I agree with you. I probably know more about prostate cancer then my family doctor. I had been under the care of a very good conservative urologist who has retired. He is the one who turned me over to the Oncologist. I have been seeing her for a year. Last January I had a Bone Scan and C-Scan. I saw my oncologist yesterday and she has ordered a bone scan and C-Scan. Depending on results we may follow up with an MRI. Also, she is taking another PSA (I had one Tuesday). We want to see if my PSA has really increased to 33. If that is confirmed we will look at LHRH agonists (Lupron) and possibly follow it up if necessary with a Anti-androgen like Casodex). And my Oncologist agrees that there is no need for an Urologist unless there are complications that require some procedure to relieve systems.View Thread
Thanks. I had a urologist for 15 or more years who retired and turned me over to oncologist. Now family7 doctor suggest I also so a urologist. But I haven't been able to see any advantage for doing so. If I need a surgical procedure to relieve a symptoms then the urologist would do that but it seem the oncologist can apply all the hormone shots and other things of that nature.
Guess the main thing is ensure whoever it is is qualified to do what is necessary in a timely manner. I'm going to my oncologist today to further discuss this matter.View Thread
Thanks for taking the time to reply. My biggest question is what does a Urologist do that the Oncologist can't. I'm not going to get s surgical procedure. I believe the Oncologist can provide all the necessary PSA lowering shots such as hormone therapy, she also mentioned a shot to protect bones.. My Urologist turned me over to an Oncologist when he retired rather than to one of his Urologist. My family doctor is the one suggesting I also see a Urologist. I need to learn what valkue that will provide.View Thread
I have advance prostate cancer. Had IMRT 10 years ago and PSA has steadily go up. It recently jumped and now is 33. I had a clean C-Scan and Bone Scan a year ago. Two years ago I had an MRI which also was negative.
I am under care of an Oncologist. My family doctor suggests I also see a Urologist. Is there anything a Urologist can/will do considering my condition that an Oncologist can't do. Is there an advantage of also seeing a Urologist. I used to be under the care of one but he has retired and suggested my treatment be handled by Oncologist. I would appreciate receiving any sound advice based on experience or knowledge. Thanks.View Thread
My great Urologist who I have been under the care of for 16 years retired last month partly because running the business was getting too complicated. Since my PSA was 24 he was getting near advising hormone therapy. But since he was retiring he suggested that I transfer under the care of an Oncologist and recommended one who has practiced her profession for around 30 years. My Urologist said he would use her and would also recommend her to family and friends.
I had my first appointment with the Oncologist last month and was really happy and somewhat surprised that she spent about an hour with me. When discussing hormone therapy she said that there really is no magic number when a patient should begin the therapy. She suggested that the therapy need is driven more by symptoms and test results beyond the PSA. She ordered some blood tests and also a bone and C-Scan. My last bone , C-Scan and MRI were done two years ago. The results of current tests as was the case of the previous one indicated no metastasis disease was detected. I also had a PSA which went down from 24 to 19. Based on that and that I have no pain or symptoms to indicate the prostate cancer has advanced beyond local advanced we are just going to carefully watch and decided when to do hormone therapy, which makes me happy since I really wasn't looking to lower quality of life unless really necessary.
My background is I had a 4.2 PSA 16 years ago. Over the course of 6 years the PSA gradually went up and during that time I had 4 biopsies, two of which were negative and two positive showing a small foci of cancer in one area, the lower left apex. The first biopsy was positive but questioned, the second and third were negative, and finally the fourth was again positive in the same area and with the near same reading as the first. My PSA was 9.5 and Gleason was 3+4=7. I selected IMRT and received 40 doses. My PSA went down to 1.5and over the years has slowly gone up to the present reading. It has now been 9 years since I received the IMRT.
I am providing this information to possibly help others to understand one man's journey with prostate cancer. I had no adverse reaction to IMRT except for the normal sexual drive affect. I have never had any pain and am able to exercise 30-40 minutes a day on treadmill and with long walks.
Any comments and/or questions are welcomed. And, good luck to all in their personal journey with PC. View Thread
John - Glad to see yoiu are still around and being helpful. Haven't visit the board much lately. But getting near deciding on hormone treatment. Now 9 years past radiation my psa had streadily gone up. Now sits at 15. Urologist and I have discussed the hormones when the psa gets near 20. I am trying to maintain quality of life foir as long as possibloe.,
My advice to all is find a doctor who does the biopsy under anesthesia. Mine does - I had four biopsies and no pain. I think it is easier on the doctor and patient if they use anesthesia. Propofol is what my doctor uses and an anesthesiologist administers the drug.
A couple weeks ago I posted my condition and indicated I had a CT-Scan, Bone Scan and X-Ray. Bone Scan came back with hot spots and I needed to get an MRI. This is to remind everyone to stay positive. My MRI came back and showed the hot spots which bone scan radiologist said was suspect mets were in fact just a back getting old and some scratch and tears from sports I used to love to play.
Get the tests and trust your instincts and the best medical help you can find. Stay positive. Enjoy the love and friendship you may get.
Back in 1997 I had a PSA 4.2. I didn't get a biopsy then and my PSA went up a tenth or two and down a tenth or two until 10/2000 when it went to 5.2 and I got a biopsy, which came back positive in only one area (Left Apex - very small foci of cancer, less than 3%). It was graded a 3 4 = 7 Gleason (negative digital exam). With consultation of my Urologist I decided to wait and the PSA went down to 3.8 in 02/2001. In 03/2001, I got another PSA which went back up to 4.4 and got a second biopsy which came back negative in all areas. Over the next year my PSA went up a bit and I got a third biopsy 03/2002 which again came back negative in all areas. The PSA testing continued every 3-4 months and finally in 12/2004 it went up to 9.0 and I got the fourth biopsy which came back positive again in one area, left Apex (small foci) with Gleason 3 4=7 So I decided to treat the cancer with 40 doses of external radiation ending in 05/2005. My PSA dropped over several months to a nadir of 1.7 (never did get to under desired 1.0) .
Since then the PSA has remained steady or climbing slowly. Until it hit around 12.0 in 02/2012. I had an X-Ray, Bone Scan, and CT-Scan (which I had before getting the radiation treatment). All came back with no indication of metastatic cancer. I have advanced local cancer but it hasn't gone to the bones. The point I'm making is that it is now 15 years since I had the 4.1 PSA and 7 years since I had the radiation and I'm still enjoying a good quality of life (of course the radiation as does an operation affects sex life but not as much as getting hormones). I know that within a year or so I will have to start hormones if/when the cancer goes up but I'm still preserving quality of life which is very important to me.
Each of us make our own decision. Most of the time prostate cancer is very slow growing. There are arguments for getting the operation right away and others to wait. Same as selecting an operation or radiation. I would certainly get a second opinion in your case. I would also read and learn as much as I could about the disease. Dr Walsh's book on "Surviving Prostate Cancer" is a good place to start.
Good luck! We each make decisions we can live with. There is no one path.