We do have good tests for determining which PC is agressive and which is not. Most doctors are uninformed about
For example, a G6, low % cores: if PAP is normal, PCA3 is low, psa doubling time is greater than three years and color doppler and MRIS show no or very little tumor volume then your chances of dying from PC are practically zero without any treatment.
It is estimated that 50% of all men over 50 have these indolant, clinically insignificant cancer cells in their prostate and if biopsied enough you will find them. Most doctors recommend treatment, except if you are 75 or older.
Also bone and CT scans are routinely ordered for most PC patients, even though we know that unless your psa is over 20 or have a high Gleason these tests will always be negative.
I think this is the value of going to a good prostate oncologist as he has the skill to accurately stage your PC and determine it's agressiveness and appropriate treatment. Most urologists and surgeons will say, it's PC we have to cut it out. My 1st three urologists didn't know anything about
these tests. When I asked my surgeon about
them, he stammered then said they were inaccurrate and unnecessary (and a major surgery was, without having any information about
location and agressiveness of the tumor??) The light went on as I realized that the only thing these guys knew about
was cutting, and their knowledge of dianostics and staging was woefully inadequate.
Even their knowledge on biopsies is limited. After 12 biopsies I went to Dr Bahn, who is a radiologist that has done over 14,000 biopsies. He explained
why many biopsies are inaccurrate, I clearly saw the needle tracks of my last 25 core biopsy not even close to the tumor. He hit it 3 out of 3 times.
There are a few doctors that really understand PC and are worth searching out. Many more are clueless and recommend treatments using very little information to back up their recommendations. Being an excellent surgeon doesn't automaticaly make one a good dianostician. These are two separate skill sets and both are needed in order to achieve the most favorable outcome.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.
2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.
Scheduled for 5 weeks IMRT in July