Can you select your Mayo surgeon?

Diagnosed Gleason 6 in 2022 by local urologist. Got a second opinion at Mayo Rochester. Both urologists concurred, and advised that active surveillance was best step. Fast forward to today. Recent MRI showed lesion growth and PSA has risen. Might be facing surgery. I liked the Mayo urologist, but he is young. If I need a RALP, can I request a more experienced surgeon? Can I request one by name? Thank you.

Diagnosed Gleason 6 in 2022 by local urologist. Got a second opinion at Mayo Rochester. Both urologists concurred, and advised that active surveillance was best step. Fast forward to today. Recent MRI showed lesion growth and PSA has risen. Might be facing surgery. I liked the Mayo urologist, but he is young. If I need a RALP, can I request a more experienced surgeon? Can I request one by name? Thank you.

Diagnosed Gleason 6 in 2022 by local urologist. Got a second opinion at Mayo Rochester. Both urologists concurred, and advised that active surveillance was best step. Fast forward to today. Recent MRI showed lesion growth and PSA has risen. Might be facing surgery. I liked the Mayo urologist, but he is young. If I need a RALP, can I request a more experienced surgeon? Can I request one by name? Thank you.

Follow-up questions: We live about 5 hours from Rochester by car. Concerned that if there is a complication after surgery, we will be far from Mayo. Did any of you have surgery at Mayo but received follow-up care with your local urologist? How did that work? Did the local urologist show any signs of displeasure that you did not have him/her perform your surgery? Who did your catheter removal and routine PSA tests? Thanks very much.

By all means you may choose your own surgeon at Mayo! I am fortunate to live within an hour of Mayo Rochester, so I already had the first step completed: finding a center of excellence.

I wasn’t satisfied with the urology oncologist I was assigned to; after two consultations, before and after the biopsy, I just wasn’t sure if he had the personality that jibed well with mine.

You mentioned that you have seen urologists. Have you fully investigated radiation options as well? I was a Gleason 3+4=7 ( but with a high risk Decipher score of .8) and could choose any treatment from the amazing technological smorgasbord available to us these days. That was great, but so many available choices also made it a more difficult and time-consuming decision. : )

My wife and I watched countless videos and read several books and articles about prostate cancer and recovery. We looked for reputable sources, such as Dr. Scholz @PCRI, info from the prostate cancer foundation (PCF), the latest (5th) Edition of Dr. Patrick Walsh‘s Guide to Surviving Prostate Cancer. Also, we read many reputable journal articles about prostate cancer and relatively recent high-quality studies. Zerocancer.org had good info… Et cetera.

It’s very important to take the time to fully investigate your options before committing. And finding a doctor who has performed a very large number of the kind of treatment procedures of the kind you are looking for.

We looked heavily into the various types of radiation treatments, and homed in on HDR (high dose rate) brachytherapy—tiny radioactive pellets used inside the prostate. We asked the first urologist we’d been seeing for recommendations for a good radiation oncologist (RO) and he recommended a few that he works with. We chose one, and had a meeting with him. (He was kind enough to let us meet via Zoom the morning of our appointment, after our car wouldn’t start!) Again, we felt that this doctor was not right for us.

So we looked on the Mayo website and found another RO and had an impressive interview with him. He squeezed us in to his schedule relatively early, had excellent academic and experience credentials, and was a warm, friendly communicator. We left that meeting feeling very relieved that we had found the best doctor for us.

We told him that we wanted a Decipher test, which looks at your genome and rates the degree of aggressiveness of your cancer. After a few weeks the result came back as high-risk/ aggressive. That really shocked us. Also, we had had earlier followed the advice of a trained volunteer at PCRI and gotten a second opinion (on my Mayo biopsy) from Johns Hopkins. Hopkins had found evidence of “large cribriform morphology,” and we looked that up. It’s controversial and somewhat unsettled, but cribriform is not good and could raise the risk level of your cancer.

The cribriform and the Decipher score made us reconsider our options, and we looked again at surgery, which offered more certainty (following the procedure) that it had gotten all the cancer. This is because they can biopsy the entire prostate after it has been taken out and get a more accurate reading of where are you stand. Whereas with radiation, it can take several months or even a year or two before you can tell if the Pca was fully eliminated. We just didn’t want all of that worry and uncertainty.

So we sought help on Mayo Connect, and got dozens of very helpful replies, among which was a strong recommendation from someone who was very satisfied with his surgeon, both in competency and bedside manner.

This was Dr. Igor Frank. We had a consultation with him and were very impressed. So we decided to go with him. Yesterday we spent the day at Mayo Rochester for pre-op testing, a class, and another meeting with Dr. Frank and his nurse. All were very satisfactory.

So this coming Monday is the big day! I’ll have my surgery at the Methodist Hospital campus at Mayo Rochester.

We’re grateful that we did our due diligence and understood all of the treatment options available, and that we had kept searching until we found someone we felt fully confident about and comfortable with.

I wish you the best of luck as you embark upon your journey through this world of prostate cancer. Onward!

Jim G

Jim, good luck with your surgery on Monday. Dr. Frank and his team are absolutely awesome and I am confident you will have a great experience and best possible outcome. As you probably know, the first week will be the most difficult part of your recovery. However, after you get the catheter out, it is all down hill from there. Be sure to follow the post surgery therapy and Kagels.

Best of luck with your Monday surgery!!

Jim

By all means you may choose your own surgeon at Mayo! I am fortunate to live within an hour of Mayo Rochester, so I already had the first step completed: finding a center of excellence.

I wasn’t satisfied with the urology oncologist I was assigned to; after two consultations, before and after the biopsy, I just wasn’t sure if he had the personality that jibed well with mine.

You mentioned that you have seen urologists. Have you fully investigated radiation options as well? I was a Gleason 3+4=7 ( but with a high risk Decipher score of .8) and could choose any treatment from the amazing technological smorgasbord available to us these days. That was great, but so many available choices also made it a more difficult and time-consuming decision. : )

My wife and I watched countless videos and read several books and articles about prostate cancer and recovery. We looked for reputable sources, such as Dr. Scholz @PCRI, info from the prostate cancer foundation (PCF), the latest (5th) Edition of Dr. Patrick Walsh‘s Guide to Surviving Prostate Cancer. Also, we read many reputable journal articles about prostate cancer and relatively recent high-quality studies. Zerocancer.org had good info… Et cetera.

It’s very important to take the time to fully investigate your options before committing. And finding a doctor who has performed a very large number of the kind of treatment procedures of the kind you are looking for.

We looked heavily into the various types of radiation treatments, and homed in on HDR (high dose rate) brachytherapy—tiny radioactive pellets used inside the prostate. We asked the first urologist we’d been seeing for recommendations for a good radiation oncologist (RO) and he recommended a few that he works with. We chose one, and had a meeting with him. (He was kind enough to let us meet via Zoom the morning of our appointment, after our car wouldn’t start!) Again, we felt that this doctor was not right for us.

So we looked on the Mayo website and found another RO and had an impressive interview with him. He squeezed us in to his schedule relatively early, had excellent academic and experience credentials, and was a warm, friendly communicator. We left that meeting feeling very relieved that we had found the best doctor for us.

We told him that we wanted a Decipher test, which looks at your genome and rates the degree of aggressiveness of your cancer. After a few weeks the result came back as high-risk/ aggressive. That really shocked us. Also, we had had earlier followed the advice of a trained volunteer at PCRI and gotten a second opinion (on my Mayo biopsy) from Johns Hopkins. Hopkins had found evidence of “large cribriform morphology,” and we looked that up. It’s controversial and somewhat unsettled, but cribriform is not good and could raise the risk level of your cancer.

The cribriform and the Decipher score made us reconsider our options, and we looked again at surgery, which offered more certainty (following the procedure) that it had gotten all the cancer. This is because they can biopsy the entire prostate after it has been taken out and get a more accurate reading of where are you stand. Whereas with radiation, it can take several months or even a year or two before you can tell if the Pca was fully eliminated. We just didn’t want all of that worry and uncertainty.

So we sought help on Mayo Connect, and got dozens of very helpful replies, among which was a strong recommendation from someone who was very satisfied with his surgeon, both in competency and bedside manner.

This was Dr. Igor Frank. We had a consultation with him and were very impressed. So we decided to go with him. Yesterday we spent the day at Mayo Rochester for pre-op testing, a class, and another meeting with Dr. Frank and his nurse. All were very satisfactory.

So this coming Monday is the big day! I’ll have my surgery at the Methodist Hospital campus at Mayo Rochester.

We’re grateful that we did our due diligence and understood all of the treatment options available, and that we had kept searching until we found someone we felt fully confident about and comfortable with.

I wish you the best of luck as you embark upon your journey through this world of prostate cancer. Onward!

Jim G

Diagnosed Gleason 6 in 2022 by local urologist. Got a second opinion at Mayo Rochester. Both urologists concurred, and advised that active surveillance was best step. Fast forward to today. Recent MRI showed lesion growth and PSA has risen. Might be facing surgery. I liked the Mayo urologist, but he is young. If I need a RALP, can I request a more experienced surgeon? Can I request one by name? Thank you.

Biopsy performed in Ohio showed Gleason 3+4=7 at age 73. Went to Mayo-Rochester for a second opinion with Dr. Igor Frank regarding treatment options (I had requested Dr. Frank based on solely on internet information). Decided on surgery and underwent bilateral nerve-sparing robotic-assisted radical prostatectomy performed by Dr. Frank in March 2023. Just short of 1 year post-surgery I am 99% continent (very infrequent, very small leaks), completely satisfied with erectile function and have undetectable PSA to this point. Dr. Frank and his team have provided excellent care from A to Z. I feel very blessed to have found Mayo-Rochester and in particular, Dr. Frank, who I most highly recommend to anyone evaluating his prostate cancer treatment options.

Thank you for your reply. Did you stay in Minnesota until your catheter was removed? Who provides your follow up care? Local urologist or Mayo?