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  • How to research Urologists.

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    Old 06-07-2021, 02:14 PM   #1
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    MrJohnny HB User
    How to research Urologists.

    I may be a bit late with this question, and I'm probably being influenced by others, but ...

    I was speaking with an acquaintance who had undergone an RP at Mayo Clinic and he asked me why I wasn't going to Rochester for treatment (we live in Minneapolis). I'm having my RP on June 30 at the University of Minnesota medical center.

    I've been very happy with my care team at the University of Minnesota. They've been great throughout the entire process from diagnosis, biopsy, scans, treatment discussions, etc.

    But this acquaintance went on and on about Mayo being the best, why don't you go with the best, etc. that it's making me a bit nervous. I have insurance, I can afford it, should I really be looking elsewhere?

    I chose the U of M team on the recommendation of my primary physician. The U of M has a good reputation overall but I admit I didn't do a deep dive into the urology team. Being 10 minutes from the hospital makes things easier on my wife versus trips to Rochester.

    Is there a site where I can read reviews of my care team?

    My wife says I am I overthinking this due to the comments of that acquaintance and I will be fine with my current team. Is there that great a difference that I should consider a change?

    My Journey so far:
    54 at diagnosis.
    02/21 - PSA 27.1
    4/13/21 - CT scan shows 11mm tumor at left lateral apex at the 3 - 4 o'clock position relative to the urethra. PI-RADS 4. No neurovascular bundle or seminal vesicle involvement by malignancy.
    04/23/212021 - Biopsy results, 7 of 14 cores positive including left base, left apex, right base and target, all positive cores scored Gleason 3+4=7 with between 5-30% graded 4.
    05/11/21 - CT pelvis scan and Technetium bone scan both negative.
    5/25/21 - Decided on RP, to be scheduled.

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    Old 06-07-2021, 02:37 PM   #2
    Join Date: Feb 2021
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    music4ever HB User
    Re: How to research Urologists..

    Just Google "your doctors name reviews". Many different medical websites will come up some will have reviews for your doctor and some will not. If you have the recommendation from your primary physician I would go with that.

    Good luck! I'm about your age and I just had an RP - it's really not not bad!
    1/2021 - 53 y/o Dx Prostate cancer Gleason 7 (3+4) over 6 cores on right side. Prolaris report "Unfavorable Intermediate" risk - PSA 3.9. 2019-PSA 3.51, 2017-PSA 2.55
    3/2021 - Radical Prostatectomy (robotic).
    3/2021 - Post-op pathology provided – pT3a pN0 MX, Stayed Gleason 7 but moved up to 4(70%) + 3. Small positive focal margin on right side. EPE. Decipher genomic test (.97) suggests "high risk" prostate cancer.
    4/2021 - 6 week follow-up PSA is 0.08
    6/2021 - 12 week follow-up PSA is 0.06

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    Old 06-07-2021, 02:58 PM   #3
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    Re: How to research Urologists..

    There is a great value in how you feel about your doctor, how they communicate and hopefully there expertise. I would be direct and ask your doctor about there expertise with the procedure you are having. I had a great doc at Yale and when I asked him how many RALPs he had done and his answer was "I have participated in 200". Participated!!!!!! Sorry doc I need an expert. Denis
    65YO healthy man, PSA 5/17 4.6, MPMRI, 5/17 lesion. 13 core biopsy 3 positive 3+3 All cores less than 30% 8/17 - second opinion Yale (3+4) in one core, < 5%, decipher test shows intermediate risks. HDR BT completed 2/6/18. 5/3/18 3 month Post HDR BT PSA 1.3, 6 mo PSA 1.2. 1-year PSA 1.0, testosterone 475, 18 month PSA 0.4 Testosterone 524, 24 month PSA 0.4, 32 month PSA 0.4 Testosterone 391, 40 months PSA 0.3, Testosterone 630.

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    Old 06-07-2021, 05:53 PM   #4
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    Re: How to research Urologists.

    If your current prostate treatment team has a great reputation and a high cure rate, it's probably fine to stay with them.

    With that said, I can happily report that I had an RP at Mayo (by Dr Matthew Tollefson) 10 years ago (in November). My PSA has been zero ever since.

    Simply put, Mayo Clinic stands at the top of the known medical universe. Others, such as Cleveland Clinic, Johns Hopkins, are virtually the same. Mayo Clinic has the largest prostate cancer database in the world and there probably is no kind of case that they have not seen and/or dealt with.

    If you are that close to Mayo, my advice is to consult with them. But, as I initially said, you will probably be just fine if your current medical team is top notch.

    Good luck!

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    Old 06-08-2021, 06:08 AM   #5
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    Re: How to research Urologists.

    Hi John,

    Your question reminded me of a point made about surgeon experience in a recent presentation I saw by an expert. I decided to put the key information in a post, and you can see it under the title "Many Radical Prostatectomy (RP) Surgeons Are Short on Experience".


    - - - - - - - - - - - - - - - - - - - - - - - -
    21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
    Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
    Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

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