What do you think about seeing a PA instead of your Oncologist?

[alephnull]

I go for my periodic checkup this Wednesday, the first after starting Xtandi.

They have me scheduled to see a PA. I have always been seen by an Oncologist, never a PA. So, not an oncologist or an MD, just a PA.

What would you all think?

[Shooter1]

Very common. Happened my last visit, but I was scheduled to see a RO for treatment and my MO knew it.. Figured he didn't need to see me until a couple of months after radiation therapy. He was right, but I would still have liked to bounce treatments off of him and get his opinion. They work in the same building when at home so can talk to each other about me with me not present.

[alephnull in reply to Shooter1]

It just seems strange to me as I just started Xtandi 2 weeks ago,

and my Pylarify PET a month ago came back with mets to lymph nodes from neck to lower abdomen.

Seems like the Onco should still be involved more closely and not a NON-MD.

[Hidden]

It's the future. The VA I go to for medical care had job openings for 3 psychiatrists. They went unfilled for over a year. They ended up filling them with nurse practitioners. The positions started at 250K. No one took them. If I want to speak with my MO I have to go through one of her Rn's. Her PA writes my scripts.

[mrscruffy]

I see a PA about once a year, she is incredible and super knowledgeable. If there is a question she can't answer she gets it from my MO. I wouldn't stress too much unless you have a concern

[Tall_Allen]

Depends on you. If you have changes in diagnostics, you want to speak to a doctor about them. If it's just routine, you may be fine with a PA.

[alephnull in reply to Tall_Allen]

Yeah, well my pet scan last month showed mets that I never had before, so Onco added Xtandi. 2 weeks now on that.

[alephnull]

I agree.

[TylexGP]

I alternate between my MO and his PA/NPN. I full confidence in both of them.

[Joecarver]

I see mo 1 month then PA next month I get more info from my PA than Dr. she never just blows off any complaint.

[Hidden]

If your situation is stable with your current treatment and you don't have something new to deal with and/or treatment decisions to make, I don't see a problem with it. If there's something that you can't get answered to your satisfaction, you can always contact your doctor after the appointment.

[packardlover1949 in reply to Hidden]

And what will you discuss with a PA?

[Hygenator16 in reply to packardlover1949]

Are you still paying full price for the second team - maybe there should be a discount or credit?

[jimreilly]

I have seen PA's in a variety of contexts (different from yours) and have never felt I was getting less than the care I needed--and there have been times with specialists that I did not feel that way

[jbskiatook in reply to jimreilly]

Me too

[packardlover1949]

Not going to happen here, Oncologist knows cancer.

[Woodstock82]

No problem for me. My oncology team includes the MD, a PA, and a coordinating nurse. They all work closely together.

The PA saved my life when she noticed during the exam before my first chemo that the area around my port was turning a little red. She got me started on an antibiotic, and when the blood test came back positive for MSSA the team got me admitted to the hospital that same afternoon. I had a week of IV antibiotics there, then was discharged with a PICC line and completed the course of antibiotics at home.

[beachguy43]

I am fine with a PA in most cases.

[EdBar]

Pretty common to be switched to the PA, but my experience has generally been that the oncologist is more knowledgeable and answers my questions better. When making appointments I specifically request the oncologist. But you might want to give it a shot one time and see how it works out for you.

Ed

[DenDoc]

I found the PA was okay for checking labs before each chemo and going over any issues. For my followup visits which are now not so often, I have made it clear I want to see my MO whom I have a great relationship with. Tried one video visit and hated it. Every situation is different-I just happen to feel so close to my oncologist after he got me through life threatening issues. I am a retired physician and I love to see the vast knowledge he has at his fingertips. He is less than half my age and I respect him thoroughly.

[NotAlwaysSunshine]

We see both - almost every single visit. (monthly)

[SteveTheJ]

I'm totally biased against that no matter what. I would insist on seeing the MD.

[Muffin2019]

I see the PA every other time when I get my eligard and xgeva, unless the blood work shows a big change then I see my oncologist, the PA is really cool.

[Currumpaw]

alephnull,

Be fully engaged in the conversation. Ask questions. Express your expectations and ask questions about any meds, supplements or other treatments you may be receiving.

In my experience a nurse practitioner at an ENT's practice greatly exceeded her licensing level. She was well educated and intuitive.

A PA at my yearly physical was very disappointing. We soon mutually agreed to part company. She played the percentages. My CBC results were excellent --except for one--the one that is why am here. She told me that she has good results with those my age by prescribing certain drugs and a cardiac CT scan. Everyone gets the same? I told her NO! None of this was necessary.

Just as with doctors, those working on a level under the doctors are at all different levels of expertise. I hope your PA will be all that you could wish for as U found the nurse practitioner to be.

Currumpaw

[Magnus1964]

Since you're starting xtandi, the only time you need to see the oncologist is if there is a problem.

[austinsurvivor]

I may be contrarian here, but I would refuse to see a PA. 8 years ago after my diagnosis I was set to have a biopsy done and day before I needed to come in for a routine screen to make sure "everything" was okay at this major cancer center in Houston, and they had a PA see me to take my vitals and asked routine questions, yada yada...next day I go to the hospital to get my biopsy done and after waiting 4 hours past the appointment I asked what was taking so long and they tell me the PA saw something unexpected and advised I needed a MD anesthesiologist to assist in my biopsy without telling me boo....Doc finally shows up and asks why my blood pressure is so low and I say cause I'm an ultrarunner and he says he doesn't need to be there and I shouldn't have needed to wait 4 hours. Bottom line, you need to at all times take charge of your care and insist on the most qualified people that will tell you the what/why/how of everything they are going to do....and to get that you should not see a PA, they just don't know.

[Mormon1 in reply to austinsurvivor]

So true. I had a lung doc milking my insurance doing wastef tests just to bring money in. She would not say the C word or she would have to discharge me. I made 2 appointments with Cancer doctors without lung docs knowledge. Penn lied to me doc said he had 10 years c experience. He had 1. Comprehensive Cancer in NJ had a plan and saved me 4 years ago. My psa was 11,000! Take charge. You may have to switch. Dont become a number. Take action.

[Brysonal]

What’s a PA? In the UK it’s a personal assistant so nothing medical!

[alephnull in reply to Brysonal]

It's a Physicians Assistant. They receive quite a bit of medical training, but are still below a medical doctor.

[Brysonal in reply to alephnull]

Ah.. we don’t have those but some nurses do advanced training so they can prescribe in the UK but no PAs

[Mormon1 in reply to Brysonal]

Yes. Thats a PA. They can write scrips

[MateoBeach]

This is a great opportunity to make contact with the PA and check him or her out and see if they are conscientious careful and supportive. Or not. Having a smart supportive PA on the team can help you access what you need and want. Some may be better providers than some overworked MOs.This upcoming visit is just to see how you are tolerating the addition of Xtandi, nothing critical. That is why I say it is a good opportunity for you. Be friendly and do not prejudge. Ask your questions and see how they respond.

[Hidden]

Diagnosed with metastatic prostate cancer in May 2004. Seeing an Oncology PA or Oncology Nurse Practitioner is not a problem at all. First, understand that if there is a change in you, they will always report the change to the Medical Oncologist BEFORE you leave. It’s required! Sometimes I see both.

From my viewpoint after 18 years, if you are not comfortable seeing a Physicians Assistant or Nurse Practitioner, then you are not comfortable with your Medical Oncologist. Have confidence in the Oncology Staff. I have blood work including PSA and T every quarter; so I am in the clinic at least four times a year. (70 miles round trip) Good luck in killing the little bastards,

Gourd Dancer

[j-o-h-n]

It depends if she's got bit tits...........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 3/15/2022 3:35 PM DST - Beware the Ides of March

[cancerfox]

I'm not sure I wouldn't prefer talking to a PA. Every time I talk to my doctors they act like their office is on fire and they need to rush back and save their paperwork. I get more useful information from my nurses and technicians than from the doctors, who always seem like they are running behind schedule. There just don't seem to be enough doctors to go around. I wish the field I used to work in had been one tenth as unpopulated. 🙁

[j-o-h-n in reply to cancerfox]

Okay you sucked me in.....

" I wish the field I used to work in had been one tenth as unpopulated."

What was the field?

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/15/2022 5:58 PM DST - Beware the Ides of March.

[cancerfox in reply to j-o-h-n]

Engineering. People think that engineering is a guaranteed job, but every time I was looking for work and applied for positions there were 100 to 200 other applicants submitting resumes for the same opening.

[j-o-h-n in reply to cancerfox]

I feel your pain.....

In my youth (long time ago) I engineered myself out of many a deadman load with women...(good thing I could run faster than a husband, a bullet is another story however).....

What is the definition of an engineer?

Someone who solves a problem you didn't know you had in a way you don't understand. Get Well, Stay well!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/16/2022 1:32 PM DST

[MamawV]

My hubby started Xtandi at the end of January’22 and we’ve only see the oncologist with Kaiser since his diagnosis July ‘21. I would think it’s better to stick with the oncologist who’s familiar with your case vs a PA that isn’t trained to give specific cancer advice or treatment.

[Joes-dad]

The first and second MOs I had always chatted with me EVERY TIME I went. My second one would even chat like we were equals and I hated to see him retire. My new one (#3) saw me once and didn't try to get to know me. Since then I have only seen a PA who appears to know nothing about PC... That bothers me a lot😖

[TnRebel62]

I am getting ready to start Xtandi and my follow up is scheduled with the PA. I was like you and was WTH. But after thinking about it, and my wife telling me to get over it, it is just an appointment for bloodwork and seeing how I am doing with any side effects. My MO’s office runs like a well oiled machine and I have not had anything but good experiences with his staff. I trust him and so I am trusting he has good people on his staff

[Mormon1]

No!