How many saw Urologist for prostatectomy vs Genito-Urinary Oncologist?

In my case, I had a urologist (a surgeon) diagnose me; then he provided me referrals to experts in focal therapy (cryo, HIFU, & ablation), brachytherapy (LDR & HDR), SBRT (Cyberknife & Truebeam), IMRT, & proton radiation. I interviewed each of them, thoroughly studied up on each treatment, and then made the choice of treatments myself - proton.

In my case, I had a urologist willing to work with me.

I had a urologist, surgeon, diagnose, And do the prostatectomy. GU oncologist do not do prostatectomy they direct your treatment.

I had surgery in 3 1/2 years later it came back. I had salvage radiation with an RO And 2 1/2 years later, it came back.

As soon as my PSA started rising after Radiation I was given a GU oncologist to work with and to direct my treatment from then on.

I went many years without seeing the urologist once I had the radiation oncologist treating me.

My husband was diagnosed by regular urologist and too late for having an option of focal treatment because urologist was too laxe with AS . We immediately went to local cancer treatment center of excellence and broke all connection with the urologist. Not only was he incompetent with AS , his suggestion for RT for my husband was WRONG suggestion since my husband has cribriform and IDC and RP offers better curative and survival chances.
So, my advice is - go to a specialist for urogenital cancers , an urology surgeon that specialize in removing uro-genital cancers IF you plan to do RP. If he has a special interest in PC patients, that is even better. Those surgeons perform hundreds of surgeries every year and couple of thousands in their carrier of just PROSTATE ; ).

A genitourinary (GU) oncologist is a subspecialist within medical oncology. A GU oncologist does not perform surgery, but is preferable for a consultation to a general medical oncologist or general urologist if you are dealing with prostate cancer. Prostate cancer surgery is usually done by urologists who are also surgeons, and ideally who are specialists in urogenital cancer. You can find all of these specialists who focus on prostate cancer at an academic cancer center or cancer center of excellence.

Thanks for the reply. How many years has it been since your radical prostatectomy? How many radiation sessions did you have? I was surprised when my urologist said that if/when I eventually need radiation, it is "40" consecutive days of radiation..."forty days." I thought that was rather amazing. To hear you and others say that their cancer came back after radiation makes me shout a bit "HOW" and "WHY"? With the prostate gone and many radiation sessions to kill-off the remaining cells that kicked up your PSA, how did it come back. The science and the treatment clearly are not perfect. Anyway, I am most interested to the answers to my first questions: How many years has it been since your RP, etc.? Thank you

I have the prostatectomy 15 years ago. My PSA started rising 3 1/2 years later and I was given 7 weeks of salvage radiation. 2 1/2 years after that, my PSA started rising again, and I went on Lupron.

Now my case is a little different because I have BRCA2, Which prevents my body from correcting DNA errors and that results in prostate cancer for many of people with the BRCA2 hereditary problem.

I have run into many people that had prostatectomy and needed salvage radiation, Up to 40% of the people that have prostatectomies need salvage radiation.

The problem is Micro metathesis can start growing, And a PSMA pet test cannot find them unless they are over 2.7 mm in size.

I am an MD in another field so other than my background which is cardiology I am in the same boat as the non-MDs in this blog. To the best of my knowledge (I graduated medical school many years ago) a urologist is a surgically trained MD and an oncologist is a medically trained MD. The latter is not a surgeon. Medically trained MDs can do procedures. I do heart caths and stents for example. It would be impossible for me to do open heart surgery. Likewise, if I understand your abbreviation RP as meaning radical prostatectomy, this seems to me to be out of the scope of practice of an oncologist who is basically trained in the medical side of things.

Yes, RP stands here for radical prostatectomy.
Regarding urologists that are also surgeons, I am not sure that all are trained in every surgical technique and condition in urology field. Definitely not all know how to perform RARP and even lesser number specialize in PC surgery. There are urology surgeons that perform RP surgeries almost exclusively and those are really masters of their domain ; ). Their eyes are so well trained to recognize any minuscule aberration in tissue appearance and can adjust and change surgery plan on the spot. In our recent pre-op consultation surgeon went over his plan but also mentioned possible extra steps that would be performed depending of the actual scenario that he sees during surgery. Those things come only with experience and out of love for the job one is doing.
PS: Thanks for explaining cardiology field - I thought that cardiologists who place stents also do heart surgeries.

I agree that there are urologists of varied skill sets but prostate surgery is in their wheelhouse. Not so for oncologists; they are not surgeons. Cardiologists are not surgeons either. Try ChatGPT.

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Yes I wish I had went straight to an oncologist especially with stage 4 metastatic cancer.