Questions for Dr. Scholz

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compiler
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Date Joined Nov 2009
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   Posted 5/14/2011 1:09 PM (GMT -6)   
I thought this might be helpful for those of us about to consult with a good medical oncologist specializing in PC.
 
I am starting to formulate some questions to ask Dr. Scholz. I am just starting the file, but I plan to get my money's worth!
 
Here is what I have so far and I'm sure it will be greatly expanded. I seek comments and input. When I see Dr. Scholz I will be doing my first post-SRT PSA. I may not need any further tx., but it does seem the latest sentiment from the experts goes towards HT (perhaps regardless of the PSA). I'm not sure. But here is my small list:
 
(David -- this may be helpful to you for your upcoming meeting(s). Please add any questions you may have -- we can compare answers!)
 

Ask Dr. Scholz:

  1. Does my fast 2-month PSADT bode poorly for the success of ADT?

2) What PSA results or sequence of results will determine next step and what is the next step!

  1. What is the latest, up-to—date recommendations regarding diet/supplement.
  2. Realistically, what should I expect down the road in terms of OS and QOL. And what can we do to maximize both.
  3. I currently have a local urologist. Should I also have a local medical oncologist even if he/she is not an expert on PC
  4. Can we do telephone consultations and if so at what junctures?

 

Mel

 


Fairwind
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Date Joined Jul 2010
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   Posted 5/14/2011 2:54 PM (GMT -6)   
If you read his book, "Invasion Of The prostate Snatchers" , you pretty much learn everything there is to learn about Dr. Mark Scholz...Virtually every question you could ask is answered in the book...

I would FAX him your complete PC file, let him go over it, and when you have your face to face, let HIM do the talking! When he is done laying out his recommendations for you, then ask him some questions about THAT!

There is at least ONE patient who was not too impressed with Dr. Scholz...

www.ripoffreport.com/physicians/dr-mark-scholz/dr-mark-dr-mark-scholz-super-58wd9.htm

Post Edited (Fairwind) : 5/14/2011 3:23:32 PM (GMT-6)


compiler
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Date Joined Nov 2009
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   Posted 5/14/2011 6:14 PM (GMT -6)   
Fairwind:
 
His office has my complete file (it was sent as part of my new patient application).
 
The complaint from Anonymous was mostly about prices. His office people (I've spoken to a few of them) were extremely nice. They checked on a bunch of things for me (contacting my insurance to get some specifics) and they advised me up front regarding prices (the ones I quoted).
 
He does do telephone consulting and I think one of his patients said this was $45, but I'm not sure. I can find that out when I go there. I definitely want my first appointment to be face-to-face. If I feel he is arrogant, I will so indicate that on HW. Frankly, I found Strum, in his p2p postings, to be unbelievably arrogant, to the point where I would just not consider seeing him, despite his stellar reputation. Each to his own, I guess. Scholz's office did indicate that he will consult with doctors, for a fee. I agree almost all doctors do this for free, but usually that is just for some quick information.
 
Regarding his book, I have read some pretty negative things about the book, mostly about the very weird chapters written by his patient. Most of the reviewers indicated that Scholz's comments were very good. But I do have to question the doctor's judgment in picking such an idiot patient to work with. That was on the nagative side.
 
However, I also saw Scholz's videos and spoke with two patients. I was very impressed. Additionally, he works with Dr. Richard Lam, who is also among the very best PC experts. That could matter, in a pinch.
 
Regarding the questions, that would not be my first order of business. My first order is to get his input/expertise on my situations. Eventually, we will get to the "any questions" part!
 
 
 
 
Mel

davidg
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Date Joined Feb 2011
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   Posted 5/14/2011 6:17 PM (GMT -6)   
I would be curious to know what he charges someone who does AS with him over a 5-10 year period. I see the question come up often, even here. How much does it actually cost to do AS. I know this doesn't apply to your case and that you won't ask, but I think a forum like this would greatly benefit from knowing this so that it can be used for comparative purposes when newcomers ask.
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

davidg
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Date Joined Feb 2011
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   Posted 5/14/2011 6:30 PM (GMT -6)   
oh, and yeah, the diet question is of great interest to me.
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/14/2011 7:59 PM (GMT -6)   
fairwind,

glad you made me see the connection of who scholz is. i did read that book with the lame title. i am not taking away from the doctor's advice or expertise, i wouldn't know, but for me personally, i am not getting sucked into this celebrity type of doctor. i thought the book, while containing useful information, if you stayed away from the kooky patient's views, was just an attempt to exploit PC for money.

i read your link, and that is but one person's experience. i would have to see many more like that to be convinced it was a pattern with the doctor or his practice. if what was stated was accurate and literaly true, it would bother me a lot if i was considering him for advice.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 5/14/2011 10:46 PM (GMT -6)   
Mel,
While you are in his office I would take advantage of his library of articles on various PC topics. They are Xerox copies and available to all his patients.
Davidg.
Franchot who is undergoing AS from Dr Scholz did a complete breakdown of his costs. You can search for his post.
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 5/14/2011 11:02 PM (GMT -6)   
Fairwind,
Scholz consulted with three of my doctors and more than once with my radiologist and I was never charged a dime. I think if another doctor was doing the treatment the consulting doctor is entitled to a fee for his time.
Mel,
My 1st phone consult last year was $45 and my last a month ago was $75. Still cheaper than driving to Marina Del Rey.
JT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 5/15/2011 12:28 AM (GMT -6)   
Fairwind,
You have to look past that single complainer. With the number of patients that Mark Scholz has seen you need a lot more than that to risk saying anything judgmental. I once quoted a statement here that my oncologist stated and that is that 50% of doctors are below average. I see the point going both ways ~ and I will expand on that...50% of patient knowledge is below average patient knowledge. To what degree I am less surprised with each year of experience I see this but I am never totally unsurprised. Plus, I think 100% customer satisfaction is impossible in any business... I have no idea the particulars that set this patient off but the forum used, to my knowledge, is not an appropriate forum for patient complaints.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 12:46 AM (GMT -6)   
John T:
 
The phone consultation from a top doctor seems very reasonable. Unfortunately, I suspect my insurance will not cover ANY such consultations. Still, not bad at all.
 
I am pleased that he did not charge you for consulting with your doctors. I thought there was a charge.
 
I don't put much stock in one person's disgruntled opinion, especially when he is complaining about the prices and office staff, since I have been told the prices and the office staff has been wonderful over the telephone.
 
I guess I'll get my own impression when I go there.
 
John, did you get the feeling that he was arrogant and a know-it-all? Did he dictate a plan of action or did he consider your situation and discuss possibilities? (Feel free to email me the response if you feel awkward doing it on this HW)
 
David -- I agree with you about the book. That was the one negative that concerned me a lot, but as I said the other positive factors outweighed that one item.
 
Regarding "celebrity doctor," give me a break. He is unquestionably recognized as a top doctor. He has done excellent presentations. He is CLEARLY more knowledgeable than most. Why impugn the guy's integrity like that?
 
I'll withhold judgment until I see him. If it turns out I am wrong and he is a big DUD, I will certainly relay that information to my HW brothers. If that is the case, then I will have lost very little. But, of course, I would be quite disappointed!
 
 
 
 
 
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/15/2011 8:15 AM (GMT -6)   
Mel you said:

He is CLEARLY more knowledgeable than most. Why impugn the guy's integrity like that?

What I said prior:

i am not taking away from the doctor's advice or expertise, i wouldn't know, but for me personally, i am not getting sucked into this celebrity type of doctor. i thought the book, while containing useful information, if you stayed away from the kooky patient's views, was just an attempt to exploit PC for money.
 
As you can see, the devil's in the detail.  Never said anything about his knowledge or experience, and the key word following is "but for me personally".
 
Go back to to the post discussing the doctor's book, more than one person had a low opinion based on the book.
 
David in SC

Post Edited (Purgatory) : 5/15/2011 8:18:36 AM (GMT-6)


compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 9:52 AM (GMT -6)   
David:
 
No argument from me about the book. I've dealt with that in my posts in this thread. It was the ONLY negative in my analysis. As I said, the negative was that the doctor wrote the book with this very strange patient. The actual doctor's portion of the book was well-received.
 
I guess I don't understand your comment about "celebrity doctor." What makes him a celebrity? He is not Dr. Oz or Dr. Phil or Dr. Drew, etc. (and they seem to be pretty capable). But, yes, he wrote a book. So I guess you won't dare get sucked into seeing anyone who wrote a book? I'm not following the logic here, and I guess it relates to the concept of "celebrity doctor."
 
Mel

Fairwind
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Date Joined Jul 2010
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   Posted 5/15/2011 10:28 AM (GMT -6)   
If you Google "Dr. Mark Scholz" you will bring up over 4 pages of web-sites..he is a VERY popular doctor, or at least he gets a lot of press and TV time, guest appearances on talk shows, that kind of stuff..So no doubt he has a big ego.. But most prominent, successful people do...my R.O. thinks he is God....Fine with me. Your are not bragging if you can do what you claim you can do....So if you can get in the door and see him for four hundred bucks, that could be money well spent...Time will tell...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 10:48 AM (GMT -6)   
Fairwind:
 
It's a no-brainer. If I feel he is not the doctor for me, then it was still $400 well-spent because I can see Dr. Hussein at Umich.
 
I have to admit that my expectations are high.
 
Too high? We shall see.
 
Anyway, that's almost 2 months away!
 
Mel

Purgatory
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Date Joined Oct 2008
Total Posts : 25364
   Posted 5/15/2011 10:56 AM (GMT -6)   
fairwind - your post proves the point from my perspective.

mel - you got to do what you go to do, i hope you get good advice and feel you got your money's worth. i think its a better effort to hope your srt worked and you won't have to be dealling with advanced cancer. that would be the best outcome, and you probably won't really know if you have failure or not for at least 6-9 months.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 5/15/2011 11:32 AM (GMT -6)   
Mel,
I did not find him arrogant; although I could see how some would consider him that. I went to him origianally for a 2nd opinion after being Dxed with a low grade G6, after 10 years of being Dxed with BPH. He came right out and said that these DXs were wrong and the doctors I saw (6) didn't know what they were talking about. He clearly explained why these Dxs were wrong and my history reflected a serious case of PC that was yet undetected. He was absoutely correct. He gave me recommendations for futher tests and it was my choice to have them or not. Without the futher tests to exclude cancer spread he recommended full body radiation and at least 1 year of HT.When the tests came up clear and he put all the information together he felt that mono radiation would suffice. It was my choice to add seeds. He helped me find a radiologist and brachytherapist and checked out my brachytherapist credentials and reputation for no charge. He intervened when my radiologist wanted to give me one year of Lupron and convinced him that 6-9 months of Casodex would be just as effective with much less SEs. I'm more than pleased with the results seeing that my original DX and recommendation for surgery would have been a disaster. (nerve involvement and APEX tumor). He was also much more interested in my total health than any of my other doctors, requiring an echo cardiogram, bone density and a colonostopy. He stated that most of his patients die from other causes and he would be remiss if he did not treat the most probable cause of death.
He has some very strong opinions of PC and these may come across as being arrogant, but I would much rather someone be arrogent and right than very nice and dead wrong. He is very good at explaining and giving back up for what he recommends and was clearly more up to date in both futher testing needed for proper stageing and clearly points out all the SEs for various treatment options. He clearly feels that surgery is too invasive and is too high a QOL price to pay when other options are just as effective and also believes that AS is the best choice for many low risk PC patients. This may appear arrogant to many, but he readily gives his reasons for this opionion. As Tony states many times; 50% of doctors are below average. I would easily put Scholz in the top 1% from my experience with 9 doctors I have delt with for my PC. The knowledge gap was very clearly visible to even me.
JohnT
JT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 11:50 AM (GMT -6)   
Nice to read this, John. That is a glowing recommendation!
 
The next challenge for me might be following his advice!!
 
I have a sneaky suspicion that he might say I should do ADT regardless of the PSA result. I'm not sure I'm ready to do that!!
 
(Don't worry, I won't worry about THAT now!)
 
John, in their general commentary on prices, his office mentioned a color doppler and I see you had that done. Am I correct that it's main use is for dx. purposes for those WITH a prostate? In my case, without a prostate, no use for a color doppler (?).
 
Also, having had a colonoscopy in 2008, I might actually get to avoid that, too!! I would be very hesitant doing that anyway so soon after SRT.
 
It would seem an echocardiagram makes sense.
 
 
 
 
 
 
 
Mel
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/15/2011 12:47 PM (GMT -6)   
why would you want adt, even if you have no rise in psa post srt? wouldnt you rather want to wait and see if you even need to go down that path? you may not need it forever, if not for years to come.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/15/2011 1:27 PM (GMT -6)   
As I read yet another discussion about an "expert" doctor that should be seen if you really care about your disease, I get concerned.  Several people on this site insist that you can only be sure that you are on the right track if you see these few so-called "experts" in PC.  What seems to be forgotten are those of us who, because of financial hardship, lack of insurance, geographical location, or just plain satisfaction in what our "non-expert" doctors have done as far as treatment and are satisfied.  Then there are those men who get no treatment at all because of their economic status.  There are those who have no access to or skills in using a computer and can't partake of groups such as this.   I have been treated in a military hospital by military doctors and believe that I have had the best possible care.  I cringe and really wonder when I read that perhaps I should have had second opinions by these "experts".  There are those here on the board who have seen the "experts" and are no better off than those who have been treated by their hometown specialists. If a man has faith and trust in his physician and especially a long relationship, and is satisfied with his treatment, he should not be made to feel like a less than intelligent person for not seeking out the "experts" across the country.  We all want to be rid of this disease, but we each have to make our own decisions and should never be made to feel that we are less concerned about the outcome of our treatment than those who are "smart" enough and financially capable of seeing the "experts".  Sorry to rant, but over the past year and a half I have sometimes wondered if because I am not in the mainland USA and am using military doctors, that I have shortchanged myself and my family.  But, comparing my treatment and outcome to that of others here, I feel comfortable with the choices I have made and perhaps that is all that matters.  Slam away.  I'm an old Squid and can take it.
*Age 64, PSA July 2009 .66; Biopsy: 2 of 12 cores positive, Gleason 3 + 5
*open Surgery 10/22/09
*Post Surgery Biopsy Gleason 4 + 3; 2 positive margins
*03/11/10 - Bladder neck surgery for stricture
*PSA - 30 day/.07, 90 day/<.1, 180 day/.21
*07/27/10 - IGRT done - 39 zaps, 70 gys
*Post IGRT PSA - 9 mo. PSA, still <.1

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/15/2011 1:57 PM (GMT -6)   
Squid, that was very well spoken, and needs to be said from time to time. I have tried to make this point on a number of occasions, but not quite as eloquent and thorough as you. I agree fully with your sentiments, and wish you the best.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 2:04 PM (GMT -6)   
Squid:
 
I assume you are referring to my posts.
 
I really won't argue with you too much. You make excellent points. Clearly, what we can do is also a function of our health and resources. In many cases, the costs would be prohibitive. Also, in many cases, it is just way too difficult physically to travel.
 
In fact, I know one concern I have in the deeper recesses of my brain: fast forward and suppose one has advanced PC with significant, disabling symptoms. It would be great to have a great doctor locally.
 
All that being said, if you have complete confidence in your local medico and feel this person is extremely knowledgeable in advanced PC, that's fine. These folks are few and far between.
 
I have no confidence in anyone locally, in this tri-city area. (I live in a major tri-city area). We have a number of medical oncologists. NONE of them are true specialists in PC. One of them spoke at our local support group and in response to a very clear question, to wit "I recently had an RP; at what PSA level would SRT be required" he INSISTED that it was 2.0.
 
C'mon. We KNOW that's not true. We can debate 0.20 vs 0.30 vs. 0.50, but 2.0?? Yeah, if that person was not an internet person and just blindly relied on his great local oncologist, he could follow that VERY POOR advice. Fortunately, that participant knew better.
 
We are all dealing with a life-threatening illness. There are no guarantees. Period. I picked arguably the best surgeon. As David keeps reminding me, and I readily agree, it did not stop the BCR. Fortunately, I avoided incontinence and I recovered very well from the surgery, so at least that wasn't bungled. But there are no guarantees.
 
I am not amiss to going local if you have a good expert. In fact, my RO is local and I can only HOPE he is good and did a good job.
 
I maintain your chances are better when the doctor is better.
 
Mel

compiler
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Date Joined Nov 2009
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   Posted 5/15/2011 2:06 PM (GMT -6)   
Folks, this is really getting argumentative. Or maybe I am.
 
I did not mean to turn this thread into a "I love Dr. Spamodi" type thread.
 
I am seeking ideas on questions to ask Dr. Scholz, given my situation.
 
If we can get back to that original topic, I'm still seeking ideas.
 
Mel

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/15/2011 2:29 PM (GMT -6)   
Compiler, my rant was not meant specifically for you - just a general observation over a long period.  Not even especially relevant to your current post.  I just needed to get it off my chest.  Squid.

John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 5/15/2011 3:55 PM (GMT -6)   
Squid,
As one doctor told me when seeking recommendations " why would you ever want to see a doctor that is not the best in what he does". The same goes for just about any profession, lawyers, athletes and business consultants. I cost me just as much to see the best and probably much less considering the 10 years and countless office visits I spent fooling around with normal doctors.
No one is accusing anyone of being smart or not smart. I took me 10 years to come to this conclusion and I think I'm fairly intelligent. Insurance and Medicare rates are pretty standard and the best charge the same as the worst. For some travel is an issue, but it doen't seem to stop people from going on vacations. A few hundred dollars out of pocket is a small price to pay for something that will affect you for the rest of your life. The simple fact is that some doctors just know more than others and are more skilled. Getting the best on your team doesn't garentee success, but sure improves the probability of a successful outcome. Patients out of the country and in rural setting will always be at a disadvantage when seeking top notch professionals. I don't have a solution to this. But to argue that getting the best possibe doctor for the treatment you are undertaking is not important or won't result in a better outcome is contrary to established facts and common sense.
As Strum always says:
To achieve the most favorable result " choose the very best artist for the treatment that fits the biology of your cancer". This is reasonable and prudent advice for all PC patients. Why does it bother you that some patients take this advice to heart? I wish I had done it 12 years ago. Why does it make you feel any less because someone chooses to seek out the best? You can choose to see any doctor you wish, but to assume that because another patient seeks out a specialist, it somehow reflects poorly on your own decision just doesn't make any sense. This forum is about giving support and advice and a common peice of advice given is to get the best doctor possible. You may disagree with this and it's your right to accept or reject any advice given. Personally I think it is the best advice anyone can give to a new PC patient.
JohnT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

compiler
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Date Joined Nov 2009
Total Posts : 7197
   Posted 5/15/2011 4:30 PM (GMT -6)   
John:
 
Well said and much more eloquently than I.
 
I don't understand why some folks seem to feel threatened or insulted or angered or whatever it is when I express the desire to seek out the best available doctor and then act upon it.
 
I guess we all have a desire to defend our choices. This thread is akin to saying something like "I chose surgery and I don't understand why you would choose radiation as a primary tx." But this is even worse. How can one even question the fact that 1) You have a better chance of doing better with a better doctor (you best better believe it!) and 2) For most of us, the very best doctors are not local.
 
I can understand the financial points and the physical ability to travel points made. Those are valid points. But to "get something off your chest" (because somehow you've been insulted or what?) makes no sense.
 
I apologize for being so argumentative. I asked for possible additional questions, but instead folks seem to be questioning my desire to seek out the best possible physicians. I don't understand why.
 
David, I forgot to answer your post that said "why would you want adt, even if you have no rise in psa post srt? wouldnt you rather want to wait and see if you even need to go down that path? you may not need it forever, if not for years to come. "
 
 
Trust me, man. Like you, I ABSOLUTELY want NO PART of ADT. The latest research seems to be shifting towards advocating ADT even before SRT and now even post-SRT regardless of the PSA. At least that's the sense I get. I don't have a source at the moment. I am just hypothesizing: Suppose Dr. Scholz, who is up on the latest research, says this is going to be the new standard of care. Suppose he says I should go on ADT NOW and suppose my PSA is say <0.1. I REALLY do NOT want that. I would much rather wait and see what my PSA does. But then I'm consulting a top guy. What to do? So, as they say, be careful what you wish for. I might see the top guy and not like what I hear!
 
David, things are changing in the PC world regarding drugs and tx. It would sure be nice if they could come up with an ADT tx. that also prevents the SE of ADT!
 
Mel
 
 
 
 

 
 
 
 
 
 
Mel
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