Who Should Do HT?

I've been told that a MO isn't necessary until HT fails. And a Uro or RO can administer HT. But others will jump in I'm sure. Sorry you need to have treatment again!
Bob

My MO in TN said to carry on my HT care through my urologist there. She said, "No offense, but I hope you never have to see me again!".

When I moved to MI, I learned of a high profile MO here and decided to see her and ask her about the right person to manage my HT and long-term follow up. She agreed in my case an MO might be the right one, so I stayed with her care. I'm not sure it matters a lot. A good urologist might be the best overall quarterback for prostate cancer care, considering how central the prostate is to our male urogenital system.

My lead doc has been my urologist and he administered ADT. My RO and MO agreed. If I have a recurrence, I will go to the MO. Some people have their GP administer ADT. Basically any doc can do so. You just have to monitor T and PSA to make sure you arte getting the desired effect.

GFB said...
Who should take care of HT, urologist or medical oncologist?

HT is used in many different circumstances, so there is no one general answer. Also the term "take care" is vague.

The doctor who prescribes HT will be an RO if you are having it adjuvant to radiation therapy; it will be an MO if you are seeing an MO for lifelong management of incurable PC; or it may be a urologist (or an MO) if you are getting it for palliative purposes on watchful waiting.

Who administers the HT may be different. Assuming you are talking about an injectable, like Lupron, and not just pills, like Casodex, you should have it administered wherever it is less expensive. If your RO, for example, works in a hospital facility, you may incur hospital-use charges if you get your injection there. But if you get the same injection administered by your GP in his own office, you will only be charged for the cost of the drug and the GP visit.

I don't see why your age is a factor unless you have serious comorbidities.

Remind me where the nodule was? If it was detected by DRE, I assume it was in your prostate. If that is the case, and there are no distant mets detected, you may be cured simply by re-treatment - just placing some extra seeds where that nodule is.

Click on the following link to see your odds that your recurrence is not salvageable:

Most of the recurrences after primary radiation failure are salvageable

The following article shows that salvage brachytherapy can sometimes be curative after primary brachytherapy failure:

Salvage Low Dose Rate Brachytherapy (LDRBT) after primary LDRBT failure

To have this done, it is a good idea to visit one of the centers that has experience in this sort of thing, like UCSF or Memorial Sloan Kettering. It's always good to get second opinions from top specialists.