I am an open book for people newly diagnosed with prostate cancer and often hear from friends of friends. Looking back on my journey, I feel that I too quickly went the surgery route after consulting with a very good urologist/surgeon/oncologist and I erred not consulting with a Medical Oncologist first. Had a call from someone diagnosed last week (Chicago) being pressured to have surgery immediately (Gleason 3 + 3). Two questions, at time of diagnosis prior to surgery, would you recommend consulting medical oncologist and radiation oncologist or other path? Second question referral for either specialists in Chicago or traveling to Rochester Mayo Clinic?
Just as an FYI, am 11 years into this journey, mets in lung and spine but managed with Lupron and Erleada my team is based at University of Texas SW in Dallas and I am very pleased with my care level.
Appreciate any thoughts regarding correct path for freshly diagnosed person. Thanks
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darlingdb
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If your friend is low risk, active surveillance is his best option. Northwestern and U of Chicago have good AS programs. If your friend is intermediate risk (by stage and/or PSA) he should talk to a few radiation oncologists (Arica Hirsch for SBRT at Advocate Lutheran, Brian Moran at Chicago Prostate Center for brachytherapy). There is no need to talk to a medical oncologist who will only confuse things and has no relevant expertise.
The correct path seems convoluted with disparities. My path nine years ago for my initial 3+3 was second and third pathology options, multiparametric MRI with second opinion and genomic testing (Oncotype DX only at that time). Took the investigative findings to many cross-discipline consultations focused on mpMRI and cancer deemed not indolent. Today, I would add a blood biopsy, PSMA imaging and genetic testing (yes ahead of common practice). I chose RP based on on mpMRI findings, final G was 4+3 and the beast was out and about. I remain grateful for my decision to have the main tumor burden removed.
Stanley Liauw @ U of Chicago - very experienced radiologist, I was his 1200th+ patient. I spoke with 5 ROs from all over the country and could not find a better one. 2 years after treatment no side effects.
No doubt there are many good Chicago medical oncologists, I see Dr. Sartor at Mayo. He is excellent in every way. I'd advise your friend to see a good medical oncologist before doing any treatment.
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