Talk With Doctor Tomorrow

My husband has had the biopsy, bone scan and CT scan. Tomorrow we meet with the urologist to discuss the next steps.

I've got a list of questions to ask him. My question for this group: what questions should I make sure to ask? Keep in mind that some of my questions are being asked as a way to educate my husband (with the hope that he'll be listening when the doctor talks). I've done all of the homework. He has not wanted to sit down and fully discuss the cancer. So I end up giving him information when I see an opening to bring it up. But tomorrow is important (for both of us) and I want to make sure I hit all of the bases.

Any suggestions are welcome. Thanks!

Surfing....I gather the appointment tomorrow is to go over various treatment plans. Urologists are surgeons and will most likely discuss the benefits of his treatment methods. Besure to consult with an oncologist, prefered medical oncologist for other forms of treatment plans as well.

For qustions with the Urologist/Surgeon here is what I would ask:

1) How many surgeries he has performed...open or laproscopic including robotic assisted.
2) What is the planned number of days in the hospital following surgery.
3) What is his planned methods for ED treatment following surgery and when will treatment begin.

These questions were important to me and I will give you my reasons:

4) How many surgeries are performed by him on the day of surgery. I did not want an "assembly line" surgeon
5) Will he provide a list of prior patients that you can contact to discuss surgery and follow-up. I would be very wary if he didn't.
6) Will he actually perform the surgery or will an assistant be doing the actual surgery. Sometimes surgeons will be training others and he is only there to oversee the procedure while someone else less experienced is actually doing the job.

Others will provide more questions to ask,

Good Luck

Dear Surfing: Here is the list of questions my wife and I used with the urologist/surgeon: 1.       Do you recommend robotic for my situation?   How do you compare this for my situation vs. brachytherapy?   2.       How many of these procedures have you done?   3.       For my situation, do you recommend surgery alone or with any other treatment. e/g/ hormone therapy?   4.       I assume this is nerve sparing surgery?   5.       Explain the procedure and timeline…pre op, op and post op   6.       If I decided this week, when would we start?   7.       What are the side effects for your patients?   Do you have percentages?   How do your results compare with best in class?   8.       Re the urinary side effects, do you prescribe drugs to control them?   Same for sexual?   9.       Will this cure the cancer?   10.   Why would I choose to go with you rather than to go to a center like Johns Hopkins?   11.   What happens if the equipment fails during the procedure?   These are the questions we posed to the radiation oncologist:   1.       How many of these procedures have you done?   2.       Do you recommend this for my situation?   How do you compare this for my situation vs. surgery?   3.       For my situation, do you recommend brachytherapy alone or with other radiation treatment?   4.       Is there any need for hormone therapy?   5.       Explain the procedure…pre op, op and post op. .   6.       The seeds: a. Some of the literature suggests using MRI to insert the seeds.   Is that your technique and, if not, why not?   b. How many seeds and what type?   c. Have you had any issues with seed migration? d. Could you give us a general idea of how the seeds are plotted?   How many in each section, etc? e. What is the life of the seeds?   f. Do the seeds affect other organs?     7.       What is the timeline…pre op, op and post op?   8.       If I decided this week, when would we start?   9.       What are the side effects for your patients?   Do you have percentages?   How about side effects over time, i.e. quality of life 2-3+ years out?   10.   Re the urinary side effects, how effective are the drugs to control them?   Same for sexual?   Bowel?   11.   Will this cure the cancer?   12.   What do you see as the advantages of this vs. surgery?     13.   If I have this process and the cancer returns what happens?   Is surgery still possible in the future?     Good luck! .    

Tudpock did a great job of listing questions.

I suspect the first things to consider are what type of treatment - explore them all. Next, who is going to do it? Explore that! You need to have peace in your mind that you are doing the best thing for your situation. For the most part your first shot at this thing is your best shot. Also, keep in mind - depending on your doctor, he may be a radiation guy or a surgery guy. Generally, doctors try to sell their method, and they all have good arguments, but it is your life and you need to make that decision.

I found the more I read the more questions I had, and I had to go back several times just to ask questions & receive answers. Every time you think of something write it down. There is so much information on the www - read, read, read! Also, this forum is great becaus all these guys on here have been down the same road. Ultimately, you will get through it fine - this too shall pass!

RB

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04

Take notes, lots of them. Preferably a tape recorder or digital recorder. Remember no question is "dumb". You have been given a lot of great advice in the postings above.

If it would do any good, I would be most happy to talk to your hubby. I totally understand as I wanted to go hide in a cave or something. In fact, I thought it would be better just to die than face this. Well, I was WRONG. I am on the other side of the bridge and it is quite wonderful over here.

After I found that it is such a relief that the cancer is gone, that the incontinence stopped soon, that the bad ED didn't happen to me, I began to find things that I couldn't image really had a bright side. I didn't think I could handle not be able to ejaculate. Well, now that I am in that spot, I find it has its bright side too..... no mess. Sure being 54 it was kind of strange to have things different but it is not bad at all really.

If I could help in anyway, just click on the letter symbol to the left of this post and I'll reply.

I just went back to work today so I can't watch email all day long now like I did!!!!!

Have a profitable meeting tomorrow. We'll pray for both of you.

Bill

Surfing,

Maybe as he's left to think about things and make his own decision he will come around. My husband darned near cost his own life twice by ignoring his body and his communication skills. In fact, he's 52 in a week and ignoring his family history because he doesn't want to hear any potential bad news.
No problems, just a history dictates he should have a simple, baseline colonoscopy. Easier to ignore and fight for his life I guess...sheesh! Like talkin to a rock sometimes :>) His life, our problem I explained. He's better than he was. Not a fantastic communicator but, much better. Good Luck and hang in there. We can't change people. We can only change the way in which we react.

Swim

Speaking of communication, while I have never been the I-Don't-Want-To-Talk-about-It type of man, I have become a better communicator since my wife and I have traveled the prostate cancer journey together, hand-in-hand, heart-to-heart.