Definitely see if you can get into a center of excellence. I had my RARP done locally by a urologist who was also head of the robot-assisted surgery program. There was localized spread of the cancer in the seminal vesicles and lymph nodes. Post-surgery, my PSA was still higher than it should have been. PSMA, which was new at the time and not being used pre-surgery, showed an affected lymph node in the pelvis further from the ones they removed, and a second surgery was required to remove it. Still testing positive for PSA afterwards, I went to MSK (four hours away all told) for a second opinion. In my first meeting with the medical oncologist, he mentioned that their surgeons would have removed more lymph nodes in the original surgery. I would have still needed follow up, but I could have been spared a second surgery had I gone to a center of excellence from the start.