Did doctor give you radiation or surgery as an option?

I think you'll find that, in general, specialists recommend their own specialties. That's why it's important to seek out people on your own--and find the best at what they do. Not sure where you're located, but folks here are pretty good at giving recommendations on practitioners in different places.

My initial consultation was with a urologist. He outlined the risks/benefits of both surgery and radiation and also referred me to a medical oncologist so I could have an opinion from someone who was neither a uro or an RO.

In Sweden all treatments were explained and offered, none "recommended". My decision was made without being pushed by the Dr. Maybe the the difference between Capitalism and Socialism.

Cheers, Doug

The urologist who diagnosed me, didn't offer surgery, or cryotherapy, which is what he does. He only offered to set me up with the Dr who does Cybrrknife at yhe hospital at which he is Chairman of Urology, and which has a huge investment in Cyberknife. He also told me almost nobody in the area does Brachy anymore.
I saw 3 surgeons on my own, two pushed me towards surgery and spoke of why it's better, one of those , a very high profile well known surgeon, actually used scare tactics talking about rectal Cancer being a side effect of radiation. The 3rd , the one I used, told me I would do well with surgery, but also encouraged me to explore my options.

I also eventually saw the RO who does Cyberknife, he talked about all options but spent time telling me why he is not a fan of BRachy and how it's old school. Clearly a sell job.
And I also saw an RO at MSKCCS who recommended Brachy LDR but told me that both Brachy and surgery offered an equally high chance of cure.

The more responsible providers will provide you with all options. My URO, sent me to the cancer clinic for a meeting with a team of providers - surgeon, RO, etc. No one pressured me into anything - it was a process of trying to decide what was right for me.

Anyone doing high pressure tactics should be avoided.

Andrew

Thanks guys. I have to meet with the doctor on Tuesday to discuss bone scan and MRI results. He's a surgeon. Not sure what to expect but your input helps. Based on my research, radiation looks like the right choice for me. I'm hoping he will refer me to a good RO.

Tom

Wasn't pressured either way at all at John's Hopkins.

Both guys said I should do well with either treatment option. The RO even told me he thought I was more of a surgical candidate after my sharing my anecdotal experiences with radiation.


My local uro who diagnosed me said if it were him he'd do AS.

Over here, SG.. urologist explained that there are 3 types of treatments for me but as a high risk patient who are potential candidate for surgery is likely to land with all the 3 treatments. He referred me to consult a RO after that. RO just explained the procedure & the risk involved. The final decision is still mine, whether to skip surgery & go direct to RT + HT. No pressure from them.
Seem Uro is quite right, I m landing myself into that.

Through reading I decided on surgery: rational or not I wanted it out under a microscope. I decided on Da Vinci for a quick recovery and a very low probability of transfusion when compared with open surgery.

I read countless reviews, used various rating sites, looked for matches with published authors of relevant articles, considered the cost to travel to J.H. Baltimore and SK NYC.

I went to 4 clinics or hospitals as follows:
1. The local surgeon did not meet my >300 procedure requirement and the hospital didn't score well in the US New and World Report surveys for outcomes and safety.
2. I met with a Medical Onc near Boston that said since I was a G8 at biopsy so surgery was out, I'd need radiation in the future. He handed me a Casodex prescription and scheduled me to come back in a week to start other HT and then RT. All in 15 minutes.
3. I scheduled and confirmed an appointment with a known good surgeon at a Boston mega institution. At the appointment I was seen by someone else that would not disclose numbers (procedures, complications). It was a short meeting.
4. At BIDMC I met with the surgeons (Dr P Chang and Dr A. Wagner) and RO (Dr. I Kaplan) All senior staff. They were open, discussed numbers, answer all my questions and more. The RO was ok with RALP, it was scheduled and performed by both Dr P. Chang and Dr A. Wagner. I was in/out in 24 hours and Tylenol handily took care of the pain. I returned to office work in a week and a day. The only QoL issue was incontinence which was minor from the start and totally resolved in 3 months. The catheter was the only negative, no problems, I just didn't care for it.

Post surgery I was upgraded to G9 with positive margins etc, number 2 above was right, I start adjuvant RT in a week. The SK nomogram predicted it, so no surprise. There was a less than 20 percent chance that pathology could have downgraded my G score and fewer things could have be negative. But I know what I'm dealing with which was the goal.
I've had over a year with a PSA under 0.1 and very good health. I'm very happy with my treatment so far.

My local GP went MIA once the diagnosis was confirmed.

halbert said...
I think what I'm hearing is that the top end facilities and doctors are more than willing to work with patients and set up meetings with colleagues in other specialties. Those who are unwilling to refer or pass on info are not the ones we want to deal with.

I just want to highlight this - the best doctors are interested in the best outcome for their patients and understand that medicine is now a team sport with more than one specialty playing its part. Any doctor who knows their stuff, knows that they don't know it all and are more than willing to work with other doctors to find the right treatment.

Walk away from doctors who are unwilling to do this.

Andrew

My original uro pushed robotic surgery on me, and never mentioned I had other options. I had done my homework and brought it up the other options to him. He seemed insulted, especially when I pressured HIM for numbers of procedures he had done, outcomes, etc. I finally got it out of him that he would not be doing the surgery, that a "collegue" would be who had less than 50 under his belt.  I do not believe he was ever going to tell me that.  I fired him right then and there, he was not happy, but that was the least of my concerns. I found another uro, who worked with me, spelled out all my options, and said it was up to me. I chose SBRT, and this uro implanted my markers and sent me to a wonderful RO.

It ended well, because I took charge of my own body.