Is seeing a so-called "top doctor" possibly a BAD idea? (Article says yes)

Explorer:

Very good point. There are plenty of local doctors that are in the top 10%!

My family doctor is one of those. He was actually a student of mine in the 70's. He was my best Honors Calculus student and actually was nationally ranked for his mathematics prowess. He went to Umich and, of course, did fine in his pre-med and med courses. He then came back to practice in our town.

Mel

When faced with the challenge of knowing that my local urologist said that I was not the best candidate for AS, I had to start doing my research. Although I had decided that Cyberknife was not an option ( for me ), I still made an appointment with Winthrop here in NY. I then went to see the surgeon who was affiliated with the local practice of urologists. I carefully listened and knew that he had performed roughly 1000 robotic surgeries. I continued to do research and found several other "top docs" that performed significantly more (~5000) surgeries. I ultimately chose one of the top docs and it wasn't based solely on the number of surgeries or that his name was coming to the top of some google search but rather I took the time to read everything I could about him .. his philosophy, research, the hospital affiliation, his age, his experience and yes his patient stats. I wasn't dying in a month or two of my diagnosis so it wasn't a question of time and choosing who I perceived as being "one of the best" but you can spend an eternity researching Dr's, patient experiences, having tests etc and at some point you have to make a decision and mine initial was based on whether or not the surgeon was "perceived." ( by me) to be one of the best in his field

I more than welcome the feedback as it serves to benefit not only me but other members of this site. To provide a few more details, my PSA went from 3.4 to 4.2 in a year. My local urologist requested an additional Free:total PSA. This showed 13% free and PSA jumped almost another point in a week ( up to 5.2). I wasn't as concerned about the 1 point jump in a week because I have no idea if the same lab was used to do the standard PSA versus the Free:Total. Based on my age, this test statistically shows that I had a 34% chance of finding cancer resulting from a biopsy, so based on the velocity of my PSA change and the Free:total results, I agreed to have the biopsy performed. Dr took 16 cores of which 5 were shown have cancer of varying percentages (as high as 70%) and a GS of 7 (3+4). The tumor(s) appeared to be limited to the left side of the prostate. Subsequent CT scan showed that nothing had spread, but I don't place a great deal of confidence on the degree of which a CT scan can show so ultimately, my urologist felt that based on these numbers I should consider doing something as opposed to doing AS. He also ordered an Oncotype DX test ( since he already had the core samples ) but that was a moot point because according to him, patients who are staged with Gleason scores of 6 or less are better candidates for the additional testing which would indicate whether AS is a viable choice. Did he provide the most thorough information for me? I will never know because I opted for surgery and I am glad that I did. By the way, my surgeon and urologist are NOT the same Dr. The MRI I had performed at the request of my surgeon indicated that the tumor appeared to be contained but did show a "bulging". My post surgery showed all margins clear and not spread to the lymph nodes. The GS was also downgraded to a 6. Why?? who knows and at this point I really don't care. This may not be the best of analogies but I looked at my situation like this .... Shark attacks are extremely rare but you don't want to be that one anomaly who's in waist high water suddenly knocked over and finding your self in the throat of a man eating shark .. I didn't want to risk being that one guy who is being constantly reassured with "don't worry about it .. you'll likely die with the cancer rather than from it"

Post Edited (aldenyc2015) : 12/16/2015 11:43:42 AM (GMT-7)

And yet, Jack, with a 5/16 biopsy at G7, with up to 70% in one or more cores, most AS programs would not have accepted him. Adleny appears to have fallen in the group of 'those who needed a cure and received it'.

Post surgical pathology being different (either up or down) from biopsy is not uncommon. Some studies say up to 30%. The reason is mostly about the difference between having a few very small samples to look at vs. having hundreds (thousands?) of slices from the whole gland to look at.

The fact that the head of Urology at our biggest and best university teaching hospital in E. TN went to UCSF for his prostatectomy should have told me something.

Purg:

I think I missed the part about the guarantees.

Mel