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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 34647
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I was diagnosed with prostate cancer in September of this

Customer Question

I was diagnosed with prostate cancer in September of this year and was told that it is in early stage and slow growing. I will be 59 years December 10. My current urologist (Dr. John Anema in Grand Rapids, MI
JA: Are you keeping a personal medical record while dealing with this?
Customer: I'm leaning towards robotic surgery for treatment. What is your opinion on this and the other options, i.e., external radiation, inserting pellets, or some combination of these? I do not want to wait long to physically, medically treat this.
JA: Anything else in your medical history you think the doctor should know?
Customer: He knows that I have degenerative arthritis and DDD of the spine, have rods in my neck, prosthetic right hip, had post-op infection from my last neck surgery in January of 2015. I also am being treated for high blood pressure (all my adult life). I will be seeking advice from Dr. Curry for another MD urologist as well. I am told by a neighbor friend who just had prostate surgery done by Dr. Curry that he is an excellent surgeon. My neigbor is approx. 66 years old and his cancer had spread. His surgery was more complicated.
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 8 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  Dr. Arun Phophalia replied 8 months ago.

What is your Gleason score (this is given by the prostate biopsy)?

What is your PSA?

Are you diabetic, any heart disease or any significant past medical illness (apart from what you have mentioned)?

Expert:  Dr. Arun Phophalia replied 8 months ago.

The general treatment criteria of prostate cancer are based on following factors:

1) assessing the risk of the disease spreading or progressing,

2) evaluating the patient's life expectancy (if there are other medical conditions / comorbidities),

3) biopsy grade (Gleason score),

4) clinical stage, and

5) prostate-specific antigen (PSA) level.

Customer: replied 8 months ago.
Sorry for delay. My Gleason score is 6. Last PSA in October was .4
Customer: replied 8 months ago.
I cannot afford $50. I'm already in a medical hardship from other medical issues.
Customer: replied 8 months ago.
I wish to continue via chat.
Customer: replied 8 months ago.
I can clearly see that I've wasted my time and my $5.00. My evaluation will reflect such. It's about the all mighty dollar!
Customer: replied 8 months ago.
You have not responded which confirms that what I just texted is really true.
Expert:  Dr. Arun Phophalia replied 8 months ago.

Treatment of early prostate cancer (which means cancer has not spread and is localized to prostate) in your case can be;

a) radiation therapy, and

b) radical prostatectomy; which can be open, laparoscopic or robotic (da Vinci robot).

The choice of definitive therapy has been suggested to make not much significant difference in long-term survival.

c) Active survillance.

So it is your doctor and your choice to choose the treatment; as long term results are similar for all the treatment.

A Robotic surgery has an advantage that it removes whole of the cancerous prostate without affecting the nerves of erection. So out of all surgical procedure, it is best in good hands.

The radiation results are similar in survival benefits. But it avoids surgery thus there is no admitted hospital time. Though it may cause long term local complications like rectum inflammation.

We can discuss this further since now you have initial information.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 8 months ago.

There is no much difference between interstitial prostate brachytherapy (pellets) , external beam radiotherapy (radiation given from outside). The radiation therapy preserves the urinary, sexual, and bowel function.

A robotic surgery though removes the prostate completely (so one has a psychological advantage); may affect urinary, sexual or bowel function. Though in good surgical hands, the incidence is less than 5-10%.

You may choose any as both have similar results in the long term (survival benefits).

It is privilege assisting you.

Expert:  Dr. Arun Phophalia replied 8 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.