After RP on May 17, seeing primary Urologist tomorrow for 1st time - Help With Questions?

Hi Folks.. as my heading notes I go back to Boston Medical Center do meet with with primary urologist for the 1st time since being in the hospital post RP - Davinci. I knew he would be out of town at catheter removal when my pathology was also available. Was told by the associate dr who saw me that gleason 3+4 went to 4+3, and there were positive margins.

That is basically the ONLY information I have regarding my situation, other than they have me pre-scheduled to meet with their Rad Onc next week.

While I respect and understand the incredible level of detail many post here about their particular PCa, I have not gotten into that level of detail yet... and to be honest, i'm not sure I want to. I DO want to make informed decisions, and I will be looking over my shoulder for the rest of my life, no doubt, but i'm not sure i'm emotionally ready to become married to the disease on that level...

I dont know half of the terms used to detail some of these things... Who knows how big the left 40% lobe of my prostate SHOULD have weighed, who wants to know the specific dosages of radiation they are going to use..? I mean, isn't this what expertise is for?

That said, of course I want to know what I need to know... and i'm only kidding myself.. i'll be expert on all the factors in very short time. I will be asking for the pathology report..... But other than that, if YOU WERE ME, what questions would you ask if you were me and wanted to ask him your top 7 questions? Thanks so much in advance.

Bob, for starters, no one here is an "expert" with PC. Some are more informed and researched more than others. So don't feel bad about what you don't know, that's what your medical professionals are for.

While an upgrade from a 3+4 to a 4+3 is not what one wants, its not that uncommon. Yes, they are both Gleason 7's, but of course, in a 4+3 combo, assuming the pathology is correct, it is made up of more type 4 cancer cells, which are more agressive by nature.

As far as radiation plans go, thats the job of a radiation oncologist. Coming up with the "plan" is unique with each patient, and there are many factors they compensate for when determining how many treatments are needed, and at what amount (gys) and even how its delivered. Again, those are the things for the experts.

Just because a person has positive margin(s), doesn't mean its 100% will cause the cancer to recurr, just more likely. We have men here with no positive margins that have had recurrance, and men with positive margins that haven't. Such is the fickled nature of PC.

If I read your dates correctly in your stats, you haven't even had your first post-surgery PSA test yet. That should be coming up soon, I would hope you slide right into the Zero Club with a good reading.

The radiation oncologists I have met with, including the one I went with, don't like to start immediate radiation after surgery, until they see evidence of the cancer coming back. Some doctors do that differently, of course.

I fully understand your concern, as I am a Gleason 7 case with high velocity, and my surgery "failed" and I have recently finished salvage radiation, but dont worry your self sick at this point. You are clearly still in the post surgery recovery side. I will come back and post a few questions for you.

David in SC