3rd opinion: How many opinions did you get for prostate cancer?

Posted by saralie67 @saralie67, Mar 29, 2023

My husband was recently diagnosed with prostate cancer. I think maybe stage four but I’m not sure. He has a 3+4 Gleason score 13 PSA he’s 54. He has of also rheumatoid arthritis and thyroid problems. His initial urologist recommended surgery he then sent us to a specialist who also recommended surgery because of his age and relative good health. I follow a Facebook group on this subject, and Majority of them recommend another opinion, so I don’t know I’m just curious what everyone else thinks. I’m told that because the guy we saw today was a surgeon that he would naturally recommend surgery which is kind of what my husband thinks but he said today that if my husband was to have radiation first and then down the line , come up with cancer again that he wouldn’t be able to do surgery so I don’t know we’ve got surgery scheduled but I’m just curious if anyone else has been through this particular scenario what your thoughts are etc. thank you

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@michaelcharles

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(again)
PSA

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I have to admit that reading the multiple responses is so much more help than some of the treatment options available. Having a better understanding of those that have dealt with this is way beyond helpful!

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@michaelcharles

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Hello,
When I was first diagnosed with prostate cancer my General Practitioner said
“Get rid of your prostate, it’s a gland”. At no time did my Oncologist ever recommend removing my prostate. I underwent radiation, and I am still on hormone therapy since 2016. When it was available, I met with men at my hospital for group discussions. One man said he had his prostate removed only to find out that the cancer had metastasized, and he would have to start hormone therapy with Lupron. I know it can be difficult to decide on the best path to take. Looking back, I am grateful to have had access to Doctors, and Nurses that are always available to monitor my care.
I wish your Husband the very best. Hang in there!

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There are many twists and turns in this prostate cancer journey were on. It can be mind-boggling. Three things I've learned to live by. (1) Always be your own best advocate. (2) Find an oncologist you feel comfortable with. (3) Find a medical facility that fits your prostate cancer medical needs.

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Good thinking proftom2. I have had RP, been on ADT and Erleada ( androgen receptor inhibitor), when do you think that it is appropriate to bring an oncologist into this equation? I am thinking to do so when the ADT and Erleada stop working had radiation and chemo is the next treatment

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@hbp

Good thinking proftom2. I have had RP, been on ADT and Erleada ( androgen receptor inhibitor), when do you think that it is appropriate to bring an oncologist into this equation? I am thinking to do so when the ADT and Erleada stop working had radiation and chemo is the next treatment

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If were to start over I would begin w an oncologist. Urologist wants to do surgery and R.O. wants radiation. I am now seeing 2 Medical Oncologists and the guidance is whatever works for my particular condition. I did go thru 39 IMRT sessions before signing up w the M.Os. The principal M.O is at Mayo.
Good Luck

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@philnob

Hello,
When I was first diagnosed with prostate cancer my General Practitioner said
“Get rid of your prostate, it’s a gland”. At no time did my Oncologist ever recommend removing my prostate. I underwent radiation, and I am still on hormone therapy since 2016. When it was available, I met with men at my hospital for group discussions. One man said he had his prostate removed only to find out that the cancer had metastasized, and he would have to start hormone therapy with Lupron. I know it can be difficult to decide on the best path to take. Looking back, I am grateful to have had access to Doctors, and Nurses that are always available to monitor my care.
I wish your Husband the very best. Hang in there!

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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.

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@tlems

I feel compelled to respond to you on this. I also was diagnosed at 65 with stage 4, Gleason of 4+3. I went for a second opinion to one of the few National cancer centers in our region. The oncologist/surgeon felt that surgery was my best option. I had previously seen a Urologist in our home town that strongly recommended not having surgery due to the risk that the cancer had spread to other areas in the body. At the National cancer center just prior to our leaving they asked if I would be interested in a fairly new scan called the psma scan with an isotope to be sure their was no other signs of cancer in the body. ( new scan FDA approved in July 2021) I agreed and once the results came back it was determined that the cancer had spread to my L2 vertebrae. If I had had the surgery as suggested I would not have been able to target this new found tumor on my spine. The decision was made then to have 3 high doses of radiation therapy to the L2 and 28 doses to the 6 tumors on the prostate along with Lupron ADT. I only tolerated the first dose of Lupron and completed the full course of radiation. Today I feel great and my second 6 month psa was 0.11. I just feel that if i had settled with the opinion of the second opinion (surgeon) I wouldnt be where I am today as far as my treatment. Hope the information is helpful!

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So how long did u have the cancer?

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