Prostate Cancer Technology

WSRL.ORG / Prostate Cancer - February 2009 - Page 1

Newly diagnosed? Don't panic. Unless your cancer is unusually aggressive, which is unlikely, you have many weeks

Typical Biopsy Slide

if not months to study and make informed, rational decisions. For openers, why don't you review the "Newly Diagnosed" links to the right. For those with high PSA scores but negative biopsies, I would strongly recommend a 2nd test by a highly competent physician using the very latest in tumor imaging technologies. Again, links are to the right.

Who Are The Players? -

It's critically important to understand who the players are and what their function is relative to your treatment. If you live in Western Colorado and see physicians here, you most likely are seeing a Urologists. By common definition, urologists are surgeons and make a good portion of the fees from surgery. In concert with urologists are the radiation oncologists. Radiation oncologists kill cancer cells by exposing them to high levels of ionizing radiation (typically xrays). The last player and one that is generally not available in this area is the prostate cancer medical oncologists. It is important to seek out physicians that specialize specifically in prostate cancer and are recognized experts in the field.

The Biopsy -

Biopsies are generally done by urologists. In my experience, urologists in this area do biopsies in the blind (casino style) and are not able to distinguish tumor tissue from cancer tissue with their equipment. A direct quote to me from a staff medical person at the Loma Linda Proton Center follows. , "We get men in here with a PSA of 20 and zero out of 12 cores positive. We send them to Dr. Bahn. He will typically do six cores and six out of six will come back positive". To see the magnitude of the problem, go to the Moss Reports Site. Links to organizations and physicians doing outstanding work (my opinion) on the west coast can be found in the links section to the right.

Biopsy (Pathology) Read -

The accurate determination of a Gleason Score/Grade is absolutely critical to your treatment. Many thousands of dollars will be spent on your treatment and your life may will depend on an accurate determination of your Gleason Score/Grade. After two reads by local pathologists I was absolutely guaranteed that the reads were accurate. A later "expert read" changed my Gleason score. Luckly the change was minor but it is important to recognize and understand the difference between a 3+4 read and a 4+3 read. All reads were from the same biopsy. I strongly suggest that you disregard any local reads and have an expert read done by a trusted expert pathologists or lab..

Dr. Strum & Donna Pagliano

What's Reversible and What Isn't -

A prostate cancer patient needs to think carefully about what treatments are appropriate for his unique condition. Before any procedure in performed on you, you will be asked to hold the doctor and hospital totally without legal fault regardless of your ultimate outcome. Radical Prostatectomies including the daVinci procedure can not be reversed and have the potential to do a great deal of harm that is also not reversible. The same is true of any type of radiation procedure. Remember, several recent studies have shown there is no significant difference in death rates between patients that receive treatment and those who receive no treatment at all. So what is left? An awful lot of men wish they could have their treatment decision back in order to gain greater quality of life and better urological function. I most strongly recommend that patients seek out the very best professionals in the fields of biopsies (including color doppler), pathology reads and cancer staging. If you are in a low risk category active surveillance may be your very best and safest initial treatment option. The longer you can postpone any higher order invasive procedure, the more options you will likely have. Advances in the treatment of this disease are occurring at an ever increasing scale. If you agree with the above statements, I additionally suggest you seek out a highly qualified Medical Oncologist specializing in your area of need and let him/her quarterback your treatment options. Links to "Find an Expert Physician" are to the right.

The Urologists - Medical Oncologist Fight -

I think of a urologists as a mechanic with a knife. A medical oncologists is more of an artist in my view. Like a carpenter that thinks of all solutions in the form of a hammer and nail, a urologist thinks in terms surgeries or a da Vinci procedure (that was implied would work but didn't on me) . If ever your urologists states that medical oncologists really don't know how to treat prostate cancer, I advise doing exactly what I did and fire him on the spot. Life is way too short and hard for the super egos some doctors carry around. Beware The Urologist - This document describes what can happen when the patient has blind faith in the physician treating him. Always understand and agree with the treatments being given.

Diet -

Treatment by a prostate medical oncologist specialists involves many of the same things done by a urologists but typically goes much further to include such things as diet. From a statistical data basis, perhaps some of the deadliest foods on the planet are served up from the local Walmart meat and dairy sections. Do yourself a favor and ask for a copy of the China Study at you local library. It takes only a few minutes to read the Preface and Forward. If you don't agree with what's written, nothing but a little time is lost. If you choose to read the entire book, your life could, in deed, be saved as a result. The book is based on hard data findings not someone's opinions. If your doctor makes no reference to known cancer - diet relationships, perhaps you need to find another doctor.

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