What is happening in increasing numbers and frequency is that a patient will have his biopsy done by his local urologist and then go about finding someone else to do the surgery. The trend has been to look for robotic surgeons and then go there for the treatment. I am Okay with that, I think it is smart to research and talk to people and then make the informed decision that is best for the patient. The thing that prompted this post is the posts by patients on the various support sites for prostate cancer. I read time and time again about having the surgery and then returning for follow-up and seeing a physicians assistant or some other care giver rather than the surgeon. In many cases I am sure these patients have made their decision without the input of the urologist that made the diagnosis. I know this because it has happened to me. For whatever reason after the positive biopsy result, the patient does his research and goes elsewhere. When things don’t go to plan elsewhere they then feel uncomfortable coming back to the original urologist.
Here’s how you handle this: Go back to your “biopsy urologist” and listen to his input and then tell him what you have decided to do. If it is robotic then ask him who he thinks is good, if its him inquire about experience and results. If you have decided to go elsewhere tell you urologist that and then tell him you want to follow-up with him after your treatment elsewhere. There is no reason to have your biopsy and end the relationship. In my situation, the nearest robotic surgeon with a lot of experience is 70 miles away. To continue to go there instead of here just to have PSA drawn or management of incontinence or erection issues is not time efficient.
If you have appropriately handled the situation as I have suggested, then you can easily transition back into the local and convenient follow-up of the urologist that made your diagnosis. I do this all the time. I see myself as a facilitator of your decision-making process. It matters not whether you choose me or not .I would feel most urologists feel the same way. So let’s show the urologist that made your diagnosis (dare I say “saved your life”) some loving.