Who should be my supporting doctors after surgery?

Hello and welcome
I just had Greenlight laser surgery and I'll share what I'm doing. I am having "complications" or perhaps the "usual" side effects such as still having "scabs" and blood in my urine 8 weeks out. To me this is still the surgeons area so I just tried to leave a message but looks like it is better to stay on "hold" (phone system)
When I do get through I'll leave a message as to what is going on and he will return the call (or his staff will) as to whether I ought to come in or to relax as this is just part of the healing (I am on blood thinners so it may be causing a delayed healing)
Next week I hand the ball off to the RO who will schedule my radiation treatment (again but that's another story)
So if the surgeon clears me for radiation I will stay in contact with the RO They are on the same "team" of doctors so my info is shared.
After radiation my plan is to return to my regular urologist.
So in a nutshell, use the doctor appropriate to the issue. I'd guess you'd have a followup with the surgeon after the surgery and then if any issues arise, you would stay in contact.
Finally, please post more information about your case. Get a second opinion and get as much information as you can about your Pca some do not need treatment and the treatments vary so please read up

Good luck

Glen

Hi 116. First, your surgeon should see you through a post-op recovery period. There can be complications from surgery. Who told you he'll be saying goodbye?

You need regular visits with a urologist, the specialist in the best position to evaluate the longer-term recover of continence and potency (erections), to your cancer status. Your PCP can give you referrals.

There are two upcoming results of major importance:

(1) Your post-op path report. Get a copy of the complete report and post the findings. Review it with your urologist.

(2) Confirmation that your PSA a couple of months post-op has dropped to an undetectable level (<0.1).

Depending on (1) and (2), you may or may not need adjuvant radiation after a period of healing from the surgery.

Based on your recovery and these findings, you and your urologist can decide on a visit schedule.

Djin

No need for a medical oncologist unless surgery and radiation fail to control your cancer. It is premature to consider one at this point.

You have to first determine whether the surgery is successful. That will take months to years to determine and will be shown by PSA. If it is undetectable and stays such then you are done. If it either does not become undetectable and/or starts rising the first treatment would be salvage radiation to attempt to clean up what the surgeon missed. If after SRT the PSA increases then systemic treatments like ADT would be employed.

Right now trust your research and choice of initial treatment. Get ready for surgery and physical recovery. You are several months away from knowing much until you have a PSA test in the 90 day post surgery range.

JNF said...
No need for a medical oncologist unless surgery and radiation fail to control your cancer. It is premature to consider one at this point.

You have to first determine whether the surgery is successful. That will take months to years to determine and will be shown by PSA. If it is undetectable and stays such then you are done. If it either does not become undetectable and/or starts rising the first treatment would be salvage radiation to attempt to clean up what the surgeon missed. If after SRT the PSA increases then systemic treatments like ADT would be employed.

Right now trust your research and choice of initial treatment. Get ready for surgery and physical recovery. You are several months away from knowing much until you have a PSA test in the 90 day post surgery range.

JFN, you are skipping two standard of care steps:

(1) Advise adjuvant therapy (RT +/- ADT) is strongly advised if the final Gleason score is 9-10 and there is even one adverse finding in the path report (LNI, EPE, SVI, or PSM). about 75% of G9-10 men have at least one adverse finding after RP. My own uro would add LVI (lymphovascular invasion). This information is known as soon as the path report is available and the recommendation is PSA-independent.

(2) Advise adjuvant therapy if the final Gleason score is 9-10 with persistent PSA . This recommendation is independent of the path report.

Adjuvant therapy may also be advised for lower G score, depending on the adverse findings.

The OP had a G9 biopsy.

Djin

Djin, I was referring to the larger picture. I don’t remember the biopsy diagnosis. Was it a G9? How involved? High PSA? I simply don’t remember and the signature is missing. If so, I apologize for my simplicity. Even if it is, rarely would a person jump to a medical oncologist before initial treatment, unless it was determined that traditional initial treatment would be unnecessary due to a significantly advanced, clearly metastatic condition, Todd1963 at dx. He had neither surgery nor radiation and went straight to ADT and a medical oncologist. I don’t remember that is the case with 116grove.

And 116grove, it really isn’t gambling. It is just that there is limited information regarding your condition. Your surgical pathology will tell you much more. Your post surgery PSA trend will also tell you much more. These will take time to provide you more information regarding your condition and possible subsequent treatments. Such is PCa, that one former member rightfully described as “The Twilight Zone”.

Thank halbert. It is a good idea, just ASK. Right now it sounds too early. Thanks.

Hi justwondering, thanks for your suggestion. The biopsy found only one 4+5 slide, which was NOT discovered in MRI.