Urologist vs Oncologist?

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Regular Member

Date Joined Apr 2008
Total Posts : 65
   Posted 4/26/2008 7:55 AM (GMT -6)   
confused  Good morning everyone,
I continue to be amazed with the positive energy on this site and hope to some day (soon) reach a point of feeling positive. I am working toward that goal. In the meantime, I continue to have questions. If any one can help I would appreciate it.
Is an Uroligist more knowledgable about this disease than an Oncologist? My husband is currently seeing both as he receives his Lupron Inj. from the Urologist and his Zometa IV from the Oncologist. When he began having a lot of blood in his urine, the oncologist was concerned and the Urologist said that he is not worried at this time because my husband's tumor is so big (187cc) and that cancer bleeds. He said it is okay if it is a lot or a little blood. Does this sound logical?
As I read the postings here, I have not found someone who went directly to HT as the only option. Are the doctors saving other options for a later time? It sounds like there is not a lot to do if the HT does not work, although I currently read War Eagles posting who is now having Chemo. (His story is very inspiring and I pray he continues to have lower PSA). Why do the doctors wait for Chemo?
Does HT help to shrink the tumors? Does it take a really long time?
So many questions--I did purchase the book about HT and Prostate Cancer as recommended here, but I am still awaiting its arrival. I am trying to read as much as possible about this disease as it helps me have a focus.
I am glad I found this site where the feeling of understanding and compassion is so evident.
God Bless,
Karen--New York
Husbands Info:
Age of diagnosis--62
2/28/08--PSA 279   DRE--positive/rock hard
Flomax and Casadex started
Biopsy--3/7/08--187cc--Gleason 10--12 of 12 positive--Perineural and LV invasion identified
T4 bone met.--hydroureteronephrosis/right kidney
3/28/08--Lupron Inj. started
4/7/08--Zometa IV started

Regular Member

Date Joined Apr 2008
Total Posts : 62
   Posted 4/26/2008 9:12 AM (GMT -6)   
Hello Karen,
I'm on Intermittent Androgen Blockade Therapy as a first stab at attacking PCa.
Hormone therapy shrinks the prostate so should hopefully stop the blood in the urine.
There are several alternative remedies (other than RP or RT) although none are mainstream.
I suggest you read through the articles on the Dr. Bob Leibowitz web site at . . .
Good luck.

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 4/26/2008 9:25 AM (GMT -6)   
All great questions! I hope there are no urologists on this site that might get offended at this comment, but think of the urologist as a male's version of a gynecologist :-) They specialize in only that particular area for a male. Oncologist's specialize in cancer. Therefore, it is great to have a team made up of these two specialist treating your husband, because they are able to offer valuable insight and advice from their own areas of expertise. Anything related to the bladder, erections etc. ask the urologist. Anything related to overall cancer, ask the oncologist. Hopefully your two specialists are consulting on the best treatment options for your husband. It can get really confusing win they disagree.
As the previous post states, the HT is meant to shrink the cancer. Often times men will do well on HT alone for years. I hope this is the case for your husband. Chemo is typically added when HT stops working and there are not a lot of mainstream options after that point, BUT, studies are being done as I sit here and type this and HT and Chemo can buy a lot of time. Hang in there and keep in touch!!


Father's Information
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7
Post Surgery Gleason- 4+3=7
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin
One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
T3a N1 M0
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupron beg. Dec 03, 2007 2 yr
Radiation started March 03-April 22, 2008- 8 weeks 5x a week
8 weeks of radiation down!!!
Praying for a cured dad. First PSA 3 months!


Post edited to single space signture...

Post Edited By Moderator (bluebird) : 4/26/2008 9:42:24 PM (GMT-6)

Veteran Member

Date Joined Feb 2007
Total Posts : 1219
   Posted 4/26/2008 10:51 AM (GMT -6)   
My husband was put on HT not long after surgery. The cancer had already metastasized outside the prostate bed to distant lymph nodes.
Doting has given a good description of the purpose of HT. The hope is to have the effectiveness of HT last as long a possible - then there is chemo & possible radiation.
There are many on line sites that can help you - there is a list of them in Bluebird's post:
Prostate Cancer Resources and Direct Links to Sites, Videos, Books, etc. to help with your research! This is the second post on the pc forum.

Keep posting,
Husband Diagnosed 11/17/05 Age: 63 PSA: 7.96 No Symptoms
2/09/06: LRP - Post Pathology - Gleason 4+3 Stage T2b NO MX
3 mo. PSA: 11.8 Stage T3a
6 mo. PSA: 18.8 Stage IV Systemic w/ distant lymph node involvement
Start HT - Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
PSA - Undetectable since 6/07/07

Link to journey:

Regular Member

Date Joined Feb 2008
Total Posts : 467
   Posted 4/26/2008 11:03 AM (GMT -6)   


Best wishes for success in your journey.

Re. the shots, the urologist gives the Lupron because that drug is used for a variety of things of a urological nature, not just to treat prostate cancer.

Zometa IV is a cancer drug used for prostate cancer treatment, breat cancer treatment, etc., so it falls within the turf of the oncologist.

Hope this helps a bit.


Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008

Veteran Member

Date Joined Jun 2005
Total Posts : 528
   Posted 4/26/2008 1:53 PM (GMT -6)   
Having abandoned/fired my urologist, I've gotten my last 2 Lupron shots from my oncologist. Six of one, half a dozen of the other.

1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.

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