Urologists, Radiologists, and Oncologists – Oh My!
For many men, their journey with prostate cancer starts with routine bloodwork ordered by their primary care physician (PCP). An elevated prostate-specific antigen test (PSA) might indicate prostate cancer, and a man has to make the choice of which kind of prostate cancer expert to see. Asking friends or your PCP for recommendations might be effective, but which kind of specialist is the right choice?
Once a man has an elevated PSA, he is usually referred to a urologist for further diagnostic testing. Urologists are surgeons that treat diseases of the prostate, as well as the male reproductive system and urinary system. Urologists can expertly assess the stage of the prostate cancer, and can determine whether it would be medically appropriate to take a watch-and-wait approach (often called active surveillance). This approach is used when a tumor is slow growing, isn’t causing symptoms, is small, or is localized to the prostate). They will also present all the treatment options and talk with a patient about what would be the best option for them based on their diagnosis and general health. Traditional treatment options include surgery and radiation therapy.
More and more urologists across the nation area treating prostate cancer with High Intensity Focused Ultrasound, or HIFU, which is a non-invasive, outpatient treatment for prostate cancer. HIFU eliminates prostate cancer tumors without destroying surrounding healthy tissue, thus dramatically reducing side effects traditionally found with prostate cancer treatments.
A medical oncologist might be the right choice for some men. These types of specialists typically treat cancer with medicines such as chemotherapy or with hormone replacement therapy. A medical oncologist might be up to date on clinical trials that involve testing new medicines or therapies for prostate cancer. Chemotherapy traditionally comes with a host of side effects, but can be the right course for some men. Medical oncologists can handle general medical problems that come along with treatments. Typically men with more advanced prostate cancer will work with an oncologist on the best course of treatment. Men with early stage or localized cancer will typically only work with a urologist or perhaps a radiation oncologist.
If a patient decides to pursue radiation as a treatment option, they will most likely be referred to a radiation oncologist. A radiation oncologist treats cancer with radiation therapy. By using high-energy radiation, tumors generally shrink and cancer cells are killed. But, in this effective method, however, surrounding healthy tissue is also killed, leaving the patient suffering with very undesirable side effects. When using radiation to treat prostate cancer, healthy tissue is destroyed often causing urinary incontinence or sexual dysfunction. Radiation oncologists are trained to treat and manage the problems that may arise from radiation treatment.
As with any medical issue, speak with your doctor about the best course of treatment for your individualized case. Spend time selecting a doctor whom you feel comfortable with, treats you with respect, and is an expert in the field of prostate cancer.