I think I have more experience in biopsies than 99.99% of all patients. The CDU is used to eliminate the need for biopsy, and only if something is seen that a biopsy taken; 3 to 6 samples at most. From Numerous experiences I can testify that a 12 core biopsy is much worse than a 6 core biopsy and a 24 core is a real killer. The use of CDU in AS is to avoid annual biopsies.
I did read the part about
the MRIS, in fact I experienced it. Although uncomfortable, it was better than a biospy.
I don't know of anyone who recommends that a Gleason 7 and above being on AS, except when life expectance is way less than 10 years. The purpose of AS is to identify any Gleason above 6 and treat it.
Matastasis is something that occurs after years; it is when the PC goes to the lymphnodes or the bones and starts growing. Before that, it is in the locally advanced stage. It can take years to get to matastatis and HT can slow this to decades. Gleason 6 cancers rarely get to matastasis even though they can get to locally advanced. This is why that even with reoccurrances gleason 6 cancers rarely lead to death. Once pc gets to matastisis it can usually be controlled for about
10 years, depending on the type and agressiveness.
In order to fight PC effectively you have to 1st understand how it works. You also have to understand what your individual cancer is doing and tailor the treatment to match the cancer. This is what I got from the book. You clearly got something else.
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.