Jerry, it may have been a bad choice of words but what I meant by "true
undetectability" was simply undetectable using the most sensitive test
at our disposal. I think most doctors, perhaps even Strum, would accept
<.05 as sufficiently "undetectable" for future Dx use.

Frankly, I think this comes down to a difference of opinion between
those who want all the info possible about their disease and are
actively involved in evaluation and Tx on the one hand, and those who
are more content to let the doctors handle it on the other. I am not
making a value judgement; what's good for one man is not for another.

Bill Denton
RP 2/12/02
PSA .96
Memphis

On October 1, Steve (Kramer) answered Bill:

Better question: why should one not do so?

AIUI, Strum says that it is better to know early on what is happening
than not.

It seems to me that the primary argument against ultra-sensitive PSA
tests is that it might --MIGHT-- make some folks nervous.

Well,

(1) a minor change in U/S result, frex my one nanogram per milliliter
increase last month from 0.01 to 0.02, is trivial in and of itself, and
(2) it is very helpful so see changes in PSA that would not be evident
using the less-sensitive test. One can then plan one's response,
something one could not otherwise do.

So, tiny changes in PSA are not in and of themselves cause for concern,
but they can alert the patient and his medic to keep an eye on it.

Regards.

Steve J

It's hard to imagine that you would have no symptoms in this situation.

Also, I wonder what it was that made you change your mind about
treatment. I guess we will never know.

BTW my husband drew not only the skin cancer card and the PCa card but
also the high cholesterol card (w/o meds it has gone up to 365).

=======

hi leah - i've been told more than once that i should write a book
because of all the stuff that has happened in my life.

your husband's story isn't far off from mine.

i was healthy as a horse, until age 56.  in fact, (and i know this was
stupid)  i never saw a doctor but once between the age of 40 and 56.
the only time i was ever in a hospital before then was to visit someone.

and i knew my dad had pca when i was in my 50's but thinking that i
would get it "later down the road"

so, that will give you some idea of how screwed up my thinking was at
the time and i might point out that i had been researching pca
information for about some years before then.  it just didn't click i
guess.......  don't have an answer for that one.  

then, one day, after my back was against the wall from the barrage of
medical bills from the wife's sudden health problems of two heart
attacks, open heart surgery, three stents and two angioplasties,  there
was no money for my health care.  i was slowing down on the peeing part,
but wrote that off to maybe a BPH condition.

i was told that i could go to the VA and get medical treatment.  that i
was entitled to it since i'm a vet.  but being a vietnam vet, i didn't
want any part of it.   so, after much kicking around and fighting with
myself, i turned myself into them and they did the usual "check up
things" along with pulling blood for five different blood tests.   i
flunked four of them.  cholesterol was around 300 and my HDL, LDL, and
psa were out of range. and then got all this news on my birthday.  some
birthday present!!!!!

the following  year, i had 5 surgeries and ever since - my health has
been racking up more problems than tickets of a teenager in a high
powered hot rod.

but enough about that part.

you ask about why i switched treatments.  
ok - here's the story.....

as i watched my dad's psa climb from the watchful waiting and everything
he was going through with the HT treatment, i decided that if i were to
develop pca, i would have seeds.  it was the newest thing out and having
a vast of knowledge in radiation exposure,  knew that if you put the
radiation right inside where the cancer is, that you can kill it.

then, as the news hit that i had pca and the treatments were laid out in
front of me  to be chosen,  that was when i had a long, long talk with
my doctor.  i was amazed that he didn't try to end my conversation and
push me out the door. why?  because we are talking about a conversation
that lasted almost 2 hours.  he stayed there to answer ANY question and
concern that i had.  

so, when it got to the treatment on seeds, i stated my view point.  he
listened and then offered this view point.  he said,  "you know i'm a
surgeon.  this is the church that i practice at, so i'm biased".

then, he went on to discuss seeds.  he agreed with me that it would kill
the cancer inside, but added two comments beyond that.

the first comment was, "the cancer grows on the back two lobes.  picture
it like an orange and the cancer is on the peel of that orange.  you put
the radiation inside the orange, and you will certainly kill the pulp of
that orange, but will the radiation be strong enough to kill the cancer
that is on the peel of that orange?"

the second comment was very more direct.   he said, "you know, you are
going to kill the pca cells, but what about the good prostate cells.
you won't kill all of them.  you will leave some of them left.  but what
about them?  these are cells that have been heavily radiated and while,
right now, are ok, who is to say that in 3....4.....5..or 10 years down
the road, that they won't turn cancerous.   then, what are your options
at that point in time?"

it was this last question that got me to thinking.

right now, i knew that if i have surgery, and if i were to have a
recurrence, then i could use the radiation treatment later for a chance
for a second shot of beating it.  but,  if i were to use the radiation
treatment first, then, i've played all my cards and HT was the only
thing left and i already was witnessing what that treatment was like
with my dad.

the other joker in the deck that my doctor told me was this.  he said,
"right now,  you are a candidate for surgery.  but who is to say that 5
years or so,  if something was to happen to your health to where this
option is not open to you"  

i thought, boy, how right you are.  why?  because just 8 months before,
i had an echocardiogram done as part of the redux settlement and found
out that i have an enlarged heart chamber and a leaking heart valve.

so, with all of this information, i had a talk with the man in the
mirror.  and here's what i decided.

i had to look that person in the face each morning and i have to be
honest to myself.  if i were to take the easy way out and later, the
cancer came back,  can i tell myself that i gave my body EVERY chance
that it could to live?  the answer was 'no'.  i didn't.  i had knowledge
that there were two chances of survival if i went surgery, and only one
chance with radiation.   so, to me,  i HAD to go surgery because i owed
it to myself and nobody else.

oh, and to give you some idea of how bad the sympom of rental shutdown
was.  my dad was at the end of life part of stage 4 of pca, so you can
only image how bad off his rental function was as it was shuting down.  

i was having to stop at EVERY rest area on the highway to relieve
myself.   on the way over to the air force hospital, two of my sons went
with me,  we went into the rest room  - they took both of the urinals
and i had to go into a stall.  as the sons pass the stall, one said to
the other, "you know,  he pees like grandpa."   i yelled back, "hey,
this is the best i can do"   what i failed to recognize at that point,
is that my dad was 38 years older than me at that point and i'm already
there.........????

that's my story and i'm sticking to it......

i strongly feel that each  person should make the decision of their
treatment on pca with what they feel comfortable with and not have
someone else opinion pushed on them.

but you did ask and i did answer.

hope it was interesting reading......  :))

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc