Looking for second opinion

[GT63]

Can anyone recommend a urologist at the Cleveland Clinic for a second opinion?

[Tall_Allen]

Andrew Stephenson is probably their most experienced surgeon.

[GT63 in reply to Tall_Allen]

Thanks Allen.

[GT63 in reply to Tall_Allen]

Not actually sure what specialty I would best consult. I have a urologist who did the original prostatectomy, a radiation oncologist who radiated the margins when the surgery was not adequately successful and an oncologist who was added to the team when my PSA started doubling. I am currently on casodex and will soon be adding Lupron in hopes that the 2 centimeter lesion within the margin can be shrunk to the point that it can then be radiated.

[Tall_Allen in reply to GT63]

Then you don't want a urologist. It sounds like you want to do a second salvage after a first salvage radiation failure. They would use FOCAL treatment for that. Either focal brachytherapy (seeds or temporary implants) or focal ablation (cryotherapy, HIFU, FLA, etc.) For focal seed (LDR) brachytherapy, you would want to talk to Jay Ciezski at Cleveland Clinic. For focal temporary implant (HDR) brachytherapy, the closest expert I know of is Alvaro Martinez in Detroit (call first and ask if he does this sort of thing.) For focal ablation, try Gary Onik, who does focal ablation of all sorts in Ft Lauderdale.

[GT63 in reply to Tall_Allen]

Thanks again. I am scheduled for another bone scan and pelvic CT in about 6 weeks. Then I will receive the recommendations of my current team from Allegheny Health Network in Pittsburgh.

I've been thinking that the best time 2 get a second opinion will be when the results of the scans are in. Then I will know the collective thinking of my team but I would like someone else to review all my records and make their own recommendation. Do you know who at Cleveland Clinic would be best to consult?

[GT63 in reply to Tall_Allen]

I pulled the trigger too soon on that previous reply. The lesion is wedged between my bladder and colon in a position that they believe can neither be surgically removed nor radiated safely. I don't know whether a urologist, radiation oncologist or oncologist would be best to consult with now.

Ideas?

[Tall_Allen in reply to GT63]

Talk to Jay Ciezski.

[GT63 in reply to Tall_Allen]

Thanks for taking the time to think through this with me, Allen. Will do.

[GaryG1950 in reply to GT63]

Sure sounds like a medical oncologist that specializes in prostate cancer would be a strong consideration for your next step.There are a few in the US....not aware of any at CC. You might consider Dr Luke Nordquist at the Urology Cancer Center in Omaha, NE. gucancer.com Or you can contact me for more info.