What to look for in an RO

I would look for a world-class facility where there is peer review of the radiation plan and experienced techs that are running the machine. My SRT was at MD Anderson, they have six or eight IMRT machines and the techs are highly experienced.

My RO created a plan, reviewed it with her colleagues who had some recommendations and she incorporated those changes in the final plan.

Well, I just spent the last twenty minutes composing a 4-5 paragraph comprehensive response, but when I clicked 'submit' was told that my password was invalid. And of course, everything I had typed was lost. Sorry, I am too PO'd right now to start over again, but will simply wish you well.

I liked my RO because he had thorough answers to my various questions. Where things were still not well known, he said so (back in 2013 there was a lot of discussion about hypofractionation, with uncertainty about the alpha/beta ratio of prostate tissue, and he admitted it was an ongoing investigation). Hypofractionation today seems pretty well established, but it's sure worth discussing what they'd like to do and, importantly, why.

Vanderbilt (in Nashville) had 3 physicists on staff the created the radiation plans. My RO showed me the CAD model of it, explaining doses, margins, and so on, developed around the fusion of my 3TMRI and the planning CT scan. I felt very confident going in that we truly had a well-thought-out plan. We discussed the whole process, daily treatment, weekly status discussions, availability if anything developed during the week, and so on.

Everyone's mileage will vary, but I have had a very good result from that treatment plan. I think it's really important, as someone else mentioned, to feel confident in your care provider. Interview until you are.

You may be interested in the following - scroll down to the subsection on personalities:

/pcnrv.blogspot.com/2017/12/finding-right-doctor.html

It's not about them, it's about you. What makes you comfortable? One of the best SBRT ROs I know (Alan Katz) has a shabby office in a downscale neighborhood (Flushing). He is quirky and funny, but has serious knowledge and cares deeply for his patients.

I have an RO who is incredibly well informed, caring and easy to communicate with. By contrast, I have a urologist who is also among the tops in his field, but never looks at me in the scant 15 minute appointments, and can be downright nasty. But he really knows his **** so I keep him.

In my experience at several places in LA, the administrative staff at top tertiary care cancer hospitals are excellent. Billing is another story. If you're like most guys, you will build a rapport with radiation support staff (radiation techs) - the ones you will most often interact with.

So to paraphrase my earlier now kaput reply, my choice was mostly out of convenience, but everything worked out well. When we moved to Florida we had to find all new doctors. My RO's practice is a free standing facility right around the corner from our new home. My drive was typically ten minutes or less. His office is associated with my new Urologist and so has the same computer system and therefore has access to all my records.

In my first interview with him he explained everything very carefully and answered all of my questions, though not always what I wanted to hear. I had also spoken with my wife's RO in Tampa who mentioned hypofractionation, though I didn't know enough about it at the time... so that was a non issue.

My RO's staff was very friendly and knew me by name. The waiting room typically had 5 or 6 guys waiting, but I was never delayed more than once. They moved thru quickly and I got to know a few of the other men. One drove over from Orlando on Mondays... a maybe two hour drive, then back on Fridays because he could not get scheduled near his home.

The machine was a Varian RapidArc, which I understood to be a newer model. I could have driven 30 to 60 minutes to be treated at a larger facility, but I saw no reason to do so. I did also call Moffitt and spoke with them, but again, I saw no need to enroll in team oriented treatment. Mine was a fairly straightforward case of adjuvant radiation due to adverse pathology, and my RO's practice is limited to genitourinary and testicular cancers so everything seemed to fit together.

There were a few bumps along the way, but in the end, the treatment appears to have done its job, so far. I feel fortunate that everything turned out so well given that I was late to the game.

I’d look for an RO who spent his life treating prostate cancer and that would be Dr Michael Dattoli in Sarasota FL . His staff has decades working with him and yet are exceptional. They only treat PCa!
Bob