Finding a Med Onc difficulty.

My psa has been steadily rising. I was pulling 0's for 35 months after RRP. It rose to .8 in 42 months and then, BAM! 1.6 90 days later. Retest confirmed. Everyone seems to say find an MO that specializes in PCa. There has been some sort of shake up with the premier cancer center here in San Antonio, TX. I can't seem to find an MO that specializes in PCa. They all seem to be just general MO's. I can move to anywhere in the country, but my small support system is here.

I am aware that the next popular step is SRT if no proof of systemic spread. Last week bone and CT scans came back clean, so maybe I should consider a PET scan next. This dramatic jump in psa has rattled my cage.
My (New to me)family doc referred me to Hematologist and wants me to find a Uro. I don't agree and am not sure if I need to continue looking for another primary doc. yet.
All input is welcome, thanks.

Hello Startech....Sad to say, very few MO's specialize solely in prostate cancer...Here in Denver, there are more Urologists who are also surgeons who have been trained to treat advanced prostate cancer. They are quite frankly, in competition with the MO's for your business..

You probably don't want to hear this, but YOUR case, 5 + 4= 9, PSA at diagnosis 50, puts you in the very high risk category. It's a completely different animal than the Gleason 6 or 3=4=7 guys who make up the vast majority of PC patients. Perhaps you should visit one of the big teaching hospitals / research centers, meet with their doctors and get a complete evaluation and a recommended treatment plan..MD Anderson in Texas and Dana-Farber in Boston are two of the best but they are ALL good..The Cleveland Clinic, City of Hope and Stanford University on the West Coast, Anschutz in Denver are all right up there....You may choose to be treated at one of these big name cancer treatment centers or bring their written evaluation back to your home-town facility and talk it over with the local people. But your numbers say get moving on this now. Best of luck to you......

I have no idea who you are referring to when you write "Everyone seems to say find an MO that specializes in PCa." Why wouldn't you want to exhaust curative options first? Granted, with your high and rapidly increasing PSA, it may be too late for that, but I think it's worth an effort.

I agree that the next step should be an Axumin PET scan. If that fails to find any distant metastases, you may still be cured if you talk to a radiation oncologist.

If there are distant mets, hormone therapy is your most appropriate next step. For that you should seek out an MO. In UT Health in San Antonio, you have Ronald Rodriguez, who did some impressive studies while he was at Johns Hopkins.

Oh I don't know TA. I'm pretty sure I have read it on here several times like the post 1.5 hours before your post. As much as I value your input, I'm not sure it's worth your condescending attitude. I let the first few slide.

Thanks much to you all for your input, I really do appreciate it as it helps very much. I had given up on a cure with the low chances of success in my case after consulting with Dr Ronald Rodriquez 2 years ago. I left thinking he was a specialist with kidney cancer with some dabling with PCa. He was my surgeons partner that has now left UTHSCSA and gone elsewhere. I still have recordings and will review them since it's been a couple of years now. UTHSCSA now has the Axumin PET Scan and has become M D Anderson right here.

So I guess I have everything right here and you all helped me realize that. Thank you and goodbye.

Post Edited (Startech) : 7/10/2018 8:34:25 AM (GMT-6)

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Hello TA, I am sorry you felt I was attacking you and wasn't being civil. Please note that I wrote "This dramatic jump in psa has rattled my cage." and "I value your input". At the time I felt your post basically killed any more MO suggestions. Maybe I should have wrote "with great power, comes great responsibility" because you have become such a great contributor to this forum. I hope you will accept my olive branch because I still value your input.

You might want to check out Dr. Luke Nordquist in Omaha. All he does is Uro cancer. Prostate Testticular and Kidney. You won't be sorry

Carl

Keep me posted Guy. If you want to bounce some Ideas on me feel free to call at any time.

Cajun Jeff