question: oncologist or urologist

in most cases, unless you have complications from the radiation, you are through with them after your first post srt reading. your reading is great, btw.

i had loads of complications after radiation, but i was returned to the care of my urologist.

welcome to hw, btw

david in sc

The system I am in had me go to the RO for my IMRT treatments but long term I am being followed by urology. They said I'd be referred back to RO if needed but that is unlikely.

It depends on where you expect your treatment to go. I agree that once the radiation is done, the rad-onc is no longer considered to be the primary doctor. At that point I think it reverts to the urologist or the med-onc. If it looks like the initial treatment has been successful, one could stay with the urologist indefinately. However, if there is a recurrance or it is expected that the primary therapy wasn't curative, then the med-onc becomes primary.

I see my urologist quarterly, my rad-onc annually, and my med-onc semiannually. At the present time, I consider my urologist to be my primary physician. However, if my PSA starts to rise, indicating I have become hormone refractory, my med-onc becomes primary. All my docs understand that and are working well together. Btw, my urologist only does prostate work, so he is the most specific specialist on the team.

I had open RP surgery 10 years ago and SRT 2 1/2 years ago. I had 6 months follow-ups with my RO --I had some minor complications from the SRT (bleeding) which gradually got better. When I saw him last January we agreed that I'd see him again in a year unless there were complications. I still see my Uro every six months and consider him my primary doctor for my PCa. But also want to have the opinion of my RO if there are further complications going forward. This is, in part, because the RO has a slightly different perspective - is a fan of Casodex and putting off Lupron until Casodex is no longer working on it's own.

I saw my Uro last week and told him I would be seeing my RO in January. My Uro is fine with that and told me he'd send a message to both my RO and my Primary Care doc to update them on my status. All three docs are affiliated with the same medical center, though they are not all in the same group practice.

So, as far as I can tell, they are all happy to work together and exchange notes--which is made easier because they all have access to the same computer system.

Down the road if I have further complications I will consider whose advice I want to follow. There was also a medical oncologist I saw 10 years ago before I decided to go ahead with surgery. She, I, and my wife discussed various treatment options and she also gave good guidance -- e.g., reminding me that Dr. Patrick Walsh, whose book I mentioned to her (and whose book I highly recommend) is a surgeon, as is my Uro, and I might want to keep in mind that they see things from a surgical point of view. She wasn't by any means recommending against surgery, but was reminding me that I need to recognize the point of view of my various doctors and take it into account.

That said, I opted for surgery and believe I made the right decision. If I need further treatment in the future, I may look her up (she's now at a different teaching hospital nearby) and ask her for a consult.

So, there are no simple answers. Ultimately it comes down to our own choices as patients to decide what course we choose to follow. But so far in my case, I've found that all of my doctors are willing and happy to play nice together.

Talk to them both. Tell them you are unsure of the protocol. Let them work it out