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Is biopsy necessary & effective for detecting prostate cancer?
Prostate Cancer | Last Active: Jan 31 7:30pm | Replies (68)Comment receiving replies
@brianjarvis Is it possible that you and your brother just got lucky and found extra-compassionate urologists?
Is there not a severe doctor shortage where you both live?
With the exception of the rare extra-compassionate doctor, doctors don't have to accommodate patients' needs because it is a "seller's market"...car dealers don't give discounts or concessions when there are more buyers than available cars, and doctors don't have to make concessions because there are more patients than available doctors.
And my guess is that these doctors that won't do general anesthesia would do general anesthesia if it were instead a "buyer's market".
In this "seller's market", doctors can afford to only keep the "cream of the crop" when it comes to patients, which means the most compliant patients.
I'm almost afraid to even ask my new urologist about general anesthesia during biopsy for this reason.
My primary care provider is an extremely compassionate woman who really cares about patient comfort, and if I get that feeling from my new urologist then I will ask about general anesthesia, but if I get the impression that his his attitude is going to be "oh...so this guy is going to be a troublemaker" , then I won't ask him about general anesthesia. I might casually ask one of his staff members about it on the sly, though.
Seeking out a compassionate urologist isn't really an option for me, because I would want a fusion biopsy, which already limits the selection of urologists within 3 hours of me, and then there is also the factor of "how do you know if a urologist is compassionate until you meet?".
Online reviews don't help because very few men ask for general anesthesia prior to biopsy, and if they don't ask then they don't know if the urologist would be compassionate vs. hostile regarding that particular issue.
Sorry to sound so cynical and/or negative, but I think that my description of the current situation is accurate.
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@jercalif I don’t think it had anything to do with extra compassionate urologists.
When I was initially diagnosed with PCa in 2012, my first comments to my urologist were, “I don’t know anything about prostate cancer so, I’ve got a zillion questions to ask before you cut anything out of me, or bombard me with radiation, or inject toxic chemicals into me……” That set the tone for our future discussions. (In fact, he recommended surgery; I said no, my numbers are in line with active surveillance protocols. I was on active surveillance for about nine years.)
No, we have no urologist shortage here. With 2 major hospital networks, many urology centers, and a VA medical center nearby, there is no issue with access or it being a “seller’s market.”
With my PCa journey, at each step of the way - urology, radiation oncology, and medical oncoming - it always involved self-advocacy and shared decision-making.
There were no less than a half-dozen decision points where we weren’t in agreement on my treatment path. I never felt pressured or that I had to do what the urologist/radiologist/medical oncologist suggested. When their argument was stronger than mine, we went with their recommendation; when mine was stronger than theirs, we went with my recommendation. But, that required me to thoroughly research and come up to speed on the nuances and protocols with this disease so that these would be informed discussions, and not just emotional opinions.
As often happens having different medical teams, our experiences were totally different. I think that I was fortunate in having selected a medical team that was open to working with me (rather than being assigned a team as some are).
“How do you know if a urologist is compassionate until you meet?” At that first referral appointment you just sit and talk with them about your situation, as if you were interviewing them (like you would if you asked someone to work on your house, or replace your roof, or do any other major project for you). Once you feel good that you’ve found someone you can work with, then go on to the next step.
If I lived in a “seller’s market,” things might be approached differently. But, I don’t; so I can’t answer from that perspective.