need oncologist?

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gralestel
New Member


Date Joined Dec 2006
Total Posts : 11
   Posted 12/21/2006 11:14 AM (GMT -7)   
how many of you have an oncologist, urologist, radiation specialist, primary care doctor - or all of the above?

do they work as a team or do you see one more than the other?

also, where is the top facility for surgery and for brachytherapy in the US?

thank you

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 12/21/2006 1:38 PM (GMT -7)   
gralestel,

Since I chose surgery and the post op path report found the cancer to be totally confined to my prostate I did not need any follow up radiation. I have a primary care doctor that initially sent me to a local urologist when my PSA had gone up. The local urologist did the biopsy. When it was posiitve for cancer I wanted a second opinion on treatment plus I also wanted to go to a prominent medical center. I went to the Urologic Surgery Clinic at Vanderbilt University in Nashville. This is about two hours from my home and I had heard that they had a top notch urologist. I opted for the robotic larascopic radical prostatectomy and my surgeon had done over 800 of them when I got on is waiting list which is out 3 to 4 months. There are many good hospitals and urologic surgeons located across the US and I am sure that several others on this forum will chime in on their experiences. If you could provide the region of the country that you are in then more then likely there are some on this forum that are in your area and can be specific about hospitals, surgeons, urologist, radiation experts, etc. I believe that those who have researched and were motivated to go to the expertise versus those that chose convenience of a local provider have come out ahead. This is especially true for surgery as there have been some botched surgeries done by inexperienced local surgeons. I do not know anything about brachytherapy centers other then there is one in Georgia that is mentioned in Internet searches.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 12/21/2006 1:38 PM (GMT -7)   
gralestel,

Since I chose surgery and the post op path report found the cancer to be totally confined to my prostate I did not need any follow up radiation. I have a primary care doctor that initially sent me to a local urologist when my PSA had gone up. The local urologist did the biopsy. When it was posiitve for cancer I wanted a second opinion on treatment plus I also wanted to go to a prominent medical center. I went to the Urologic Surgery Clinic at Vanderbilt University in Nashville. This is about two hours from my home and I had heard that they had a top notch urologist. I opted for the robotic larascopic radical prostatectomy and my surgeon had done over 800 of them when I got on is waiting list which is out 3 to 4 months. There are many good hospitals and urologic surgeons located across the US and I am sure that several others on this forum will chime in on their experiences. If you could provide the region of the country that you are in then more then likely there are some on this forum that are in your area and can be specific about hospitals, surgeons, urologist, radiation experts, etc. I believe that those who have researched and were motivated to go to the expertise versus those that chose convenience of a local provider have come out ahead. This is especially true for surgery as there have been some botched surgeries done by inexperienced local surgeons. I do not know anything about brachytherapy centers other then there is one in Georgia that is mentioned in Internet searches.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06


jeb187chs
Regular Member


Date Joined Aug 2006
Total Posts : 62
   Posted 12/21/2006 5:02 PM (GMT -7)   
gralestel,

In most cases everyone does as Tamu lays out. GP, urologist, surgron in my case, radiation oncologist, then a general oncologist. The last two hopefully you will never need if you choose surgery and it gets it all. I wasn't that lucky.

Barnes Hospital here in St. Louis and it's Siteman Cancer Center are among ther best in the nation, in top 10. I would suggest checking the Top Docs listings and top cancer treament centers listed by the National Cancer Center and American Cancer Society. Barnes and their Siteman Cancer Center are associated with Washington University of St. Louis and their medical school. Most of the famous cancer centers and top hospitals have a university related to them.

I really believe the most important thing in seeking PCa (Prostate Cancer) is finding a doctor that you first of all feel comfortable with, secondly is an expert in his field judged by his peers, and thirdly in the case of surgery a surgeon that has sucessfully performed hundreds or thousands of the procedures you decide on.

This field of Prostate Cancer treatment has gotten to the point I believe it takes several second and third opinions sometimes to feel confident in making a decision. If a doctor makes you feel uncomfortable run...... don't walk to another and see if he or she makes you feel more comfortable. My wife and I were so depressed after a first meeting with a new doctor we almost gave up. A second doctor gave us a new lease on life and a renewed sense of "determination" in beating this abominable foe.

My sister lives in Georgia and several of her friends husbands have used the "brach" therapy center there and swear by it. I thought about that route and comparing it to surgery. With surgery the prostate is gone and the pathology report gives you a first hand look at the real scenario. With radiation seeds or rad treatment the use of surgery later is off the table in most cases because of damaged tissues caused by the radiation treatments. I also found that my insurance wouldn't cover it because it wasn't local. Seeds can migrate and escape into stool and urinary track.


Anything we can help you with ..... we will be here for you.

John
Diagnosed Aug. 7, 2006
Age 56
Biopsy 8 of 10 positive
Gleason 8
PSA 16.2
Negative CTscan, bone scan, Carbon 11 PETscan, and lung x-ray
Lapro Prostatectomy 9/7/2006
Capsule penetration, seminal vessicle involvement, clear lymph nodes.
Post op PSA 0.2
95% chance of reoccurance
Hormone and Chemo Therapy on NCI Study CALGB 99904 11/28/06
Followup radiation on about 3/15/07


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 12/21/2006 7:47 PM (GMT -7)   
Hi! gralestel....
I am going to post on your original thread .... see you there!!
:)

mama bluebird - Lee & Buddy… 53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

April 3, 2006   PSA 4.6   Gleason  3+3=6  T2a  

Confined to Prostate   June 29th ~ PSA Less than 0.1 Non-detectable


parson
Regular Member


Date Joined Dec 2006
Total Posts : 55
   Posted 12/23/2006 8:18 AM (GMT -7)   

This is my first attempt at a site so bear with me. I jjust learned ( 12/21/06 ) that I have prostate cancer, age 64, PSA 3.5, Gleason 3+3=6.Spent last several nights through the internet. As a result of my personalty I would prbable opt for surgery. Hence, any thoughts on pros and cons of perineal v. lapro.

Barrister


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 12/23/2006 8:53 AM (GMT -7)   

    Parson,  I would either consider the Radical Retropubic Prosectomy (also known as the open or RRP on here). Or the Di Vinci robotic lathroscopic.

    I opted for the RRP for my situation.  Mr Dr. did not recomend the perneal method.  If I remember correctly he said it was more difficult and had a higher risk for complications that the other two metods.

  The decisions is yours to make.  We all have our own reasons for what we choose to do.  Good Luck.

  KW


    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct, 17 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov, 9
    Next Dr. Appt and first Post op PSA on Dec, 11
   


jeb187chs
Regular Member


Date Joined Aug 2006
Total Posts : 62
   Posted 12/23/2006 8:56 PM (GMT -7)   
Parson,

Check with your surgeon..... a lapro (minimal invasive.... less complications, faster healing and less discomfort.) Two flavors normal lapro and robot assisted (Davinci) .... see what techniques your doctor uses and ask alot of questions. If you don't feel comfortable find another doc. If your doctor is an expert, has had a huge number of successful surgeries with a super track record and lots of satisfied patients that's all you can ask for. Mine prefered standard lap.... it went wonderfully.... a friend had the Davinci at another hospital and his went great too. If my cancer hadn't been so advanced our recovery schedule would have been identical.

John
Diagnosed Aug. 7, 2006
Age 56
Biopsy 8 of 10 positive
Gleason 8
PSA 16.2
Negative CTscan, bone scan, Carbon 11 PETscan, and lung x-ray
Lapro Prostatectomy 9/7/2006
Capsule penetration, seminal vessicle involvement, clear lymph nodes.
Post op PSA 0.2
95% chance of reoccurance
Hormone and Chemo Therapy on NCI Study CALGB 99904 11/28/06
Followup radiation on about 3/15/07

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