Medical Oncologist?

[B8ssist]

After reading some posts here , is it wise to get a Medical Oncologist versus just my Urologist? Sometimes I feel stupid, that as a nurse who has worked oncology, I don’t know this stuff. But most of my oncology experience has been dealing with blood cancers, never with Prostate cancer. Should I seek out a medical oncologist?

[6357axbz]

I think most here would tell you to absolutely get a medical oncologist, preferably one who specializes in prostate cancer.

[Tall_Allen]

Prostate cancer is a weird cancer in that we all start out by seeing a urologist instead of an oncologist. The dividing line is whether the cancer is curable or not (i.e., metastatic). It may be curable by primary surgery, radiation, or salvage. You are still potentially curable with salvage radiation, so your doctor should be a radiation oncologist, rather than a medical oncologist. If your salvage radiation fails, you will need systemic therapy beyond just testosterone suppression, so a medical oncologist should be enlisted if that should happen.

You might want to read the section "The Right Specialist" -

prostatecancer.news/2017/12...

[B8ssist in reply to Tall_Allen]

Thank you Tall_Allen. Not having had any scans completed to know if the cancer is anywhere else in this body always leaves me with a big question, if there was one positive lymph node are there others? For now, my PSA is at 0 from the Eligard.

[Tall_Allen in reply to B8ssist]

Yes, assume there are others- lymph is a fluid. PSA is not a good indicator of that.

[B8ssist in reply to Tall_Allen]

Very true. This is why I am considering getting a medical oncologist. So hard to tell. I believe my Urologist means well but that could work against me.

[Tall_Allen in reply to B8ssist]

That is why you should talk to a radiation oncologist - they specialize in exactly that sort of thing. A medical oncologist wouldn't know - he would just refer you to a radiation oncologist. No need to have a middle man who would just be in the way.

[Hidden]

Yes, Ditch the urologist!

[Hidden]

My uro told me six months Chemo and that I d die in 36 months no matter what I did. Thankfully for me I got into a test drug program

ran by Pc specialist Dr Pariminder Singh that put me on Lupron and tak 700 with imrt that’s kept me 5 years no pc evidence seen on scans. Singh’s knowledge of pc was greater than the dismal uro’s.

[fireandice123]

Get an oncologist. It doesn’t mean ditch the urologist. I have both a medical and radiation oncologist along with a urologist. My urologist referred me to my MO. I still see him to help treat the collateral damage to my urinary track that cancer causes. While they see a lot of PCa and can treat it urologists simply don’t have the training or experience to deal with more complex cases. It’s not their specialty.

[michael00]

I've been seeing both but when there was a difference in opinion the urologist always yielded to the MO opinion. I am dropping the urologist in a couple months since he is retiring and i don't see a reason to break in a new urologist when all he does now is eligard ehot and MO can do that

[larry_dammit]

Yes 👍👍👍. My urologist missed my stage 4 by just giving me a test instead of a biopsy, also lost a father in-law due to a urologist screw up. My medical oncologist has saved my life and made me comfortable now for almost 5 years 🙏🙏🙏. Never give up warriors

[Masirah]

In November 2020, I was diagnosed as having PCa, Gleason 9. I was prescribed tablets for ADT but these had horrible side effects, so I took myself off them. I read up on surgery and radiotherapy and didn't like the sound of the side effects. I spoke to my oncologist, who agreed to allow an active surveillance. My PSA levels went from 4.2 to 4.6 then back to 4.2. As a 70 year old I am told this is within an acceptable range. My urologist doesn't agree with the oncologist's decision, but I am inclined to agree with the oncologist. You'd have thought they'd sing from the same hymn book, but then one is from Bangladesh and the other from Germany, so perhaps that's asking too much.

[Magnus1964]

The reason to get a MO is if you need chemotherapy or an iron infusion. If you need an MO your urologist should refer you to one.

[Explorer08]

Get a urologic oncologist.

[Carp1707]

I was Dxed in July 2015 with a Gl 10. I got a lupron shot, went home and called Fred Hutch at UWMC in Seattle. I asked for an appointment. Her reply was, 'We get you Tens right in.' I was seen within a week by my MO, 3 days later by a UO. Still have both of them now.

I did not feel I needed a referral from a urologist that knew I was going to quit him.

[EdinBmore]

No harm in seeking additional information or a different perspective. And, in theory, the MO should have a broader and more "balanced" perspective than a uro or RO alone. For whatever it's worth, I got second opinions - 2 uros, 2 RO and one MO after dx. Btw, they were from different medical centers.

EdinBaltimore

[Hidden]

I think eventually you may need a Medical Oncologist, but don't see a need to rush especially since you will be getting radiation next.

I'd wait to see what happens after that. If the cancer continue to progress, you will of course need more systemic treatments and then for sure a Medical Oncologist.

You could start looking around and perhaps have a discussion with your current docs.

Wishing you the best.

[B8ssist in reply to Hidden]

Thank you gregg57. All the replies I have received have helped me in my decision.

[2dee]

Absolutely add a Medical Oncologist as the main manager of your care team. Keep Urologist Oncologist as well.I have my Urologist give my ADT shots so we can talk and review a bit and use MO for main counseling and most referral. Remember that the Urologist is usually a surgeon with that perspective. When/if needed I will add a Radiation Oncologist or others.

Good luck,

2Dee

[B8ssist in reply to 2dee]

Thank you for your response. My urologist in Texas is connected with a Radiation Oncologist. I went through 7 weeks of radiation treatments to the pelvic bed and all the lymph nodes post Prostatectomy because my PSA was still elevated more than my Urologist in Tennessee liked 6 weeks out. The 1 positive lymph node makes wonder if there are others that were missed which is why I am considering a MO.

[2dee]

Chose a MO PCa specialist. Get opinion and get a second opinion from another.Select the best you can find somewhere near you.

Ask here for recommendations in your area. They will become your primary and likely most knowledgeable doc.

2Dee

[Doseydoe]

When you have a plumbing issue, you need a urologist. When you need drugs, you go to the pharmacist. If you need radiation, you see the radio oncologist and if you decide to have chemotherapy, you need to find and medical oncologist. Similar to doing house renovations, get the right speciatist. I started with a urologist as I had problems peeing and I was referred from there. I now see my MO every couple of months as he assesses my bloods. Use the right tool for the job. My car needs a service next week so I'll take it to the mechanic, simple 😜 DD.

[Grouser]

My husband was seeing a urologist for years we had no idea an oncologist had a different role. Without going into detail I vote for both ! Each one will tell you that is the best route.