Urologists are almost always the doctors who diagnose men with prostate cancer. Typically, most men remain under the care of their urologist through primary treatment and follow-up PSA monitoring. But when you have been initially diagnosed with advanced prostate cancer or you have a recurrence, you should add a medical oncologist to your team, preferably one with considerable experience dealing with patients with advanced prostate cancer.
There’s an on-going debate in the medical profession between urologists and oncologists about the typical urologist’s qualifications to treat men with advanced prostate cancer. Choosing the doctor to spearhead your treatment is a very personal decision. My personal opinion is that if you elect to have your urologist head your treatment team, make sure that he or she has received significant additional training and has ample experience treating advanced disease. Above all, don’t be afraid to ask your urologist about special training; this is a very important question.
Finding the right doctors is a critical task and will involve a substantial investment of time and energy. When we go to the supermarket we often spend time reading the ingredients in the things we’re considering buying. We may try on many different suits from the rack in order to find one that looks good on us and is comfortable. Think of finding the right doctors in the same way. Don’t be afraid to “try on” a number of them before making a decision. Even after you’ve made a decision you can always choose to change your doctor.
Keep looking until you find the doctor that fits you.
Just as important as your doctor’s expertise and experience is how well his or her philosophy and attitude aligns to yours. There are doctors out there who feel they “know it all” and you, the patient, are basically ignorant and should just follow directions. Condescension has no place in a doctor-patient relationship. You must feel comfortable and know that you are a person, not a number. The doctor should be willing to spend the time needed to thoughtfully address your concerns and answer your questions. (Which is another reason why educating yourself about your disease is so important.)
The best doctors appreciate good questions that also demonstrate you’re taking the time and effort to learn everything you can about this disease, its treatment, and how it may affect you.
Always get a second and even a third doctor’s opinion, no matter what type of doctor you have or how famous they are in the trade. Much of medicine is subjective, and different doctors may offer different views of your condition and how to treat it. If possible, consult with different medical oncologists and urologists from different medical practices at different institutions. Some institutions develop standardized protocols that they follow despite the individual nature of your disease. Meeting with doctors at different institutions is also useful because some doctors are not happy contradicting a colleague with whom they work. Always remember: you and your disease are different from every other man and his disease. Standardized protocols have a valuable place in medicine, but mainly as a jumping off point, not as a cookbook recipe on how to treat you.
It is important to me that my doctor listens to my concerns and seems to care about what I have to say.
Every doctor wants a satisfied patient. You can build your peace of mind by getting second and third opinions. Seeing another doctor for a second opinion should not offend the original doctor; this practice is common and expected. Insurance almost always covers a second opinion. A doctor who gets angry or upset that you are seeking a second opinion is not the doctor for you…or for anyone else. That said, not everyone lives in a large urban area where “doctor shopping” is practical. Wherever you live and whatever your economic circumstances are, do your best to consult with several doctors. But, don’t beat yourself over the head if this proves difficult because of your location.