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How many have kept their original surgeon for followups?

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Posted 10/14/2011 11:53 AM (GMT 0)
Hello,

Just wanted to throw out a question. Had RP 15 months ago and so far all seems well. Psa's have been undetectable, urine control is great (actually better than before surgery), ED issues but meds seem to work.

Anyway, my doctor that did surgery is a two hour trip and since it seems all I am doing is going over to get a psa test done and answer a few questions I feel that I want to just get this testing done locally by finding a local urologist.

Plus side is not taking a full day off work and traveling 4 hours also it may be easier to tinker with the ED dose adjustments locally, minus side is I have heard doctors dont like seeing patients that they did not originally treat.

Anyone with experience with this decision?

Thank you.

Posted 10/14/2011 11:55 AM (GMT 0)
Your GP can do the PSA test.... And odds are if you have a regular GP, he or she has and will share info with your surgeon.

My surgeon in only 20 minutes away so I still see him one a year.

Posted 10/14/2011 11:56 AM (GMT 0)
I'm in contact with mine all the time. I see this as a 10-15 year process and am comfortable and secure in maintaining a relationship with him and his staff. That said, I am a 9 hour plane ride away now so I do all my testing elsewhere. But I make sure to send all my results to his office so that he can keep my chart updated. You could do the same.
Posted 10/14/2011 12:53 PM (GMT 0)
I dropped my urologist in favor of a medical oncologist. I figured, with the plumbing gone, I didn't need the plumber anymore. However... I have come to learn that not all medical oncologists are better than urologists. Since urologists have pretty much owned the market, they have more experience; and because medical oncologists are just now beginning to take a more prominent role in PCa, they may not be very experienced or even knowledgeable.

Case in point is my current local oncologist. While he is highly respected, particularly with breast cancer, his knowledge of prostate cancer seems to be more limited. For example, he failed to order standard tests for my hormone treatments, and gave me inaccurate information, such as that erections wouldn't happen when on Lupron.

Still, post-surgery, a good urologist is no match for a good medical oncologist specializing in prostate cancer -- if you can find one. The urologist is a surgeon and spends his time with other issues and training, and can rarely be an expert in all the treatment options for PCa. I ended up finding a specialist in California who works with my local GP. I essentially use my local oncologist to get my Lupron shots.

Of course, for a simple PSA test, your GP would do just fine. But if the cancer comes back, you might think of switching to a medical oncologist.

Nellie
Posted 10/14/2011 1:00 PM (GMT 0)
Mine is about 40 minutes away and I have no intention of seeing anyone else, he's a keeper.  So far I'm in the zero club so he gave me the option of just seeing him every 6 months, and for the 3 month PSA he would call me with the result.

This is possible because they don't do the blood test in the office here. At my appt, the doctor gives me a req. form for the blood and urine tests he'll want done for the next 3 month appt. If I'm skipping an appointment, he gives me 2 req. forms.

A few days before the appointment I go to our local hospital where the  lab collects samples between 7 and 10 in the morning to be sent for testing. The results are then sent to my urologist and family doctor.

 

Posted 10/14/2011 1:04 PM (GMT 0)
I also dropped my surgeon when a had a BCR, switched to medical and radiation oncologists and haven't seen my surgeon or any uro since. After my six month appt with my very busy surgeon, he suggested that I go back to my original uro if it was more convenient for me.
Posted 10/14/2011 1:06 PM (GMT 0)
My surgeon is also my urologist and only 4 miles from my house. He is in the same medical building as my GP. I will keep him as long as I live where we are now. He does his PSA testing in house so I know all future tests will be on the same equipment and any changes will not be because of different labs doing the work. He is  also an ED specialist and I will be seeing him until  things return back to normal if it does.

Terry

Posted 10/14/2011 2:14 PM (GMT 0)
my urologist did the RP, but when i had a PSA rise, he transferred me over to the radiation oncologist.  all my followups and PSA's have been with the RO, but personally, if i wanted to talk serious ED questions, i'd go back to my urologist.  maybe that's just me and how i get along with my doctors...

bob

 

Posted 10/14/2011 3:18 PM (GMT 0)
Switched from my urologist who did the RP to one who knew more about (and was more willing to treat) ED.
Posted 10/14/2011 3:32 PM (GMT 0)
I still see my uro/surgeon 3 years after surgery. He still does all my PSA tests, and has since 2007. Even my oncogist has no problems with this arangement, as he's a big believer in consistency with PSA tests. My uro simply forwards him the results.

david in sc
Posted 10/14/2011 4:51 PM (GMT 0)
My experience is the same as BB_FAN..I let my GP who has an office right up the street and I can get an appointment anytime, I let him do the routine PSA, "T" and other blood work..My radiation oncologist gets copies of these test reports..Every 6 months we get together and talk about baseball and barbeques..At the 6 month check-up, my surgeon told me "You and I are done"..I replied "Sounds good to me doc..." Haven't seen him since...

I REALLY want to get off the Eligard and see if my PSA will behave without it..My R-doc wants me to endure a full 2 years before we "find out" ......
Posted 10/14/2011 5:05 PM (GMT 0)
I'm keeping my urologist(surgeon), he is half an hour from us. He is cocky but very confident which works for me.
Posted 10/14/2011 6:22 PM (GMT 0)
Since being passed on from the uro who did my biopsy I see the same urologist (or his assistant). When I was referred to the RT doc it was only a few yards away across the hall in the same hospital, and the uro's assistant sat in when the RT discussed my case.
It was agreed that I would stick with them, and that my blood tests would all be done at their lab.
it takes me about an hour to get to the hospital which is fine for me.
I now have alternate appointments with uro and RT.

Alf
Posted 10/14/2011 9:39 PM (GMT 0)
I still go to the same medical practice but my Uro is no longer practicing. He is now a director of DaVinci training at a local hospital.
Posted 10/14/2011 10:21 PM (GMT 0)
I trevelled four hours to the City of Hope for surgery. After my surgery, my surgeon and I only spoke on the phone about my post op pathology. He suggested that we turn things over to who is my oncologist today. I never went back to see my surgeon for my follow up care. It wasn't necessary. I healed well and I was under the care of a great doctor.

But that wasn't the last time I saw him. Tim Wilson is well known surgeon and he speaks at major events regularly. When I went to the AUA conference in 2010 he was there at the Intuitive Surgical booth and we hooked up for the first time since my 2007 surgery. At this point I was a support group leader and I invited him t travel to Las Vegas for a speaking engagement ~ and he obliged. He was also at the PCRI conference this, and in past, years. I keep him in the sights just in case I need him to come out to speak. LOL, and with my oncologist I have some great guest speakers...

Tony
Posted 10/14/2011 11:51 PM (GMT 0)
I have asked to be seen by the surgeon who did the RALP, and it seems like he was reluctant at first, but came around to the idea. He said if everyone he did RALP on switched to him then he would be overloaded schedulewise.
Posted 10/15/2011 12:40 AM (GMT 0)

Right after I had my RP three and a half years ago, my uro/surgeon told me that I would be his patient for the rest of my life. So far he has been right. When I had recurrance 18 months later he placed me in the careful hands of a radiation oncologist. Throughout that time I saw my uro/surg every 6 months for follow-up visits and every 6 months I also saw my rad onc. We timed it so that I was seen every 3 months by one or the other. A year after RT, I once again had recurrance and both dr's felt HT was next. HOWEVER, my rad onc wanted me on HT for the rest of my life. My uro/surg. suggested we move slowly and consider IHT. I am seen only by him now and after 6 months on Zoladex, I am now off cycle and had my last injection last February. My GP has always stayed in the loop and I see him for special appointments once or twice a year. My uro/surg. would not hesitate to send me to someone else if I needed treatment beyond his skill level. Actually I don't feel that there is anyone else I really trust with my health other than him. He was right; at present I continue to see him every 3 months.

Jack 

Posted 10/16/2011 11:28 AM (GMT 0)
My local uro sent me to a surgeon 2 hrs away for my RALP. Although he seems to have done a decent job, I consider him a line surgeon. 4 per day. I saw him twice post surgery and he released me from his care. I was a little surprised, but it reinforced my notion that he was an assembly line surgeon. He had nothing to say about post operative options should PSA increase, leaving it to my local uro.
Posted 10/16/2011 1:08 PM (GMT 0)
I'm currently going through a bit of a dilemma. I very much like my currently urologist but he's fairly young and if I do opt for surgery I would like someone with more experience. I don't know if it's kosher to have a urologist but have someone else do the surgery or if that doesn't make sense because your surgeon should be the one to do follow up. Anyone else been in this position?
Posted 10/16/2011 2:00 PM (GMT 0)
I definitely said thanks but no thanks to my urologist and went with a more experienced guy. My urologist had done somewhere in the neighborhood of 300-400 surgeries. Don't recall exactly. He told me the learning curve was 250. I went with a guy who had done thousands and had a policy of doing them all himself. So I "let go" my local guy and headed to the city for a big time guy. That's the other advantage these big names in cities have, just because of location and medical affiliation they are bound to get much more traffic and more traffic means more experience. I feel strongly that more experience typically results in better results.
Posted 10/16/2011 6:59 PM (GMT 0)
More isn't always better, got to be careful of these assembly line surgeons, that push many through a day. Once the learning curve has been accomplished, i would be looking for the quality of the surgery, not the sheer body count. due to the complication of the surgery, i was glad that my surgeon never does more than one a day, and when he does a RP, that is he only surgery for the day. I had him fresh, with me as the only patient on his mind. Don't be fooled by some of these big name surgeons with huge numbers, they often only assist with each surgery, not actually perform the entire surgery.

david in sc
Posted 10/16/2011 8:40 PM (GMT 0)
Actually 5 surgeries a week is a pretty good nimber for any surgeon doing RP's. My surgeon, the busiest in my area did 4 per week max. He operated on Tuesday and Thursday doing one in the morning and one in the afternoon.
Posted 10/17/2011 1:53 AM (GMT 0)
"Anyone else been in this position?" <Dreamer>

Once you lose interest in them. they will most certainly lose interest in you..

If you travel to find a "name" surgeon, don't expect your local surgeon, who you rejected, to welcome you back..That's not how the game is played...
Posted 10/17/2011 2:33 AM (GMT 0)
My local uro was pretty unhappy when I decided to go with another surgeon who was considered the best in the area. but I had to consider what was my best course of action. The local guy was much less experienced, and clearly I was to be another notch in his belt. Luckily I am in a area where it wouldn't have been hard to find another good uro.
Posted 10/17/2011 9:13 AM (GMT 0)
The surgeon who did my op is a mystery man. He came to see me the morning after my surgery to tell me what he had done etc, he was with me about 10 mins and I have not seen him since, only seen his minions or nurses, but I have been told that he was an experienced man in the davinci proceedure.

This is the NHS in England so is probably par for the course, but I must say I was treated well and quickly.

I am now 30 months out from surgery, psa is zero, no incontinence, but ed persists, but I can live with that along with an understanding and thoughtfull wife.

All the best from England.

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