HealingWell
Search Close Search
☰

Who's the quarterback?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/22/2014 12:19 AM (GMT 0)
Hi all. My father is a little over halfway through his radiation treatment. One question we haven't gotten a satisfactory answer to is who is supposed to oversee his treatment after radiation. My father wants to stick with the hospital system that has done the radiation, and his original urologist is not part of that system and therefore not the preferred option. The radiation oncologist sounds like he is out of the picture once the radiation is over. What kind of doctor should take over from here?

I should add that my father didn't have surgery, so there are none of those issues involved.
Posted 10/22/2014 1:29 AM (GMT 0)
I would think it would be his urologist so they can schedule psa tests. I had surgery but after three months I returned to my urologist. I hope that your father is doing well.
Michael
Posted 10/22/2014 1:49 AM (GMT 0)
With your father's stats, I would suggest finding a good Medical Oncologist, with experience in PC. Wouldn't hurt to get one familiar with his case, and while waiting to see if the radiation he is undergoing is going to be effective in stopping his cancer. Just my take.

David
Posted 10/22/2014 2:23 AM (GMT 0)
Yes, the RO usually is only around during treatment then hands you back to whoever referred you. They don't monitor long term. Normally you go back to a URO because most PC cases start there. For low/intermediate cases that is just fine as all you need is follow up PSA monitoring and treatment for some symptoms like ED, urgency and such that a URO would treat. That's what it's like for me - my GP detected the rise in PSA, then sent me to the URO for biopsy. Then I went to the cancer clinic where I decided on IMRT and was put under the care of a RO. Now it's back through the chain. My URO follows me for PSA monitoring and ED meds while my GP is still in charge of my over all case.

But with your father's case at G8 I am with David - you should look into getting a medical Oncologist who knows PC to follow you after RT. The reality is likely that you'll need to build a medical team. It will also depend on the outcome of the RT. If it works, then a URO monitoring PSA and treating side effects is fine but if it doesn't you'll want more than just a URO on your side. If the medical system you're in now has a good URO on staff and a good oncology department you can consult with that might be okay.

Hang in there,
Andrew
Posted 10/22/2014 3:43 AM (GMT 0)
In my experience the RO and uro are both on board. I see my R0 once a year since treatment and I see my uro twice a year. I also see my primary twice a year. My Uro sends them both notes about my tests and status. I want my RO on board as I move forward -- another set of eyes and another opinion, given that the decisions are ultimately my own.
Posted 10/22/2014 8:34 AM (GMT 0)
My RO also turned me back over to my Uro for regular PSA monitoring but did say he would like to see me in a year just to find out how I am doing.

Interesting side not concerning the MO. When I was looking to start radiation, I made contact with a MO. His first question was, "Why do you want to see me, you need a RO?" He then explained he is the doctor of last resorts so to speak. When everything else fails that is when I need to see him for such things as chemo etc. After reading other post on this community I was kind of stunned by his response. I told him I was under the impression it was a good idea to involve a MO and wanted the benefit of his advice. While he was very polite and answered all questions I could think of, I really got the impression that I was wasting my time and his for any future visits until and unless radiation failed. I have heard good reports from friends and relatives about this MO so I see no reason not to use him in the future, if it comes to that point. I certainly don't want to dissuade anyone from contacting a MO if they are in a similar situation, I just wanted to share my experience.
Posted 10/22/2014 11:38 AM (GMT 0)
My uro is the lead and I see him quarterly and have a PSA draw. I see my rad-onc once a year and that will probably stop after the next visit (five years). I have consulted a med-onc for confirmation of the initial plan and to be in his files should I have a recurrance. My uro's practice also has a urologic onc that I have met, but not consulted.

If your father wants to stay in the hospital system he will be assigned the docs in most cases. If your father likes the current uro and he is good at treating prostate cancer, why not stay with him? As to the med onc, I would get ready to see one, but I imagine they will defer involvement until there is an indication that the radiation has not put him in remission. You will know this either through PSA progression or involvement that appears on scans.
Posted 10/22/2014 2:20 PM (GMT 0)
My RO wants follow up visits periodically. Every three months or so for a while. My MO is taking care of the ADT shots and does the lab work (PSA, etc) every three months. The MO also is going to continue after the ADT is finishes. My MO deals only with urological cancers. I have completely cut ties with the urologist. I have a uro I like if I ever need one again. They also communicate with my PCP.
Posted 10/22/2014 2:53 PM (GMT 0)
I understand your father's feelings toward his RO.

I had surgery and now go back to my uro for follow ups but I go see my surgeon's office once a year.

It feels like home when I go back to the hospital and surgeon who took care of me. They laughed and said I can come back anytime I feel like it.


Bill from Florida cool
✚ New Topic ✚ Reply