Doctor search

I'm in the decision and education phase being recently diagnosed. G6, 5/12, T1c N0 M0. Only talked to surgeons who recommend RP. Seeing radiology next week for their opinion. Anyone use Dr Givens at Urology of Va that could tell about their experience.

No on the AS because I am 5 of 12 positive on the biopsy. Is there a better place in this forum to research doctors. Thank you for the response.

Sorry about your diagnosis. I'm on the west coast so can't help with any east coast referrals, but hopefully some others can weigh in soon. (Although there's less traffic here on the weekends...) The radiation part is more difficult to research since there are so many types. (FWIW, some of the most favorable radiation reports here are from guys that have had SBRT or HDR brachytherapy.)

One thing that you could do at this stage is to get a second opinion on your biopsy slides from John Hopkins. The newly diagnosed sticky explains how to do that--it's cheap (maybe even free, depending on your insurance) and easy. If I were you, I'd want verification that I was really a G6.

BTW, I also wouldn't exclude AS a possibility. Any kind of radical treatment will change your life. I'm not saying it will debilitate you by any means, but you will be different when you come out of the other side of the rabbit hole. At the very least, your diagnosis gives you tons of time to make a treatment decision so I'd take advantage of that. My brother had similar stats to yours and he took about a year before being treated.

Good luck to you and I hope we can be helpful to you!

My urologist also balked at getting a second opinion on the biopsy slides and told me it wasn't necessary. But I did have it done and in my case it resulted in an upgrade of Gleason 8 to Gleason 9, which was important info as I assessed my options. JHU has a lab that reads nothing but prostate cancer slides, while other hospital pathologists look at all kinds of slides.

I also wouldn't expect a second reading to come back negative (although it could). I think it's more a matter of confirming the G6 diagnosis. If any of the cores changed to a G7 that would change your risk category. And if you were confirmed G6 you could move forward knowing that you're in the low risk category.

I'm under the impression that JHU has good surgeons, but I'm less sure about their ROs. Others here are much more knowledgable about who are the various top guys in their fields.

Malcolm,
You've gotten some good advice so far, but often things are slow here over the weekends. That shouldn't be a problem for you, though, since your pathology report of G6 puts you into the low risk category, which means that you have a lot of time to be able to learn about treatment options (including active surveillance), and to decide what, if any, is appropriate for you at this time. Don't underestimate the value of being able to delay treatment for a while. All of the treatments, aside from AS, have some form of side effects, and the sooner you are treated, the longer you get to live with the side effects. Take your time to be sure that you make the choice that is best for you.

Tall Allen makes a good point (well, probably several, but I will focus on one). Whichever mode of treatment you want to learn about, be sure to consult with a doctor who does that particular treatment. For example, if you want to learn all about SBRT, but you meet with a radiation oncologist who only does IMRT, you won't likely get the full story. Each of these docs is really only qualified to tell the whole story about those treatment modes that they regularly practice. They may know a lot about the others, but they have no reason to stay up-to-date on those they don't offer. They may tell you that they know all about the others, but why would they? They can't offer those, and can't make any money convincing you to select a treatment that they can't offer to you. I don't mean to be blunt about it, but the medical profession is a business, too. I don't hold it against them, I just work within the system to get what I feel is best for me.

As you can see in my signature, my pathology wasn't that different than yours, and I chose SBRT after almost 3 months of learning. For me, so far, so good. I have no regrets. I am NOT saying that you should select the same treatment. I AM saying that you should follow a process much as I did, in which you learn which treatments could be appropriate to your pathology, learn all you can about them, and then YOU choose which one you feel is best for you. It wasn't the easiest process for me, but I do sleep well at night after having employed it in my treatment choice.

Malcolm, for my initial treatment, I went to Hampton Proton Therapy Institute where Dr. Sinesi was my RO.

For my recurrence, The RO's I conferred with were Dr. Givens, Dr. Ansel at VCU and Dr. Robert Lee at Duke. In reference to your question, I thought Dr. Givens was well-qualified.

I didn't use any because I chose to go with cryoablation at Duke.

Note: My neighbor used Dr. Fabrizio (sp?) at Urology of VA for a Radical Prostatectomy back in 2010 and has just celebrated 7 years of <.01 PSA.

I'm in Virginia Beach, feel free to reach out if you need more info.