I guess that we will have to agree to disagree. If you read Walsh's and Scardino's books and then read Myers' and Strum's books you wll see a vastly different philosphy in diagonosing and treating PC.
This I believe is a result of their training in completely different fields, even though they all specialize in PC.
The biggest differences I see are that the 1st choice of Walsh and Scardino are surgery wheras Strum and Myers look at surgery as only one option and usually not the 1st option of choice.
Diet and supplements are a large part of an oncologist's treatment recommendatons.
More emphasis is placed on treating the whole body, not just the PC part of it.
More emphasis on using imaging to stage the cancer. Myers and Strum routinely send their patients to get color doppler ultrasound and Combidex if there are any questionable stats. I know of no urologists or surgeons that have recommended their patients for these tests.
Myer's and Strum place more emphasis on PSA kenetics to see how the cancer is manifesting itself than Scardino and Walsh.
Oncologists are more familiar with the results of various treatments and their affects as a very large part of their practice is dealing with failed local treatments of all types. Failed surgeries are usually passed on to someone other than the surgeon who did the 1st treatment.
I would suggest that everyone read all four books and come to their own conclusions.
By the way, the current head of urological cancer at Anderson was the one who mis diagonosed me during the three years I was his patient.
I agree with you that many patients don't need an oncologist as their PC is fairly straighforward, but it's way more than 1%. If one is seeking a 2nd opinion for anything relating to PC, I would strongly recommend putting a prostate oncologist on your list as they will look at your PC differently and from a different angle than a surgeon or a radiologist. If we look at the PC stats and see that nearly 1,000,000 men have been over treated and 25% to 30% of all treatments result in reoccurrances then we have to admit that our current system is not very effective.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.
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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.