When do you get assigned an oncologist?

Posted by chipe @chipe, Aug 24 7:50am

Hi all,
I have a surgeon and a urologist, but no oncologist (yet?). So when does an oncologist get involved? When it's time for hormone therapy or time for radiation? Thanks.

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Not sure where you're being treated. I specifically had to ask to speak to a radiation oncologist and a medical oncologist and then was given appointments with them. Otherwise, the urologist would have just assumed I wanted to do surgery. The medical oncologist was the most objective of the three.

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When I saw a urologist last year, he was actually a urologic oncologist. I don't know that if would apply in your case, but it's worth checking.

In any case, I agree with @scottbeammeup that you should see some kind of oncologist ASAP. Everything starts then.

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When your PSA starts rising after surgery or radiation and has a significant doubling rate, you should get in contact with a genito urinary oncologist. they are the only oncologist that specialize in prostate cancer and no more about what is going on in the latest medical techniques.

If your urologist puts you on Lupron or Orgovix they are doing it because it is a big money maker. They know you should be seeing an oncologist at that point.

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I got assigned to one immediately following the confirmation of cancer in a lymph node. It was about a week after my surgery.

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To answer the original question, I saw a radiation oncologist a week or so after my surgery (emergency debulking of the metastasis on my spine), and a medical oncologist a few days later. Since we decided on ADT, Apalutamide, and radiation therapy to both the surgery site and prostate, the radiation oncologist took primary responsibility for my care.

Caveats:

1. I live in Ontario; every state or province is probably different.
2. I live in a big city with dedicated cancer centres affiliated with teaching hospitals and a research university. Small-town hospitals are probably different.
3. I was a hospital in-patient, so I was already in the hospital system.

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If you live in Ontario Canada, there are no GU oncologists there. Medical oncologist are the only doctors available. There was one genito urinary oncologist in Vancouver.

Canada treats prostate cancer patients quite differently than the United States, some procedures are just not available.

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If you already live in the cancer world, I'd find an oncologist who specializes in your specific problem. The sooner the better.

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@jeffmarc

If you live in Ontario Canada, there are no GU oncologists there. Medical oncologist are the only doctors available. There was one genito urinary oncologist in Vancouver.

Canada treats prostate cancer patients quite differently than the United States, some procedures are just not available.

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Good to know about genito-urinary oncology. Thanks for the info!

As I mentioned, I'm being treated by a radiation oncologist (and team). They're part of a multidisciplinary Cancer Centre and also teach at the university medical school. I've found them very up-to-date on the latest PCa treatments and best practices (comparable to what I read here from U.S. cancer patients). My new RO did a fellowship at Harvard Medical School before coming back to Canada.

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I went to a bone doctor on a friday, x-rays showed cancer, went for MRI on saturday, was seeing Oncologist on monday. I been seeing same doctor every month for just about 18 months. He is the only doctor I have.

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@chipe after my MRI, and by the time my urologist did their biopsy and recommended either surgery or radiation, I had already done enough research to decide on radiation and the type of radiation machine I wanted to use. I contacted five radiation oncologists that used that machine (my urologist had heard of the machine but nothing more), provided each of them with my MRI report, urology report and my genetic test (Decipher) and proceeded from there via in person and zoom meetings.

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