Once you have been diagnosed with invasive bladder cancer, you should try to select a urologist and oncologist who deal with bladder cancer on a regular basis. Several issues should be considered when you select a physician.
Competence: You need a capable doctor who is knowledgeable and can apply that knowledge.
Technical skills: If you are considering a radical cystectomy, you want an individual who regularly performs that operation. A radical cystectomy is a complicated, time-consuming procedure that some urologists rarely or never perform. The old dictum “practice makes perfect” certainly applies here. Furthermore, if you are interested in the neobladder option for reconstruction of your urinary tract, you should make sure that the urologist is comfortable with that portion of the operation. The neobladder adds complexity to the procedure for the surgeon, and not all urologists are well trained in this area. The urologist should know his or her own complication rate for the procedure and not just quote widely published rates for other surgeons. He or she should be comfortable and willing to discuss these rates with you.
Compassion: Cancer can be a frightening word and disease no matter how you look at it. You want a physician who understands your fears and concerns and who is willing to take the time to help you make your management decisions. There is no good measure for this, but trust your instincts at your first meeting with a new doctor.
Approachability: As you go through the decision-making process about bladder cancer, you would like your physicians to be available for questions and to be able to answer them in a timely manner. Delays in diagnosis and treatment will add to your anxiety.
My first urologist was just who my doctor told me to go see. He was always running in the room, all out of breath. One day, he just said to me, “ You have bladder cancer. The nurse will call you and tell you when to go to the hospital for surgery.” Then he made me sign a bunch of papers, and that was it. I told my doctor how upset I was, and he found me a young woman urologist who I just love to pieces. She’s made it all so much easier for me and my husband. I wish I had gone to her first. (L. R., 66 years old)