Advice on doctor/facility

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BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 2/11/2010 6:34 AM (GMT -6)   
I have had a recent increase in PSA less than one year after surgery. Still less than .1 and must be confirmed through futher testing. However, since I had a geason 8 tumor, I want to prepare for the possibility that I will need further treatment. I read of a survey that indicted high risk individuals have better survival rates at national cancer facilities. I am going to make a appontment to see someone at Yale. Was wondering if anyone had a recommendation for a doctor at that facility. Also, does the doctor really matter, or is the facility chosen more important. I could need a medical oncologist, radiologist or both. Any advice would be appreciated.
Dx with PC Dec 2008, PSA 3.4, Biopsy: T1c, Geason 7

LARP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa April 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 2/11/2010 7:54 AM (GMT -6)   
Since the facility doesn't have the ability to make life or death decissions - I'd put my money on the Doctorsmilewinkgrin
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 2/11/2010 8:46 AM (GMT -6)   
Dr. Strum has urged patients to focus on the doctor, rather than the institution.  (He sometimes refers to allegiance to an institution, without regard to the particular doctor, as "edifice complex"). 
 
 
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/11/2010 9:00 AM (GMT -6)   
You need a good radiation oncologist for starters. He/she will determine what you need and how it will be delivered and will monitor you. Even a good local radiation center will have up to date hardware and means to deliver the "plan" once it has been "mapped.".

Most will want to wait to see if you have true recurrance to begin with, which will be 3 consecutive rises above .10, no matter how small they are.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 2/11/2010 1:37 PM (GMT -6)   
Thank you for your advice. I agree Dr is very important. I guess that I am looking for the best of both worlds. Top notch Dr at a top notch facility. I heard that the facility can open doors to new treatments and/or clinical trials that may not be available everywhere, and Drs at those facilities may be aware of and familiar with new treatments.
Dx with PC Dec 2008, PSA 3.4, Biopsy: T1c, Geason 7

Robotic Surgery March 2009 Hartford Hospital
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05

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