should you have an oncologist

whipple

My husband had the divinci january 4th, 2009. psa befor surgery was 4.6, gleason 4+3. Pathology: present in right and left lobes and involving 40% of the prostatic tissue. Tumor involves inked margin at base. Seminal vesicles involved. Perineural invasion. Lyphatic/vascular invasion. Tumor type Acinar. He is T3C.

We went to Northwestern in Chicago. The surgen said he should have radiation. We have an appointment with a radiation oncologist the end of February.
Questions I have if any body knows.
1. Before the surgery I asked the surgen if we should get any scans and if we should see an oncologist. He said we didn't need to. Could a cat scan have showed if the seminal vesicles were involved and if so would they have just done the radiation and not the surgery? I know whats done is done but it goes to feeling comfortable with the surgens advice.

2.) Should we also see a regular oncologist?

3.) I've read about adjuvan goserelin stating the last week of radiation therapy.

4.) What methods determine if it is local versus systemic. What tests and scans will he have next.
Thanks for your help. I'm a worried wife looking for help making the best decisions for him.

Mitch128

Oncologist Necessary?
~ Could a cat scan have showed if the seminal vesicles were involved and if so would they have just done the radiation and not the surgery? ~

In my particular situation, CT Scan, Bone Scan and Prostiscent tests were all inconclusive. As unpleasant as it was (along with the ensuing results) the conclusive test for me was an Endorectal MRI. My Oncologist went over the chart in interpretive detail, so I feel his specialty was definitely necessary. I had decided against surgery from the onset so that particular course of treatment was, for me, moot.

My opinion based on your comments, is a combination of (no Lupron) Hormone Therapy (ADT) and Radiation (EBRT) would have MY course of action. The always present catch-22 about Radiation Therapy is that (as I understand it) once administered, surgery thereafter is no longer an option.

I didn't answer all your questions, but I hope this helps a little.

Best wishes, Mitch

2ndBase

Options
As you have probably figured out a lot of men get dragged into surgery and find out the cancer has already spread which means that surgery was a total waste of time and money not to mention the side effects. I had psa of 24 and gleason 9 and radiation killed all the cancer in the prostate. I had another biopsy 5 years after radiation and there was no cancer left in prostate. As I said it had already spread so now my psa is 80+ and I am doing fine. Many treatments are available, all have consequences, and none are cures. I plan to ignore most advice I get from now on and keep the stress out of my life. Quality of time left is much more important than quantity to me. 95% of the tests offered are totally a waste of time as most give no help and a rare few give mixed results. Try not to show your worry to him and stay busy doing what you both enjoy and stay positive. Let him make the decisions of how to proceed. If this sounds blunt it is meant to be, it is the truth.