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Medical Forum / Diseases and Disorders / Prostate Cancer / October 2005Questions ...
Since many of you frequent this NG quite often, I have a question or two. Don't you feel that many (most) men get themselves much to upset at a small rise in their PSA, and even more upset at the prospect of the treatments involved with treating the prostate? I see men asking questions and looking for answers (which are usually answered very well) but most often looking for reassurance in their quest for cure. I kinda feel that many (most) men are NOT given the assurance, and too little information from their docs and uros. If nothing else, would you agree (or not) with that last comment? BTW, I haven't seen too much said about ultrasound and/or how very tolerable it is. And what about the reassurance a man can get from/by having those pics of the prostate made and examined by experts. Comments? moto >Since many of you frequent this NG quite often, I have a question or >two. [quoted text clipped - 17 lines] > >Comments? Most doctors can't give you spot-on diagnoses, but also tend to "play in their own sandboxes". Circumstances and patient's conditions taken into consideration, a Uro will advocate for surgery, a Radiation Oncologist will steer you down that path, with a sprinkling of Hormones on the side. If you're a bad case with Mets, you'll get Salvage Radiation Therapy and possibly Chemo. All doctors are very leery about being positive, in case they are sued. When you refer to Ultrasound, what's your point of focus? Biopsy or HIFU or something else? There are NO experts! -- Reader to complete... -- Please reply to this ng as my email adress is fake: -- Regards -- CC CC ... My family doc had me have ultrasound as a means of further evaluation of the/my prostate. It's done through the rectum, and is NOT that uncomfortable. I asked for an 8x10 glossy of my prostate, but instead, got a cold stare from the tech giving the exam. :) moto Forgive me--I really mean it, forgive me--but you have truly made me laugh (out loud) and it felt good. Why in the world would you want an 8x10 of your prostate? I can't stop laughing.. > CC ... > My family doc had me have ultrasound as a means of further evaluation of [quoted text clipped - 5 lines] > > moto Starvos ... I love to put these 'techs' that do the tests on. About 6 months ago I had a lung fill up. They hadda 'pump it out'. In case you're not aware, they stick a VERY long needle through your back into the chest cavity and suck the sh.t out. Now, before they can do that, they wanna know exactly where to put that needle. They use ultrasound, then mark the exact spot of entry of the needle with a drinking straw. The first time I had this done (it had to be done three times, but I digress) I didn't say a word. The second time however, I was ready. When the ultrasound tech pushed the straw to make the spot, she asked if I was okay. I screamed. She jumped about three feet. I laughed like crazy, and so did the doc who was gonna draw the fluid out. He KNEW it couldn't possibly HURT. I turned around to the tech and said: "Who in the hell do you think you can hurt with a paper straw? BTW, that metallic taste you said I may get in my mouth from that shot you gave me? Well, the thing I taste in my mouth is very much like what I tasted the last time I had a Big Mac. Onions!! Now what do you wanna do about that?" This poor gal didn't know to sh.t, or go bowling. This happened very quickly, and by the time EVERYBODY caught on to what was taking place, that whole crew was laughing their a.ses off. Mission accomplished. :) moto At the suggestion of my onc I saw Dr. Duke Bahn in Ventura, CA, for a color dopplar ultrasound. The color indicates quite vividly the location of cancer cluster(s) within the prostate. Bahn and others use the color dopplar US to guide biopsy needles and to gauge changes in the cancer over time. No pain, very minor discomfort (other than that caused by baring my butt to a youngish nurse) and as a souvenir I came away with TWO Polaroids of my prostate. (Copies also went to my onc.) Not really suitable for framing, and a bit large for wallet-size... Alex > CC ... > My family doc had me have ultrasound as a means of further evaluation of [quoted text clipped - 5 lines] > > moto Alex ... Seems like a lotta confusion about ultrasound, and Doppler. Some saying it's (mostly) without merit, and others (like you and I, I guess) are all for it. I haven't heard of anything LESS invasive (and less painful) that tells as much about the prostate as ultrasound can. You (they) can actually see the beast. I'm guessing some folks just think enduring pain is part of some kinda package they've been sold on. I still want a pic for my wallet. :^) moto Hondas Rule. Harleys drool. A bird in the hand ain't worth much. > Some saying it's (mostly) without merit, and others (like you and I, I > guess) are all for it. The problem is . . . it's the urologists and imaging diagnosticians that are saying ultrasound is not a valid tool for evaluating PC. I.P. >> CC ... >> My family doc had me have ultrasound as a means of further evaluation of >> the/my prostate. >> It's done through the rectum, and is NOT that uncomfortable. Trans-Rectal MRI is a good imaging tool... looking into that myself. >> I asked for an 8x10 glossy of my prostate, but instead, got a cold stare >> from the tech giving the exam. :) That guy needs a clue! > Trans-Rectal MRI is a good imaging tool... looking into that myself. Now THAT'S flexibility! I.P. O, that is so funny. >> Trans-Rectal MRI is a good imaging tool... looking into that myself. > > Now THAT'S flexibility! > > I.P. > O, that is so funny. I agree emphatically >>> Trans-Rectal MRI is a good imaging tool... looking into that myself. >> >> Now THAT'S flexibility! >> >> I.P. Brian... still chuckling... No, I don't do self-DRE. "moto" asked > Don't you feel that many (most) men get themselves much too upset at a > small rise in their PSA By whose standards? Reactions are a very personal thing. But if my doc had gotten upset -- hell, had paid any attention at all -- three years earlier, my chances of dying FROM PC would be way less than 10% of what they are now. > and even more upset at the prospect of the > treatments involved with treating the prostate? I'd venture that MORE men should be MORE "upset' -- at least to the extent that they do more research before jumping into both primary and secondary/adjuvant treatments so eagerly. Every PC treatment has significant odds of significant SEs, and far too many doctors gloss them over. It's up to the patients to research them and pick their poison based on their own spate of (rational) fears. > I kinda feel that many (most) men are NOT given the assurance, and too > little information from their docs and uros. Any doc who gives assurance is blowing smoke. The most they should do is spout statistics, tilted maybe towards each patient's age, condition, etc. > If nothing else, would you agree (or not) with that last comment? Many here and in the literature support it. > BTW, I haven't seen too much said about ultrasound and/or how very > tolerable it is. And what about the reassurance a man can get from/by > having those pics > of the prostate made and examined by experts. Last I heard a year ago, ultrasound wasn't viable for diagnosis or treatment. I.P. I.P. Ultrasound, which I've recieved, and as I understand is a further (just slightly invasive) means by which to examine the prostate. (see my response to crow) moto > I.P. > [quoted text clipped - 4 lines] > > moto I had ultrasound, but if I remember correctly (it's been a couple of years) the purpose was not to further diagnose, but to determine more accurately the size and location of the prostrate prior to brachytherapy. And yes, they did give me a picture to take home, but it wasn't 8 by 10 :) Bob > Since many of you frequent this NG quite often, I have a question or > two. [quoted text clipped - 19 lines] > > moto Reminds me of Woody Allen in sleeper. A health food store owner, he wakes up in the far future to find out among other things, that all the stuff he's been avoiding his entire life.... fat.... sugar.... junk...... were found out to be actually good for you! This should be the case for PSA & PCa.  SignatureJK Sinrod Sinrod Stained Glass Studios http://www.sinrodstudios.com/ Coney Island Memories www.sinrodstudios.com/coneymemories/ JK ... Who knows, maybe 10 yrs from now they'll find most of us who suffered PCa are smarter and suffer less brain fade. Can't say I'm as sharp as I used to be, but way the hell ahead of many others my age. Thank God. :) The chemo maybe? moto My experience from years on this NG is that most men were absolutely unaware of PSA testing results, let alone what they meant. They rely nearly 100% on their general practitioner. We have also found that a significant percentage of doctors have been unaware of anything more than "4 is bad." That standard went out with the old millennium. Rarely have I seen a man push his doctor or consider his doctor too inexperienced to make a sub-4 PSA diagnosis. Ergo, I would say that if you are talking about pre-diagnosis or pre-treatment, your statement would be in error. Conversely, if you're talking post-treatment rise in PSA, yeah, that's enough to scare the most hardened of us. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Since many of you frequent this NG quite often, I have a question or > two. [quoted text clipped - 19 lines] > > moto > that's enough to scare the most hardened of us. Which, apparently, is a pretty small group. '-) I.P. But that's about ALL. |
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