Oct 07, 2012 - 5:33 pm
This is my first post on this board. I am a 55 year old man with a history of Hodgkins Lymphoma for which I was treated 29 years ago. Since that time my health has been less than robust but I have l been quite fortunate in that I never had a relapse in all those years. Last year my PCP referred me to a dermatologist for a half-dollar size spot on the skin of my lower chest. He biopsied it and the results came back basil cell carcinoma. The treatment was simple enough, it was surgically excised and I was on my way, no further treatment required. Last month I had a regular check up with my PCP and she did a PSA blood test. I had had one a few years back and it was in the normal range. This one came back at 10.2. She referred me to a urologist for followup and we discussed my history and family history, etc. I told him my older brother had been treated for prostate cancer about 7 years ago. He urged me to have a biopsy. He also did the digital exam and told me it felt like a normal healthy prostate to him, neither hard nor squishly. I enquired if the PSA could be in error and he acknowledged it could be and offered to run another one. That's what we did and it came back 18.8. I scheduled the biopsy and it was done two weeks ago. The urologist's office called me last Monday and said they had to reschedule our follow up appointment, could I come in tomorrow? I said yes and when I went in I got the news that the biopsy was positive, 7 of 12 samples cancerous and my Gleason score 8 (4+4). I must say I had prepared myself for bad news, but not that bad. I mostly listened to what he had to say in a state of befuddlement. He said I should have a CT scan and a bone scan. He said I should do some research and get a second opinion but I should act soon, no more than two months to commence treatment. He said in his opinion my best option was surgery, radical prostatectomy. I responded that I did not find the surgery option appealing. He said, okay, radiation also delivered good results for many patients. I left the office and went back to work. The urologist's staff was to schedule the CT scan and bone scan.
After having a couple of days to reflect, I don't believe I want to continue with this urologist. First, in each of my interactions with him, I have had to remind him I have a history of cancer, the Lymphoma and the basil cell. He says, oh yeah you mentioned that as if it is of no great importance. Also, he asks me each time, someone in your family had prostate cancer, right? Yes, my brother did, I have now told him four times. Next, why is he telling me that surgery is my best option when he hasn't any more information than the biopsy, no CT scan results, no bone scan results. How can he possibly make a recommendation? Lastly, his office staff never delivers on promises to call with results, schedule followup, etc. It has always required followup on my part.
I am in the Houston area and I have now scheduled a visit with MD Anderson. They have a satellite clinic in my part of town and I will go in on Tuesday to meet first with their urologist and later a radiologist. This Thursday, I will have an appointment with the oncologist / hematologist who checks me annually for my Hodgkins lymphoma followup. I had just seen him in July and he gave me a clean bill of health. Wow, what a difference three months make. I do have very good confidence in this particular doctor and if he has any recommendations regarding a followup with another urologist, I will definitely take him up on it. I would give any advice he might have great weight. Also, the CT scan and bone scan has now been scheduled for the following Monday. If the MD Anderson doctors want to do one in house before then, I can always cancel.
That's where I am now. To say I am stressed and anxiety ridden would be to understate it badly. Fortunately, I have a wonderful supportive fiancee and very good health insurance provided through my job. I feel very fortunate for both of those things.
Any advice would be much appreciated. Do you think I am unreasonable in my criticism of the diagnosing urologist? Do you think my decision to walk away from him is correct?