Just wondering????

I think that only a very few places, like Memorial Sloan Kettering, routinely put together a team. To have it work requires a good information-sharing mechanism -- regular meetings and/or good online info sharing.

Where they don't have it already set up, it's possible to put together one's own team. For my friend with advanced PC, we've so far put together a "team" that includes Dr. Scholz's team at Prostate Oncology Specialists, imaging at Arizona Molecular Imaging, and at UCLA, a radiation oncologist, an oncologist and an immunologist. My friend takes on the burden of sharing updates on the meetings and distributing DVDs and reports, as well as dealing with his insurance company with his doctors' help. It's vital to obtain and keep copies of everything. Other teams may include sexual medicine doctors, urologists, social workers, psychologists, cardiologists, etc., depending on the individual's needs. The advantage is that we can include doctors from anywhere, but it can be a lot of work to coordinate the activities of lots of doctors in different places.

I'm not sure if this would be the same kind of team we're talking about, but my uro/surgeon at Mayo Clinic has a staff of doctors who work with him. Along with my surgeon, himself, I have had private appointments with the others as well.

One of them went over all the pre-op stuff with me and the other has asked me pre and post-op questions to gauge my progress. She also prescribes the meds for me, such as Cialis, etc.

So they seem to work in conjunction with my surgeon. They are not specialists in other forms of treatment (such as radiation), though, so they are all working together to assist the surgeon with my case. Naturally, Mayo sees thousands of patients and the surgeon has a couple days a week in surgery, so I guess each uro has a staff of other doctors who assist him in completing the full picture for each patient.

It all works very well, just like clockwork.

I imagine every doctor across the country, every clinic, has its own system that works best for them and their patients, so there are probably variations of this everywhere. I suppose it can also be a bit different if a uro practices from his/her own private office -- a different process than at a clinic, etc.

Anyway, for whatever it's worth, this is what my own personal experience has been with my prostate cancer situation.

Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.

I had it explained to me that the medical oncologist is the quarterback of the team of doctors. He carefully designs the treatment plans and coordinates closely with the U.O., R.O and the plethora of other doctors mentioned above.

My M.O. lives in Las Vegas and I fly down to see him. He is amazing and demands constant communication with the other oncologists treating me. He even gets my internist involved with the treatment plan, notes of the treatments, etc.

Steelguy, Way to go on your current stats. I too am a G9 and so happy that you PSA is so low. I am so happy for you.

I had visits with a number of doctors, but my lead is my Uro/surgeon. When RT became an evident need, I added an RO for that, but the RO did not desire to be involved in any continuing treatment, and handed me back to the uro at the end of RT.

I have a medical oncologist, but he is happy with how my uro is handling things, and suggests that the office fees he charges would be wasted money in my situation. He is on record, and I can consult with him should I need to.

My GP sees me every six months, and gets copies of all of my medical activities.

So, do I sit in a room with a table of multiple doctors? No.  Do I have a "team"? Only if I need a "team".