I thought the urologists were the gatekeepers. Your GP would normally refer you to an urologist for an initial consult. This would generally require a biopsy to determine whether you have cancer and your Gleason rating would determine the aggressiveness of the cancer. In most cases you will be put on active surveillance to monitor the cancer. When your Gleason score reaches 7 it is recommended that treatment is required. Yes, your urologist will generally recommend surgery, however, it is at that point that you should ask for a referral to a radiation oncologist to get their opinion. I didn't think that a medical oncologist would get involved until a later date when hormone therapy is recommended or required.