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Posted 9/12/2018 11:41 AM (GMT -5)
Okay, I have a URO, RO, Should I get a MO....?
Posted 9/12/2018 11:53 AM (GMT -5)
Your signature didn't come through. Sadly I'm getting old and can't remember everyone's information.

Unless you have distant mets, I doubt an MO will be all that useful at this point. An RO can deal with any salvage RT and a URO can deal with surgery and most basic treatment modes.

Still, if you want the opinion of an MO, make sure to find one who specializes in PC. Not all do.

Andrew
Posted 9/12/2018 12:26 PM (GMT -5)
I started with an MO that specializes in PCa and he helped me stage my disease and helped me develop my treatment plan. It was immensely helpful, but also a bit of a luxury since the RO was providing the treatment. If you've already decided on a treatment option, then it's probably even less necessary.

But to Andrew's point, it also depends on your diagnosis...anything you can share?
Posted 9/12/2018 12:33 PM (GMT -5)
For those who may be able to hel- MG, here are his stats ....

DX 7/23/18
Gleason 9
Prostate size 44
stage T2B
No mets.
PSA 5.2
6/16 probes positive 2 maybes.
All on right side 1 on the left
Age 65 with lung problems.
HT 8/22 Eligard 6 month shot
Posted 9/12/2018 12:42 PM (GMT -5)
I am not an MD.

Personally, because you are Gleason 9, I'd get an MO. In my not so humble opinion, a MO will give you unbiased treatment advice.
UROs do surgery so they often suggest that.
ROs do radiation so they often suggest that. (I actually was told the most honest words from my RO, he said if this doesn't fix it, then it's incurable. Hard words to hear, but honest.)
Posted 9/12/2018 12:44 PM (GMT -5)
MG - when you post, you should see a checkbox for "include signature."

Thanks Prat for digging that up.

I'm going to change my answer from "likely not" to a "maybe." At G9 and other health issues a consult might provide useful info, but your treatments will still be in the hands of the URO and RO.
Posted 9/12/2018 12:50 PM (GMT -5)
Thanks for the tip about sig....
Posted 9/12/2018 6:11 PM (GMT -5)
MG...have you made a treatment decision yet?
Posted 9/12/2018 5:45 PM (GMT -5)
Since I'm doing Radiation, I no longer see a uro. So if you ask me, and you shouldn't, I think it depends on what treatment you are going to be receiving. In the begging you need a uro, best to talk to an ro, then go from there.
Its up to you I guess, some want to cover all the bases and talking with as many docs as they can to get as much info.
Posted 9/13/2018 9:36 AM (GMT -5)
michael-T

Talked with RO decided on Radiation 45 treatment....HT for 2 years..
Posted 9/13/2018 11:41 AM (GMT -5)
Really nothing for the MO to do right now. Any discussion would be general. After the initial treatment and HT wears off then you watch for a recurrence. If that happens, it will mean the cancer is most likely systemic and then the MO would be in charge to manage the disease.

If you do want to establish a relationship with one in case you need an MO in the future, be sure to find ones that do specialize in prostate and urinary cancers. I know of one at Georgia Urology that is well regarded and does a lot of prostate work. Also look for those that specialize with the hormone based cancers, prostate and breast.

When I was diagnosed, my wife was being treated for a second bout of breast cancer. Her MO did primarily breast and prostate work so I had a consultation with him. He gave me good information, supported my treatment direction and choice of docs, and said if my PSA starts going up to call him. Fortunately my PSA has not gone up...unfortunately he died a few years ago from a heart attack.
Posted 9/13/2018 1:17 PM (GMT -5)
Once my initial therapies were done, and was on a lengthy ADT plan, I started seeing an MO when we moved to another state. I needed a new PCa support team anyway at that point, and setting up a new doctor relationship the MO seemed appropriate. I found one at University of Michigan who was well known in the prostate cancer field.

You could say an RO would have been appropriate too, but they really specialize in treatments, not follow up for work done somewhere else. I do have a urologist too, but he's not my cancer "quarterback".

With my situation, if the PSA ever does bump up again it's unlikely I'd need either a urologist (surgery) or RO (radiation). Any local "salvage" therapies would be unlikely to be effective (my case is unlikely to have a local-only recurrence), and would have really serious side effects.

My future treatments, if any, would be in the MO's realm for the most part, hormonal and so on. So far so good, my numbers have stabilized and I feel great. G9 is serious and unpredictable, but even with that it's possible to do well for quite a long time.

For someone early in the planning, I think it's worth talking to an MO just for perspective. When I did that back in 2013, the MO explained her general area of responsibility (mostly recurring cases), thought I had a good plan, and said she hoped she'd never have to see me again!
Posted 9/13/2018 4:34 PM (GMT -5)
"Since I'm doing Radiation, I no longer see a uro."

I still saw my uro. he did the PSAs, DREs and Lupron injections but he was in a "partnership" with the radiation clinic which is why he did not want to do surgery unless I insisted.

I really free fortunate about the arrangement. in fact this is the first year I haven't seen my uro. he told me last year I was "cured" and I didn't need to come back unless I wanted to. the decision not to go back was made recently when my new GP -- a guy I really like -- ordered a PSA test with my annual bloodwork (my previous physician was instructed not to).
Posted 9/13/2018 8:29 PM (GMT -5)
When I was trying to decide between radiation and surgery, I had a phone consultation with an MO. He was very helpful since he didn't have a dog in the fight, as he put it.
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