Doctor recommendations?

[Hank777]

Hi Everyone, I'm new here and newly diagnosed with prostate cancer. I want to get a second opinion. Any doctor suggestions in the southern California area? I am in Orange County, but can travel.

[RyderLake2]

Hello Hank,

Try Dr. Mark Scholz in Marina Del Rey. One of the best.

[Hank777 in reply to RyderLake2]

Thanks!

[ggbk]

Hi Hank,

There is a practice in Marina Del Rey that is devoted solely to prostate cancer. Prostate Oncology Specialist is the name and they are on the internet if you just google the name. I go to Dr. Jeffery Turner there but either of the other partners there Dr. Mark Scholz or Dr. Richard Lam would be excellent.

Best of luck,

George

[Hank777 in reply to ggbk]

Wonderful, thanks!

[Tall_Allen]

What kind of prostate cancer are you newly diagnosed with? If you have been diagnosed with advanced prostate cancer, seeing a medical oncologist is a very good idea. But if you have been newly diagnosed with a curable type of prostate cancer, it is a very bad idea. Medical oncologists are only experts in medicines that help one live with prostate cancer, but are far from expert at curative therapies.

If you have advanced prostate cancer, I've met most of the medical oncologists in the LA area (including Scholz and Lam). The one who most impresses me is Tanya Dorff, now at City of Hope.

[Hank777 in reply to Tall_Allen]

Thanks for your input. Are you recommending then that I do not see Dr. Scholz or Lam or any oncologist if I only have Stage 1?

[Tall_Allen in reply to Hank777]

If your prostate cancer is curable, you should only talk to doctors (urologists and radiation oncologists) who specialize in curing prostate cancer. Seeing a medical oncologist (who has no working knowledge or experience in treatments) would only get in the way. MOs know a lot less than those other doctors about curative therapies. You are fully capable of meeting with doctors and making up your own mind (I met with 6 before I decided on treatment). In fact, you are the only person capable of making that decision.

When faced with the primary therapy decision, there may be a large number of doctors you meet with - one or two urosurgeons, an IMRT specialist, an SBRT specialist, one or two brachytherapy specialists, a specialist in proton therapy, a specialist in ablation therapy, an active surveillance specialist, as well as experts in special diagnostic tests. It is tempting to want one doctor to be a "quarterback" and some doctors advertise themselves as doing that. I recommend that you resist that urge - never give up your power, and rely only on doctors with specific expertise. There is no doctor who knows anything close to what experienced practitioners know (which will not prevent them from expressing opinions). Get your information directly from the experts, and assess it yourself. It can be a formidable task, so take your time. There is no rush - even men with high risk prostate cancer did no worse if they waited 3 months between diagnosis and treatment.

Here are some tips for finding the right doctor, dealing with doctors, and assessing what is important to you:

pcnrv.blogspot.com/2017/12/...

pcnrv.blogspot.com/2017/12/...

pcnrv.blogspot.com/2017/12/...

[Hank777 in reply to Tall_Allen]

We are trying to get as much information as we can. We have an appointment scheduled with the highly recommended Prostate Oncology Center in Marina Del Rey, Dr. Turner, for this Thursday. We hope to get more images done as well. Being at Stage 1, we anticipate a cure, and I already changed my diet to a plant based one. Thanks for your recommendations and insights. I agree that it is best to get multiple perspectives.

[Tall_Allen in reply to Hank777]

As I said, I think that's a poor idea.

[Hank777 in reply to Tall_Allen]

I was under the impression that the Prostate Oncologist Center was involved with curing and eradicating the cancer too. Am I mistaken?

[Tall_Allen in reply to Hank777]

Yes, you are mistaken. Although Dr Scholz puts on patient events every year that bring him a lot of business (and make him famous among patients, which is why his name often comes up on sites like this), and he will throw his two cents in to any patient willing to pay for a consultation, he does not himself offer any curative treatment - radiation or surgery. He just refers patients to his favorite ROs (never to surgeons).

Don't get me wrong -- I think he is a very good MO, and I like Dr Lam even better, but he knows much less about curative treatments than even I do, and I am not a doctor. I've talked to patients who want to use him as a "quarterback," which is a poor idea, imho. There is no need for a quarterback - every patient is fully capable of making the treatment decision for himself. There is no reason to give up your power, and it can only lead to treatment regret if you do.

[Hank777]

I see. Mine is at an early stage, but my urologist is recommending surgery. I wanted to get a second opinion. Do you have suggestions for doctors who offer curative therapies?

[Raymonda100 in reply to Hank777]

Search for books on the topic. Amazon has several. You have a very steep learning curve ahead of you. You need to educate yourself thoroughly before seeking a second opinion or even a third. If your cancer is at an early stage you have so many options – – much more than those who are diagnosed at later stages. You need to really understand these options and then discuss them with multiple physicians to see what they think.

[Tall_Allen in reply to Hank777]

All urologists recommend surgery. They'd better, otherwise they are in the wrong business. They know nothing about the various kinds of radiation therapy, however. You will have to meet with those doctors yourself.

If you say where you are and give more details of your diagnosis, i might be able to recommend other doctors to talk to.

[Hidden in reply to Hank777]

Whoa. What is your gleason score? Have you had abdominal and bone scans? If you are interested in HIFU I would have you talk to a Dr Michael J Lazar in Santa Rosa (surgery in SF).

[wstein25]

Go to nutritionfacts.org. This is the web site of Dr. Michael Greger. This is the exact opposite of hocus pocus. Search his site for prostate cancer and learn everything you can. For Urologists (they are surgeons) the whole world is to be solved with a knife. There may be other alternatives. I am taking another course, for now (diet and exercise), I have reduced my PSA marginally, I get tested every 3 months, my next test is in a couple of weeks. I had an MRI, which showed a lesion but was graded as "equivocal", I hope to get another MRI soon, to see if I am reducing the lesion. Dr. Dean Ornish did landmark research and proved that prostate cancer can be reversed thru diet and exercise:

ornish.com/wp-content/uploa...

Best of luck whatever course you choose.

[cfrees1]

Beware of anyone suggesting "alternative therapy" in place of science-backed treatment. Getting a second opinion is a great idea and you might want to talk to a radiation oncologist as an alternative to surgery. Can you share your PSA at time of diagnosis and the biopsy results? Gleason score? Also, have they done any scans yet to determine if there has been any metastasis?

[bigbassman]

Welcome. You've come to a place which has many very knowledgeable contributors. When you say "Newly diagnosed", has that been confirmed from a prostate biopsy? Any supporting scans and blood tests? As many here would likely agree, you have a lot of learning to do to help you to decide on next steps. I would agree with others here that you should absolutely look into/research alternatives to surgery before committing to that route. It would help members here in terms of offering advice or ideas if you share your PSA figures (free and total) as well as Gleason score (if you've had a biopsy), disease staging (any metastases?) and info from scans.

Good luck and best wishes.

[Hank777]

Thanks, everyone, for all the great advice and suggestions. Yes, in Aug of last year, my PSA was 4.4; six months later was 5.8. My urologist ordered the biopsy and results showed 4 of 6 zones had cancer cells. Gleason score is 7. I'm scheduled for the bone scan in a couple of weeks, and will also have the MRI done. My urologist seems to have a pretty balanced approach. He is okay with me looking into alternative treatments and talking to a radiologist but in his opinion, surgery is the best treatment option. Sorry, I see this forum is for those with advanced prostate cancer. Hope it's still okay to participate.

[Tall_Allen in reply to Hank777]

Was your Gleason score 3+4 or 4+3? Did you send it to Epstein at Johns Hopkins for confirmation? A bone scan is ridiculous for a GS 7 with your PSA. All professional organizations (AUA, ASTRO, NCCN, etc.) recommend against it and with good reason. It will show any old injury or arthritic joint you have, which will spur further investigation and create anxiety. And the likelihood of finding mets is negligible.

I would also cancel the MRI for now. Most surgeons do not need them, and radiation oncologists may want a different kind of MRI for the planning session, and it should be done after the fiducials are set. Let the doctor you choose for therapy tell you what kind of imaging you he needs from you. insurance may not pay for multiple MRIs.

[E2-Guy]

Hi Hank,

I have been extremely pleased with my surgeon/oncologist's conservative approach to dealing with my PCa. He has kept me alive with an excellent quality of life for 13 plus years... no ADT, radiation, or chemo. Only two painless robotic surgeries that I recovered from in a couple of days. His Name is Dr. Thomas Ahlering and he is at UCI in Orange. I have no idea what my future holds, but as of today I am symptom free doing all of the things that I did 40 years ago. If this nasty disease gets me soon, I still have to be thankful for the wonderful years that I've enjoyed since my doctor in Dallas, TX predicted I would never see. I will never forget his words after getting the results of my biopsy. "Ron, you have the real deal!" My best to you, Ron

[Hank777 in reply to E2-Guy]

Thanks for the reference. We will look into Dr. Ahrlering. Hope he's in our insurance network.

[dockam]

Hello, I was diagnosed in 01/2015 and live in OC also and I see Dr. Vora in Long Beach at Todd Cancer institute.

theloopnewspaper.com/story/...

Fight on - Randy

[Hank777 in reply to dockam]

Loved reading your story at the link! Keep running!

[hysir]

I live in orange county and there are quite a few cancer centers or specialists you can see. UCI is a National Cancer Center that you can investigate. Hoag in Newport Beach and St. Joseph's in Orange have very good doctors. There is also UCLA, so you have quite a few options. I ended up at Prostate Oncology Specialists in Marina Del Rey. I was referred to UCLA for some procedures and had radiation treatments in Newport Beach. But get a second opinion.

[j-o-h-n]

To: Hank777

Listen to these guys....They're like the crème de la crème for Pca information.

Good Luck and Good Health.

j-o-h-n Wednesday 03/28/2018 6:39 PM EDT

[Hank777]

Thanks, everyone! This is so helpful.

[LVRob129]

I just completed HIFU treatment with Dr. Robert Pugach at Pacific Coast Urology. Well worth the look. I had failed proton beam so this was the next option. My numbers were similar to yours, doubling time about 2 years so no hurry. Good luck!

[tkalaf]

I live in the Pacific Northwest, Seattle area. I too am newly diagnosed. My story follows.

I was diagnosed with prostate cancer early Feb. It started when a small nodule was observed during a DRE. My PSA measured in at just under 4. I was recommended a biopsy or to close watch. Due to the invasiveness of a biopsy, I decided to watch. I was told the nodule may be benign, if cancer it may be slow growth, and my PSA 'was' below 4 (if only slightly).

A year later and another DRE, an observed nodule growth of ~10% was observed. My PSA now measured above 8. A biopsy was definitely recommended. I visited 2 other urologists for 2nd opinions, both recommending biopsy. My biopsy was performed on Feb 1, and from its' results both CT and Bone imaging scans were performed on Feb 13.

> Biopsy not good - Gleason score of 9. aggressive in 9 of 12 samples

> Scans were good - not found elsewhere, so deemed non-metastatic

My urologist presented and discussed all available options. I decided to undergo a radical prostatectomy (RP), as I am a family man (63) with spouse and children (19 and 21). I felt it was best choice for my longterm outcome with my particular diagnosis.

Once I made this decision, he mentioned a clinical trial. He said I may qualify for it, and he briefly discussed its' purpose. It sparked my interest. Here is a public link:

clinicaltrials.gov/ct2/show...

My urologist referred me to an oncologist. The oncologist reviewed medical history and asked lifestyle/family questions. He said a blood draw is required. After my labs were examined/approved, I was offered to join. Details of the trial were sent to me. We met again to fully discuss the trial and to get any/all of my questions answered. I signed up, and am now 3 weeks into this trial. My RP is scheduled for early June.