The GP's perspective

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BillyMac
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Date Joined Feb 2008
Total Posts : 1858
   Posted 11/9/2010 9:21 PM (GMT -6)   
This is a sort of advisory article for GPs. It is a good read but be warned there are some confronting images.

www.australiandoctor.com.au/htt/pdf/AD_025_032_JUL23_10.pdf

Bill

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 11/9/2010 11:18 PM (GMT -6)   
Those pictures, posted in urologists waiting rooms, would reduce the number of biopsies to almost zero...

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 11/10/2010 2:35 AM (GMT -6)   
Wow!
That article is lacking in a bit of "bedside manner"
Images like that are perhaps too clinical for the non-medical guy.

Not for the faint hearted - the guy on page 32 looks like he is watching the guy in the photo on page 31 while next in line. Put up those pictures and guys will be wetting themselves before even having treatment.

The algorithm at figure 2 puts it all very succinctly though.

And the picture in fig 3 shows them breaching hygiene rules during a biopsy - the guy holding the biopsy gun on the right is wearing a corduroy jacket when he should have bare arms, and he is also not wearing gloves!!!!!

Table 3 makes interesting reading so I think I might post it as a separate thread.

Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
Tired
BMs weird
14 Sep 10 PSA <0.1
Erections OK

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/10/2010 9:18 AM (GMT -6)   
gee, billy, some good info, could have done without the pictures, lol. didnt look like very sanitary or clinical settings where they took the pics.

the paragraph on psa velocity re-scared me, something i have known all along. 5x chance of death from PC despite treatments,
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 11/10/2010 10:40 AM (GMT -6)   
I can't say for sure, my back was turned, (!) but I think the ultrasound probe and the biopsy gun were combined into a single unit when they did mine...The only instrument I saw was the ultrasound probe....Yeah, the second ungloved hand holding the biopsy device, WHAT?? Is this what "Socialized Medicine" looks like...??

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3805
   Posted 11/10/2010 11:01 AM (GMT -6)   
they put two condoms on the ultrasound probe, which i believe had channel running its length that the biopsy gun slid into.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 11/10/2010 11:05 AM (GMT -6)   
Fairwind - carefull, we got a rule 11 called on us on another thread this morning - no "sm" -

Alegar
Regular Member


Date Joined Oct 2010
Total Posts : 91
   Posted 11/10/2010 11:12 AM (GMT -6)   
OUCH!

Brings back some bad memories. I don't think I'll share this with my 54 year-old friend who is afraid of having his PSA done
54 year old 188 Lb. 6 ft.
Diagnosed July 1, '10 with PC,
PSA 3.88 Gleason 3+3=6, 2 out of 12 samples positive
DaVinci Oct 1 '10
Cath/JP Drain out Oct.16, '10

AIRBORNE ALL THE WAY!

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 11/10/2010 11:51 AM (GMT -6)   
Very ouch. I've just had another look. aaaaaaaaaaaaaargh!

Definitely something to look at after a biopsy to see what was going on behind your back rather than to see it beforehand while investigating.

(It's reminded me that my dad didn't like me looking at his (explicit) medical text books)

When I jump at certain sounds I've just realised that it's not because they sound like someone's working the action of an automatic, but because it sounds like the uro clicking his biopsy snapper.

How am I meant to sleep tonight?

Alf

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/10/2010 12:41 PM (GMT -6)   
Rule 11 is a good rule, and glad to see it brought out from time to time. If not, there's no telling what kind of people would be trying to force their religious and/or political thoughts down our throats. Great things to talk about in person, if both parties are willing and wanting, but not on a forumn.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 11/10/2010 12:47 PM (GMT -6)   
This isn't as bad for me - remember I am the one they put in stirrups, so I saw him headed my way with that thing in hand. Granted there was the desire to get out of there ...

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 11/10/2010 12:58 PM (GMT -6)   
My second uro put me in stirrups, so I've had it both ways. When I was in the stirrups what was most alarming was that they had not even shut the door to the corridor!
And when I was having a DRE at the first uro a secretary just walked in without knocking to put some papers on his desk!
My GP gave me a DRE standing up which was the most comfortable, and while not wanting to compromise myself in anyway that may also have been the best because it was a lady and thus it was a small hand (sorry finger) and I've know here for several years.

Like I've been saying here for a while wouldn't it be nice if there was something other than a "jab you with a sharp object" procedure that could get a tissue sample to a lab that could show conclusively whether you did or did not have cancer.

Sorry if I'm being too flippant, but I've had two nights in a row where I only hand to get up one to pee! Yes!

Alf
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