There are a lot of new people on this site and their main question is what should I do and what is the best treatment. Unfortuanately there is no clear cut decisions.
I'm surprized how many doctors don't use the available nomagrams to at least inform their patients of the probabilities of sucess of the treatment options they are considering.
Nomograms are formulas used to predict the probable outcome of different treatment options, based on data from thousands of prostate cancer patients. You plug in your own specific data such as PSA, Gleason grade, number of positive cores, % in cores ect. They are not perfect but they can provide a lot of information on which a more sound decision can be reached, and they can lead to better questions, like why are you recommending this treatment when the nomograms show it only has a 20% chance of sucess in my case.
Nomograms can be downloaded from the Slone Kettering web site and you and your doctor can use them in determinine what is the best option for you and your particular situtation.
The PCRI web site, in the "newly diagnosed" section has a paper by Dr. Mark Sholtz on how to use nomograms and adds a few more pieces of information to them to make them even more useful. If every newly diagnosed patient used these tools along with his doctor it would reduce the numbers of reoccurances and some of the horror stories that we read every day on this site.
I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%
I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I most likely didn't have PC, but to keep getting biopsies every year.
in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.
2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found wis indolant and statistacally insignificant, but PSA histor was a major concern and ordered a few more tests.
Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland, currently scheduled for Feb 14.
Changed diet and takiing supplements while I wait. The location of the tumor plus the high psa make surgery an unlikely option. I'm still evaluatiing all treatment options and will make a decision once I get the results of the Combidex scan.