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Urologist, Oncologist, Hematologist - who is in charge of my case?
After 8 weeks of radiation and completing 8 of 18 months of Orgovyx, I am having difficulty determining who is in charge of my case. The Urologist defers me to the Oncologist concerning future Orgovyx use vs active surveillance. The Oncologist defers me to the Hematologist who prescribed Orgovyx and who is not interested in discussing anything but the text book recommendation for treatment. Should either my Urologist or Oncologist take a leadership role in reviewing and making a recommendation concerning on going treatment?
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I have a straight-forward care team. Genito-urinary oncology is the boss, Cardio-oncology has veto power, Radiation oncology zaps what shows up. I can call each separately should I feel the need to do so, but they will still coordinate with Genito-urinary oncology.
PCP, Urology, and Cardiology are in the back seat for the time being.
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1 ReactionUltimately you are in charge of your case. You can stop the ADT early if you want and see what happens. It may not be a wise move, but your doctors cannot compel you to stay on any medication. The doctor that prescribes the ADT is usually the one that would stop it and your other doctors have already deferred to the source. From the doctor's viewpoint if there is a recurrence, they would much rather have a note that says patient refused further ADT treatment than one that says they recommended stopping the treatment early. It also keeps them out of lawsuits.
My radiation oncologist (RO) coordinated my radiation treatments (28 fractions of proton radiation); my medical oncologist (MO) coordinated my ADT injections (two 3-month injections of Eligard) and periodic bloodwork (PSA, testosterone, CBC, & CMP). I haven’t seen my urologist since my decision (in December 2020) to go with radiation.
As for who was in charge…. We all worked together. I had the final sign-off with any action we took - self-advocacy and shared decision-making.
You should take the leadership role in reviewing and making a recommendation to them concerning on-going treatment.
> During my 9 years on active surveillance, my urologist always recommended a prostatectomy. I looked at it differently.
> When planning my radiation treatments, there were a half-dozen decision points where my RO and I weren’t in agreement on the treatment path. But, it was always about self-advocacy and shared decision-making. When his argument was stronger than mine, we went with his recommendation; when mine was stronger than his, we went with my recommendation.
> My MO and I have seen eye-to-eye with almost everything.
Step up and take charge; you’ll feel better about the journey by having a direct say on what comes next.
Like others, I have a GU Oncologist Managing my case. I had surgery which my urologist did, Radiation which my radiation oncologist did. Once I had An oncologist on my team, they were in responsible for all treatment. When I first started ADT My urologist prescribed it. He Continued prescribing it until I spoke to my GU oncologist and asked to switch to Orgovyx, At that point, she is the one that prescribed it.
My urologist was not involved for over 8 years In my Prostate Cancer treatment.
Thanks for the replies!