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do I need my urologist?

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Posted 11/21/2019 12:24 AM (GMT 0)
It's been two years since I completed SRT and my PSA remains undetectable. I get PSA tests through m y urologist, and see him every four months. Is there a good reason to continue these visits? I can get my PSA tested through my primary care provider. And if PSA rises, is a urologist the person to help with that?
Posted 11/21/2019 12:57 AM (GMT 0)

fiddlecanoe said...
Is there a good reason to continue these visits?

Cash flow for the Doc?
Posted 11/21/2019 1:03 AM (GMT 0)
Your PCP can do the PSA tests. A uro doesn't need to be involved - unless the numbers are rising. Under my health plan I was discharged from the urology department back to my PCP after I finished treatment. They have a "cancer monitoring" department that schedules tests, sends me and my PCP the results. I've been told that if the numbers don't fit into certain limits, they'll make a referral back to urology or I am free to make an appointment with the URO at anytime I want to discuss things (normally I get a phone appointment if I just have questions).

Andrew
Posted 11/21/2019 1:17 AM (GMT 0)
I just had my one year urologist check and their protocol is just annual visits for 5 years, PSA’s are at 3 mos. for two years and at 6 mos. for the next three years. At five years, I guess you do whatever you want after the last checkup since their chart ends there. In my case, their office is a mile further than my PCP on the way to Home Depot. I decided to stay with them for PSA’s since they have a good reminder system and it keeps it all in one place.

I asked my Uro about going to a MO at Mayo next if my PSA rises and he said to not think that way. If and when that happens, he would call and discuss options with me depending what the numbers are, otherwise enjoy life and see you in a year. Hard to argue with that.
Posted 11/21/2019 1:22 AM (GMT 0)
ps: I am on a Medicare Supplement plan so the tests are at no additional cost and I can go anywhere I want. Those on more restrictive health plans may have different protocols to follow as ITS said.
Posted 11/21/2019 1:25 AM (GMT 0)
I agree that it’s just fine to do your PSA tests with your PCP, if he is willing to do it every four months as you have been. You’re undetectable, but don’t get lazy with monitoring the PSA.

If your PSA ever becomes detectable, the next stop is a PCa MO - and NOT your Uro IMO. At this point in your treatment I would recommend a PSA test with a 0.1 cut off. No need for a more sensitive test after RP/SRT.
Posted 11/21/2019 2:06 AM (GMT 0)
Uros and MO's fight like dogs and cats for PC patients business..Did you have a Prostatectomy and was it performed by this uro ? If you had SRT then his surgery failed and from now on a MO should be calling the shots. For routine PSA tests, your PCP is the man to see..There are some uros who have cross trained and are also Urological Oncologists..
Posted 11/21/2019 2:22 AM (GMT 0)
my uro gave me the boot after about 5 years. he told me he didn't need to see me anymore but said he would continue to see me if that's what I wanted. now I get my annual PSA tests from my regular doctor. if my PSA were to rise i'd go back to my uro for at least a consultation.
Posted 11/21/2019 11:26 AM (GMT 0)
My seed doc had my psa checked every 4 months after implants for the first year. Second year once every 6 months, there after, once a year like the olden days. That's of course if the psa tests don't jump like crazy. I would say your uro is milking you.
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