And to think . . . I hesitated
Moderator Emeritus
Lifetime Donor
15+ Year Member
Apr 16, 2004
SF Bay Area
Attending Physician

Interestingly, four times as many patients regret undergoing RP rather than salvage/adjuvant XRT. Urologist should therefore not hesitate to refer patients for post-RP adjuvantly rather than waiting for PSA failure. Also, Urologists need to discuss pros/cons of RP (particularly in high risk patients) better, explain that post-op XRT may be necessary and consider referral for definitive XRT.


Senior Member
15+ Year Member
Sep 20, 2004
Attending Physician
In other news, water is wet and the sky is blue.

They need to go publish this in the J Urol and at the AUA if the authors want anything to change as I'm sure all of us likely knew these results anecdotally. I don't think very many urologists read the "Journal of medical imaging and radiation oncology" unfortunately.

Prostate cancer by far has the most amount of shadiness going on. I see the occasional breast surgeon doing too many mastectomies or IR guy trying to offer primary RFA for early stage lung, but the cryo/hifu/inappropriate RP by urologists takes the cake by far in my personal experience in the community.

A pcp can be involved in the workup of a breast or lung nodule (sometimes in conjunction with pulmonary), but the elevated psa workup goes straight to urology and they generally end up being the driver of subsequent care.
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