As those who have waded through my complaints about the botched
cryosurgery of 11/03 and the numerous diagnostic tests that my former
urologist failed to order may recall, I recently went through a course
of IMRT and am presently on ADT.

Contrary to my rad onc's advice, and because I followed my own advice
published here, I consulted a med onc a couple of weeks ago.

Thank God.

I had demanded and gotten a DXA (or DEXA) bone mass density test. It
disclosed, as previously reported, that I had pre-existent osteoplasia,
a precursor of osteoporosis, a common SE of ADT. My rad onc didn't think
of it. I could have suffered a catastrophe if I had not done my homework
and taken the initiative.

I'm now, thanks to the med onc, on the bisphosphonate Actonel 35mg q
weekly, plus 1000 mg calcium and 200 mg vitamin D qd. This regimen,
which will continue so long as I am on ADT, will prevent osteoporosis
and such fun things as pathological vertebral fractures.

The med onc (well, OK, I'll publish her name: Sharon M. Ondreyco MD,
Palo Verde Hematology and Oncology, Scottsdale, Arizona) also ordered
six months of "ultrasensitive" PSA tests, plus a new testosterone assay,
and a prostatic acid phosphatase (PAP) test.

Now, I have the results:

PSA: 0.03 ng/dL (the rad onc's "regular" PSA test = 0.1 two weeks prior)

Testosterone: <20 ng/Dl, as it should be on ADT. I dunno why the lab
didn't report a definite number. Previous report = 36 ng/dL, which, as
my rad onc assured me after I complained about it, *some* clinicians
consider to be, er, good enough.

And, to top it off, PAP = 0.8 ng/mL. According to the literature I've
seen, a baseline PAP test enables one to assess the liklihood of PSA
recurrence post-treatment. A *baseline* PAP result of <3.0 indicates a
low probability. So the report is very good; better than I expected.

The uro who botched the cryo never thought to order this vital
diagnostic test in September 2003, when all this was starting, and I was
too ignorant to demand it. I learned about it from Stephen Strum's _A
Primer on Prostate Cancer_. I had thought that, because I had undergone
primary treatments, it was too late for the PAP test to be useful, but
Dr. Ondreyco believes otherwise. Fine by me; I haven't caught up to her
yet ;-)

There is a number of other diagnostic staging tests that were not done,
and that it is now too late to do.

Brothers, we must take charge of our cases. Our medics have many, maybe
hundreds, of patients to follow. We each have just one. The conclusion
is obvious.

Regards,

Steve J