It very simple, if you are going to get a 2nd opinion on biopsies slides and relie on the 2nd opinion for a major decision, why not use the best available pathologists; it doesn't cost anymore, involve any travel or time. A regular patholigist may see a few cases of PC every months. The top guys are looking multiple cases a day, and yes they may see something different than a normal patholigist because they are experts in PC.
The exact same goes for surgeons; 80% of surgeons doing prosectamies do less than 10 a year. The top surgeons have less side affects and better cure rates than average surgeons. Why would I have my local urologist do my surgery when I could get Scardino or Walsh. Why in the world would I ever want to use an average doctor when the best are available; why take the chance when you don't have to. These guys are recognized by their peers as being the best because they get better results. I'm not saying that these guys are the only ones that are good, but I am saying that you will get better results if you pick the doctors that are in the top 5% rather than the doctors that are at the median or lower.
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.