Mayo Clinic Dr to guide conversation on treatment options

Posted by dbee @dbee, Dec 27, 2023

I had a biopsy at Mayo in 2022 that showed Gleason 3+3 cancer. I've been on active surveillance since then. I am in the process of scheduling a second biopsy at Mayo in the coming months. I had previously met with a PA to schedule the biopsy. I met with a surgeon to get some input afterward, but I haven't really found a doctor to sit down with and explore the different treatment optionsm should the second biopsy show worsening results.

My situation is a little more complex due to diabetes and BPH. Does Mayo have general oncologists to work with to explore the various treatment options before meeting with specific specailists, like radiation oncologists or surgeons?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Hi @dbee, the short answer is, yes. When you get scheduled for an oncology consult, you will meet with an oncologist specializing in prostate cancer who has reviewed together your medical records, prostate cancer history, and tests, likely with a team of experts as required. Your existing conditions of diabetes and BPH will also be taken into account.

They may also suggest a consult with a cardio-oncology specialist if necessary.

Mayo Clinic offers a program to address heart problems associated with cancer treatment called cardio-oncology or for people who have a pre-existing heart condition when diagnosed with cancer. The Cardio-Oncology Clinic (https://www.mayoclinic.org/departments-centers/cardio-oncology-clinic/overview/ovc-20442193) evaluates people prior to cancer treatment and patients who have experienced side effects due their treatment, and can help evaluate treatment when you have both cancer and heart conditions.

May I ask which Mayo Clinic location are you going to? I can help connect you with other members who have been there and can share how it worked at their first consult.

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You may also be interested in reading the tips shared in this similar discussion:
- First appointment with oncologist: What to expect? https://connect.mayoclinic.org/discussion/first-appointment-with-mo/

@dbee, can you share more about the details of your diagnosis, for example stage, type, when you were diagnosed and if you’ve had any treatments?

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They absolutely do! I had an appointment yesterday with a Mayo oncologist who’s specialty and focus is “palliative” medicine for cancer patients! He specifically deals with treatment modalities for side effects, more effective care, pain control, nausea control, etc. etc. My appointment was very enlightening and informational. Over the years, I have seen radiation, oncologists, urology – oncology surgeons & the list goes on. FYI, I use Mayo Clinic at Jacksonville Florida and am very, very blessed to have them so close to home!

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I was on AS for 2.75 years, had lots of BPH, did a second biopsy at Mayo. But when I got Tulsa Pro I went outside Mayo to Dr Scionti in FL. One can get some real good discussion with all the doctors including Mayo, but nothing will beat your own reading around, plus calling and meeting all kinds of doctors at many places. I met with all kinds during AS and after my second biopsy said I needed treatment, but finding them all in one place will be hard. Yes do meet with every doctor you can at Mayo, but do meet with many others. If you want you can read more about my Tulsa and my prostate cancer issues here:

https://connect.mayoclinic.org/discussion/tulsa-pro-initial-experience/

I probably had some unique issues in that MRI contrast seemed to do a less good job since I started AS, so that made it hard.

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@bjroc

I was on AS for 2.75 years, had lots of BPH, did a second biopsy at Mayo. But when I got Tulsa Pro I went outside Mayo to Dr Scionti in FL. One can get some real good discussion with all the doctors including Mayo, but nothing will beat your own reading around, plus calling and meeting all kinds of doctors at many places. I met with all kinds during AS and after my second biopsy said I needed treatment, but finding them all in one place will be hard. Yes do meet with every doctor you can at Mayo, but do meet with many others. If you want you can read more about my Tulsa and my prostate cancer issues here:

https://connect.mayoclinic.org/discussion/tulsa-pro-initial-experience/

I probably had some unique issues in that MRI contrast seemed to do a less good job since I started AS, so that made it hard.

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What is "AS"?

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In reply to @cowpoke43 "What is "AS"?" + (show)
@cowpoke43

What is "AS"?

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Active surveillance is AS.

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@colleenyoung

Hi @dbee, the short answer is, yes. When you get scheduled for an oncology consult, you will meet with an oncologist specializing in prostate cancer who has reviewed together your medical records, prostate cancer history, and tests, likely with a team of experts as required. Your existing conditions of diabetes and BPH will also be taken into account.

They may also suggest a consult with a cardio-oncology specialist if necessary.

Mayo Clinic offers a program to address heart problems associated with cancer treatment called cardio-oncology or for people who have a pre-existing heart condition when diagnosed with cancer. The Cardio-Oncology Clinic (https://www.mayoclinic.org/departments-centers/cardio-oncology-clinic/overview/ovc-20442193) evaluates people prior to cancer treatment and patients who have experienced side effects due their treatment, and can help evaluate treatment when you have both cancer and heart conditions.

May I ask which Mayo Clinic location are you going to? I can help connect you with other members who have been there and can share how it worked at their first consult.

Jump to this post

Rochester. I also had the first biopsy at Rochester.

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@colleenyoung

You may also be interested in reading the tips shared in this similar discussion:
- First appointment with oncologist: What to expect? https://connect.mayoclinic.org/discussion/first-appointment-with-mo/

@dbee, can you share more about the details of your diagnosis, for example stage, type, when you were diagnosed and if you’ve had any treatments?

Jump to this post

Yes, I reviewed the first appointment with the oncoligist thread you reference. The stage is 1, Gleason 3+3, August of 2022 biopsy and diagnosis, no treatments yet. I have contacted Mayo about a follow-up and to schedule the second biopsy. They indicated that I start in the Urology dept for consultations and then bring in oncology from the cancer department if the cancer has spread. That was confusing to me given the other threads that seem to indicate others have consulted with oncologists and hadn't yet shown a spread of the cancer outside the prostate. Maybe there are oncologists in the Urology department familiar with all of the different treatment options?

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@dbee

Yes, I reviewed the first appointment with the oncoligist thread you reference. The stage is 1, Gleason 3+3, August of 2022 biopsy and diagnosis, no treatments yet. I have contacted Mayo about a follow-up and to schedule the second biopsy. They indicated that I start in the Urology dept for consultations and then bring in oncology from the cancer department if the cancer has spread. That was confusing to me given the other threads that seem to indicate others have consulted with oncologists and hadn't yet shown a spread of the cancer outside the prostate. Maybe there are oncologists in the Urology department familiar with all of the different treatment options?

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I don't know if it helps, but originally I went to Mayo to meet with interventional radiology (Dr Woodrum) and urology was partnered with them in various treatments they cover together, I saw others along the way too each time I went. Dr Woodrum had/has various treatments for urology: cryo, Focal laser, etc so I scheduled with him to see what he could do (if anything) and stayed in AS with urology there till I had to have treatment.

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Normal process is to work with a Urologist first, for testing, diagnosis and recommendations regarding treatment options. The Urologist is required to present all treatment options and Active Surveillance... which is often recommended for Gleason 6 with PSA below 10.

I highly recommend reading Dr. Walsh's "Surviving Prostate Cancer". This will help you understand the options. I flew 1500 miles and stayed in Rochester in December and January a year ago for proton beam SBRT. Very happy with my treatment and follow on care.

Best wishes for finding the path that is right for you.

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