Recommendations for ROs and MOs in Houston

[Rambo2789]

I’d like to request the names of one or more good ROs and MOs in or near Houston, TX (not at MD Anderson).

My husband (age 71) was diagnosed with highly aggressive PC in late December 2021. Gleason Score 9 (4+5), PSA was 12.5. CT and bone scans indicated no metastasis but PSMA PET scan indicated likely metastasis in a nearby lymph node.

After consulting with various Houston urologists and ROs as well as with a panel of docs at MD Anderson, he opted for an RO with whom he was quite comfortable, he trusted and who was easy to connect with; however, since he was referred by a urologist in the same urology group he made sure that the urologist remained in the loop on treatment. He was started on Lupron in February and Prolia in late March (he has osteopenia and wasn’t informed about the Lupron bone density loss issue). Both of these were administered by the urologist. He just had his first radiation treatment yesterday (which is to continue M-F for 9 weeks).

Since nothing had been mentioned, I asked the radiology technician yesterday about follow-up and consultations with the RO during treatment. To my complete surprise, she told me that he’d be meeting with a different RO during his treatment and that my husband would not be seeing his own RO that he had chosen. When I asked her why, she said she didn’t know what was going on.

My husband then called and later texted his RO to find out what was going on and why. The RO said this was just how they operate at his facility, having another doctor step in as a kind of weekly check on all his patients and no worries since the other RO is also board certified. He also said he told us about this during one of our earlier consultations but we must have forgotten due to information overload. This is hogwash. I attended every consultation with my husband and took extensive notes. This was not mentioned.

We feel like he is suddenly being “passed off” by his RO whom he totally trusted and selected for his care and that there is probably more to this than he’s being told. Also, his RO treats only prostate cancer patients and the RO doing the weekly checks does not specialize in prostate cancer but treats many different types of cancer. Hence my request for recommendations and I’m curious whether others have had a similar experience.

In addition, he was told by his urologist that he didn’t need an MO, but we’re feeling now that he should see one.

Any help with comments, recommendations or referrals will be greatly appreciated.

[6357axbz]

I see Dr. Eleni Efstathiou at Houston Methodist. She a bit unconventional and not strictly a SOC doc.

[Rambo2789 in reply to 6357axbz]

Thank you. Not sure what you mean by a bit unconventional but I take it she has helped you?

[6357axbz in reply to Rambo2789]

For example, some years back she agreed to give one of our participants on this forum early (just after dx) docetaxel along with ADT. It wasn't standard of care back then but today it’s accepted as an effective, if not preferred practice, depending on your cancers characteristics.

I had been in a clinical trial at MDA and my RO (the trial leader) took me off ADT/abiraterone after IMRT to my prostate. He planned to let my PSA reach 2.0 before MDT to my oligometastatic Mets. She was with MDA at the time but not my MO. However during Covid and when my current MO was out sick she saw me. Rather than wait for my PSA to reach 2.0 she had me wait till it reached 0.5 and had me go to ucla for a GA68 scan (before it was fda approved), then put me back on ADT and arranged to have my Mets zapped. This was not SOC but it made sense to me. She also switched me from prednisone to dexamethasone.

Now she’s about to try something else.

[Rambo2789 in reply to 6357axbz]

Great. Thanks so much for this information.

[Boywonder56]

I live part time in houston....i goto houston metro urology....i see dr zvi scheffman.....a great doc...state of the art...Another dr. I built a house for dr. Kevin slewayne....

[Rambo2789 in reply to Boywonder56]

Thanks very much.

[Tall_Allen]

I don't see why he needs an MO either. Hopefully, he will be cured. I don't think I ever saw my RO during treatments - his job was done with the plan. After treatments I saw him once but realized that even that visit was unnecessary. It's only necessary if he is having a problem.

[Rambo2789 in reply to Tall_Allen]

Thanks for your response.

We were expecting there would be an ongoing doctor-patient relationship with his RO.

About recommendations for an MO, he’s been told by his urologist he’ll need to be on Lupron for 2+ years and seems he needs the Prolia to help combat bone density loss, but it also may have some serious side effects. Having read posts here mentioning other treatments that may improve outcomes with respect to muscle loss, fatigue, hot flashes, etc. (all of which he’s experiencing), we thought an MO might be more knowledgeable about these. Is this inaccurate??

[Tall_Allen in reply to Rambo2789]

His RO, who is an oncologist, should be able to discuss and prescribe medicines to deal with the side effects of his temporary Lupron treatment. But if he isn't, hopefully, an MO will be. It sounds like he might benefit from an estrogen patch for all the side effects you mention.

Prolia usually does not have serious side effects within 2 years.

[Hidden]

Solid ROs. Both Professors. Brian Butler and Bin Teh. When I met them in 2003, they were at Baylor College of Medicine and Methodist. Now at Cornel Weill and Methodist. I highly recommend. They interacted with him every time I had radiation.

As far as MOs, I used Robert Amato; how ever he died. I followed him from Baylor College of Medicine and Methodist to McGovern Medical School and Memorial Herman. If I had to search for another MO, I would look toward Baylor College of Medicine.

I never looked toward MD Anderson, because the long time reputation as a fine institution is accurate; however generally, it’s cattle call time and one becomes a number instead of a person.

Gourd Dancer

[Rambo2789 in reply to Hidden]

Thanks for your response.

Neither my husband nor I (for a female issue) have fared well with MD Anderson for the very reason you mention. After his initial consultation with various doctors and having the benefit of having his PSMA PET results which showed likely metastasis in a lymph node they immediately scheduled more tests/biopsy and wanted to delay starting him on ADT. Despite multiple efforts, he could not get a response from the RO to a couple of questions he had after the consult.

[SteveTheJ]

Dr. Paul Corn at MD Anderson, cannot recommend highly enough. The man listens and is very personable. I don't have a radiation oncologist so cannot help you there.

Anything MD Anderson has to offer is good and they're plugged in to all kinds of research.

[Rambo2789 in reply to SteveTheJ]

Thanks for this info.

Is it possible to see an MO at MD Anderson if he's getting his radiation therapy and other treatment at another facility?

[SteveTheJ in reply to Rambo2789]

Ask the doctor in question.

[Bigm789]

Dr Eric Walser UTMB ,

[Rambo2789]

Thank you.

[caltexboy]

I don't understand anyone knocking MD Anderson in Houston. My wife was treated there for BC and had outstanding care, doctors and services. I think it is the best cancer hospital in the world along with Johns-Hopkins. I also did not see an RO during my IMRD salvage radiation for PC. As TA says, the plan is being followed.

[beachguy43]

I have been a patient at MDA for 15 years. Can say nothing but good.