I have read about
4 or 5 studies on CDU that were published. about
50% show a significant advantage over a standard 12 core biopsies and others show a minor or no advantage.
I believe that skill and experience are probably just as important as technology. You can look them up on Pubmed.
I'm an avid fisherman and compare a color doppler to a fish finding sonar. I can identify the bottom or a fish, but a charter captain who uses it every day and depends on it for a living can identify exactly what type of bottom he's over and exactly what species of fish he is metering. Same equipment, just a different level of skill and experience.
I absolutely believe that Drs Bahn and Lee have developed a skill level with the technology that few others will achieve. Dr Scholz has a CDU and when he sees something he always refers his patients to Dr Bahn. He says, he's just so much better than I am in looking at the scans, and Scholz probably does 10-15 color dopplers a week.
I know that some will only take randomized controlled studies as evidence in any treatment or diagonostics, but I believe that skill is left out of these studies. We accept in sports and business that some individuals consistantly produce superior results that can't be duplicated by others, but when it comes to PC we will only accept controlled studies that are usually done by average or below average doctors and researchers, and can't accept that there a few exceptional doctors than can get results that can't be duplicated by most other doctors.
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.