Doctor Recommendations: Would really... - Advanced Prostate...

Advanced Prostate Cancer
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Doctor Recommendations

Portugal-2
Portugal-2

Would really like to have the best prostate oncologist and prostate radiologist recommendations for Philadelphia and New Jersey and New York. Gleason 9-10 and had Davinci robotic surgery. Now PSA rising and will need best doctors that are informed and keep you alive with some quality. Also a doctor that is a expert in prostate cancer and connected to clinical trials. Thank you. If you’ve had many years then that’s what I would want to hear about . Thank you so much!!!!!

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The kind of doctor you should be talking to is a radiation oncologist (RO). Hopefully, some salvage radiation can still cure you. The RO I would encourage you to talk to is Michael Zelefsky at MSKCC. He is one of the few that gives a sufficient radiation dose and treats a wide enough area.

Thank you Tall_Allen!! I read all your comments to others. So glad you replied to mine. So you think radiation before even hormones? Really not aware of the steps to follow now because I was lucky to have four years after surgery alone. Now I need to make the best decisions inorder to keep working and survive for my family. So all knowledge is appreciated!! Don’t have a Prostate Oncologist yet only my urologist at this moment. But it’s something I want to prepare for and it seems like many on this site have had some great doctors and have lived 10, 15 or more years since their dx and surgery. Would the radiologist be doing IMRT? Also what did you mean he treats a wide enough area? Wouldn’t that harm good cells too? Thanks again for response.

Tall_Allen explain to me again why a Prostrate Oncologist would not be the first step. Aren’t they part of the entire team that follows your case. Before surgery I was given 6-12 months to live. Now thankfully I am starting my 5th year but the PSA is starting to rise went from undetectable to now .2 I know it not time to panic and I will repeat blood tests to show any increase and and how quickly it’s happening. But I respect your knowledge and explanations to others. My wife after taking care of me developed an aggressive tall Cell thyroid cancer with a very poor prognosis. So she has been through the ringer with her cancer. So I need to be prepared about my next steps and I am focused on her right now. Not ready to make my child an orphan just yet.

No, I do not think a medical oncologist is a good next step for you. This is not how it works with other kinds of cancer. Prostate cancer is VERY specialized - an RO knows about his field, a urologist knows about his field, and an MO knows about his field. i have learned to talk to the expert in field you are interested in. I do not think a "team approach" is in the patient's best interest. You are fully capable of making the key calls yourself- do not give up your power. I also believe in exhausting all curative options before moving onto maintaining PC as a disease you can live with. So my advice would be to work with an RO FIRST, and then if radiation fails, move onto an MO.

Yes. of course there will be some collateral damage with radiation. But with today's technology, that toxicity can be very limited. Frankly, knowing what we know today (and I mean TODAY) you should never have been treated with surgery in the first place. Read this:

pcnrv.blogspot.com/2018/07/...

But we didn't know that when you had your surgery. Gleason 10s are very virulent, so it has to be treated with whole pelvic radiation and with adjuvant hormone therapy. The hormone therapy begins 2 months before the radiation begins so as to sensitize the cancer to the radiation. But if done right, and trust me, MSK does it right more than just about anybody, it is highly curative.

Hi It’s been a while since posting. Hope you’re doing well. I had a Davinci RP. Five years ago. My PSA has been doubling in last 6 months. My doctor recommended a radiation oncologist. Just as you suggested 5 months ago today. I need to go closer to home because I must work. My appointment is tomorrow.

I would love to get input from you especially and any others that have done 8 weeks of radiation. Please give me suggestions and tips on what to ask the radiologist, and what symptoms to expect, how you handled anything externally or internally that worked for you, or you used during the treatments. Also, were you able to continue working while going through the 8 weeks. Any info, tips, suggestions would be appreciated. My wife has stage 4 aggressive thyroid cancer and I need to work. Thanks for your help. I wish I could go to Sloan but it is too long a distance to do this daily and seeing someone attached to my surgeons practice tomorrow. So I want to be prepared

Here are questions - adapt to your situation

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

Dr. Twardoski(?) at St Johns in Santa Monica is one of the best in the LA area. He previously was at City Of Hope in Duarte, known as THE best.

Dr. Karen Autio. Genitourinary med oncologist at Memorial Sloan Kettering NYC.

Thank you! Who else is on your team of doctors if you don’t mind.

Currently just the med oncologist. But if you need additional team members I am sure she would consult

Dr. Zelefsky nuked me at MSKCC (main campus at 68th street/first ave in Manhattan). I also sang Doctor Zelefsky da da da dum to him - parody of Officer Krupsky da da da dum from the musical West Side Story (he laughed, then nuked me -hard that sob lol).

Dr. Morris at MSKcc (Kimmel center - 68 street in Manhattan). He's my "old/timers" oncologist. If you see him ask him to give you a demo on how he washes his hands. lol

VERY Smart and Good Bedside manners.

Good Luck and Good Health.

j-o-h-n Tuesday 07/10/2018 1:55 PM EDT

p.s. There's a site here for people who speak Portuguese. Now don't puusssh it cause you'll really be pulllling it.

Portugal-2
Portugal-2
in reply to j-o-h-n

Thank you j-o-h-n! May I ask your history and treatments thus far. When were you diagnosed and was radiation the only thing you did next?

j-o-h-n
j-o-h-n
in reply to Portugal-2

I just sent you an off line message at:

Wednesday 07/11/2018 1:18 PM EDT

Good Luck and Good Health.

j-o-h-n Wednesday 07/11/2018 1:22 PM EDT

Portugal-2
Portugal-2
in reply to j-o-h-n

Thank you once again! Really appreciate everything you told me!

j-o-h-n
j-o-h-n
in reply to Portugal-2

You're very welcome. I must reiterate MSKcc is a top notch hospital. Keep asking here on this site for more and better info. Don't be shy in repeating yourself. Guys here are a great supply of knowledge.

Good Luck and Good Health.

j-o-h-n Wednesday 07/11/2018 6:20 PM EDT

Dr. Gordon Brown Sewell NJ. He also has offices throughout the Jersey area. I have the utmost respect and admiration for his knowledge and compassion. My journey began with him and I couldn't be more satisfied. Leo

Portugal-2
Portugal-2
in reply to leo2634

Thank you Leo. He is a prostrate oncologist? May I ask your history of cancer and your treatments thus far? What year were you diagnosed

leo2634
leo2634
in reply to Portugal-2

He is a Prostate Oncologist and surgeon along with a urology practice. I was diagnosed in February 2018 and treatments include Zytiga,Prednisone,Eligard and Xgeva for bone Mets. PSA went from14.7 to undetectable in a little over a month.

Portugal-2
Portugal-2
in reply to leo2634

Thank you Leo! So you never had surgery at all? That’s amazing! I wish all the best and many many years to enjoy!!!

leo2634
leo2634
in reply to Portugal-2

No surgery that is my first line if treatments. I might add I feel better than I have in years. My next appointment is August1st I will keep you posted. Never give up never surrender. Leo

Portugal-2
Portugal-2
in reply to leo2634

How are you doing? Need to get radiation. Does your Dr. have people he recommends in south jersey. Possibly at Cooper Hospital Camden? If you know name of local radiologist, that would be great!!

I am no expert, just another pilgrim (stage IVa, Gleason 9 and 10, Dx May 2 2018) on this grim journey, but I do believe that I am being well served by the rad-Onc team at Fox Chase Cancer Center in Philadelphia. It is a national center and also part of Temple University, which I take to mean that they are up on the latest research and they participate in trials and studies. The huge benefit to me is that their research and trials show 26 days of radiation to be as effective as 40 days. Plus I quite like my principal doctors there, urologist Marc Smaldone and rad-Onc Eric Horwitz. They both - and their excellent resident doctors-in-training - have taken time to answer my questions and explore my alternatives, and to consider the whole person along with the specific disease.

Thank you John so much for the information.

Hi, how are you doing? Need radiation now. Your radiation oncologist has been highly rated although a little far. Have you had radiation? What type? You mentioned 26 vs 40. What name and dosage for the 26, if you know. Would like to know if your doctor could recommend a radiation oncologist in south jersey or at Cooper Hospital in Camden. Thanks!!!!

William Merriam, Academic Urology, Paoli, PA - Gleason 4+3, RPC 9/16

Portugal-2
Portugal-2
in reply to Ken51

Thank you Ken51 for the recommendation!!

Comprehensive Cancer in Sewell NJ Dr. Trina Poretta very detailed. Up to date.

Portugal-2
Portugal-2
in reply to Mormon1

Thank you Mormon1 for the recommendation!

if you have good ins check her specifically. I was dying, weak, psa 11,000, lost 20 lbs in pain in dec 2017. Now psa .4 much stronger, back to work, my 36 pants fit again, back to boating on delaware. She a smart cookie but very personable too. She listens to me.

Dr. Gordon Brown New Jersey Urology Sewell NJ. He is a Urologist,Surgeon,Oncologist and sits on the Board of Directors of multiple PC organizations . I couldn't be happier with his knowledge and compassion, along with his excellent staff.

Dr. William Oh Medical Oncologist Mt. Sinai Manhattan

Dr. Richard Stock Radiation Oncologist Mt. Sinai Manhattan

Hi all! I had a Davinci RP. Five years ago. My PSA has been doubling in last 6 months. My doctor recommended a radiation oncologist.

I would love to get input from others that have done 8 weeks of radiation. Please give me suggestions and tips on what questions to ask the RO and what to expect, how you handled anything externally or internally that worked for you, or you used during the treatments. Also, were you able to continue working while going through the 8 weeks. Any info, tips, suggestions would be appreciated. My wife has stage 4 aggressive thyroid cancer and I need to work. Thanks for your help.

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