
> example only, my non-robotic LRP took 2.5 hours - average according to
> the uro. I've heard of open RP being something of a marathon haul and
> I'd be surprised if the average was lower than my 2.5.
>
>

On Mon, 21 Apr 2008 11:35:29 -0500, Leonard Evens
<len@math.northwestern.edu> wrote:

>> I believe laparascopic procedures (robotic or otherwise) are faster
>> too but perhaps less generally, I'm not 100% sure about this.
>
>I think in fact you are 100 percent wrong about that.

I don't want to be made to appear to be careless with all-important
facts. Above I say I am *not* 100% sure.

> It is my
>understanding that generally laparascopic prostatectomy takes at least
>twice as long as convention RRP.

according to;-

http://www.roboticoncology.com/Lapar...statectomy.php

- surgery time is similar.

We were both wrong.

On Apr 19, 1:19*am, Dedman <dedman.walk...@yahoo.com> wrote:
> On Sat, 19 Apr 2008 00:15:54 -0400, Leonard Evens wrote
> (in article <gtidnVopudtm7JTVnZ2dnUVZ_sKqn...@comcast.com>):
>
> > What I don't see is why you are insisting on robotic when a first rate
> > surgeon like Dr. Brooks is available.
>
> I can't answer for the OP but from what I understand the recovery time from
> the surgery is much shorter.
>
> --
> Dedman
>
> ** Posted fromhttp://www.teranews.com**

And I hear the after effects profile is better with robotic.

I might check into Brooks anyway.

Some docs say it's important to be able to feel the tissue by hand to
distinguish cancerous from healthy tissue.

I.P.