Choosing the Best Doctor

By MARK SCHOLZ,MD

Prostate cancer deals with an incredibly intimate aspect of a man’s life.  Choosing the right doctor can lead to greater remission rates and a better quality of life.  In the prostate world, doctors come with a variety of skills and knowledge.   

Types of Doctors for Prostate Cancer Care

There are six main categories of doctors you may interact with during your prostate diagnosis: general practitioners, urologists, radiation oncologists, medical oncologists, radiologists, and pathologists. It is important to understand the role each specialty plays.

General Practitioners

Primary medical doctors (PMDs) do annual physicals and screen for prostate cancer with yearly PSA testing. If an elevated PSA is found, they will typically refer their patient to a urologist who usually recommends a biopsy. Some PMDs stay involved after a prostate cancer diagnosis and help guide the patients through the treatment selection process.

Medical Oncologists

Medical Oncologists are trained to oversee the general care of the cancer patient. Cancer therapies require a team of physicians who work together.  Medical oncologists “quarterback” the team by designing and implementing the overall treatment plan.

Pathologists

Pathologists diagnose disease by examining biopsy or surgical samples using microscopy. For prostate cancer, the pathologist assigns a Gleason score to the core samples.  

Radiation Oncologists

Radiation Oncologists are specially trained to administer radiation therapy to all types of cancer.  If you undergo radiation treatment, you will need one of these doctors. 

Radiologists

Radiologists interpret MRI scans, X-rays, PET scans, and CT scans.  

Urologists

Urologists are surgeons who are trained to manage problems with the genitourinary tract.  Urologists have been the first line of defense against prostate cancer for over 100 years.

Choosing Your Doctor

It is best to rely on more than one doctor.  Second opinions are important! After you have met a variety of specialists, one doctor should be selected as your primary physician, acting as your advocate and analyst.   Additional doctors, such as surgeons or radiation therapists, can be used to administer therapy.  Pathologists and radiologists help provide accurate staging. Having a different advising and treating doctor helps avoid a conflict of interest.  Doctors are naturally biased toward the treatment they are trained in, for example urologists are trained in surgery and are therefore naturally more comfortable recommending surgery than radiation.  

Resources for Finding a Doctor

1. Referral:  Primary care physicians are very familiar with the skills of the doctors in their local community. Ask your PMD for the name of the best doctor in town.
2.  Online Search: The internet is a great resource. Start with the doctors rated four or five stars.  This being said, not all online ratings are genuine.  Use your discretion when reading ratings and keep in mind that even a five star doctor may not be the right fit for you.  In addition, your health insurance company will typically publish a list of their in-network doctors online.  If you decide to go out-of-network for your care, check to see if your health care plan offers any out-of-network coverage.
3. Word of Mouth:  Ask friends and family who have had first-hand experience with prostate cancer. Since they have already been diagnosed, you can learn from them.
4. Support groups: Support group members have faced the similar decisions and choices. They are great resources to consult.  Visit pcri.com to find your local support group.   

Criteria to Consider

1. Experience: Expertise comes with experience.  The larger number of prostate cancer cases the doctor sees, the more comfortable they will be with selecting and recommending treatment.
2. Specialization: If you are receiving treatment at a specialty center you are more likely to receive world-class care.  Medicine is changing so quickly that generalists are unable to stay abreast of the latest breakthroughs. Seeking a specialist is a great way to navigate a complicated illness such as prostate cancer.
3. Know Your Disease: The best way to evaluate a doctor’s competence is to approach the initial interview from a position of strength.  You must develop a working knowledge of prostate cancer.  You can streamline the learning process by identifying your stage. Take the free prostate cancer Staging Quiz online at keytopc.com/quiz.