Questions for focal ablation therapists (read this link first)
1. Am I a good
candidate for focal ablation? Why do you say that?
2. What about
proximity to other organs – urethra, bladder neck, rectum?
3. How would
you assess my risk of urethral stenosis requiring catheterization?
4. Is there a risk
of recto-urethral fistula?
5. Should I
expect some incontinence for a while? For how long?
6. What about
damage to the neuro-vascular bundles on one or both sides?
7. What is the
risk of losing the ability to have erections? Orgasms? or have painful orgasms?
8. What is the
likelihood that I will still be able to ejaculate at orgasm?
9. Should I
expect blood in semen? In urine? Is climacturia ever an issue?
10. Should I
expect bleeding and sloughing of necrotic tissue through my penis?
11. How long
after the procedure can I have anal receptive sex?
12. What is the
likelihood that undetected cancer in the untreated area will become a problem?
How will we monitor that?
13. What is the
likelihood that cancer in the treated area will not be fully killed off? How
will we monitor that?
14. Will we use
imaging (mpMRI or PET/CT) to assure the cancer is gone? Will we do a follow-up
biopsy? Is there a pathologist here who is expert at reading biopsies of
ablated tissue?
15. How will we
monitor progression after the procedure? Since my PSA from the unablated zone
will always be there, how do we know if progression has occurred?
16. What is the
cost of the procedure? Does that include anesthesia?
17. What is the
cost of a re-do, if I need one?
18. Are any of
the costs covered by insurance?
19. How many focal ablations (as a primary
therapy) have you done?
20. Have
you always used the same equipment?
21. How
has your practice changed over the years?
22. Are you going to be doing all of the
really important parts of my procedure yourself?
23. What percent
of those required re-dos?
24. What percent
eventually needed other salvage therapies? What kinds of salvage therapies were
used? Radiation? Surgery? Were they successful? What kinds of side effects
occurred from the salvage?
25. What is the
longest follow-up you’ve done of patients you’ve treated?
26. How long
should follow-up be before we deem it a success, or am I always on “active
surveillance”?
27. What kind of
aftercare will you provide, and how will we monitor side effects, and for how
long? Will you regularly monitor my urinary and erectile recovery progress with
validated questionnaires like EPIC and IPSS?
28. What is the
best way for us to communicate? May I ask short questions by email?
Questions not to ask:
1.
What treatments should I consider and which is the best for
me? (this would be asking your doctor to
be an expert in treatments outside of his specialty, and also to know which
benefits and risks are most important to you – he doesn’t have time or
inclination to be expert in all therapies, and he’s not a mind reader.)
2.
If I were your father, what would you recommend? (You don’t know how he feels about his
father (lol), and more importantly, what he would feel most comfortable with is
not necessarily what you would feel most comfortable with. This is your
decision to make and live with – don’t give up your power!)
