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Medical Forum / Diseases and Disorders / Prostate Cancer / April 2008

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Checking on doctor

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Califchief - 18 Apr 2008 11:00 GMT
Dwight wrote and asked:

> I just had a consultation with Dr. Harcharan Gill at Stanford.
> Said he's done about 200 RPs, and does two per week.

That's approximately 2 years (2 x 52 x 2)

> He said I had an 80% chance of being cured, and 100% chance with
> radiation.  In the context of the conversation, it seemed he meant
> radiation after surgery.  Does this make sense to anyone?

No it does not make sense.

Sounds like a used car salesman at Cal Worthington.

Does he offer a writen guarantee containing those numbers?
If he won't back up his oral statements in ink, I'd do a
quick about face and walk out of Gill's office.

How does he define "cured?"  PSA = 0.0000?   (No less than symbol)
The patient dies of a heart attack before PCa kills him?

With only 2 years in this business, how can he forcast a "cure"
or "survival" rate of his patients?

___ Blue Wave/QWK v2.12
Dwight - 18 Apr 2008 16:30 GMT
>  Dwight wrote and asked:
>
[quoted text clipped - 10 lines]
>
>  Sounds like a used car salesman at Cal Worthington.

I was sort of getting this sense too.
Alan Meyer - 22 Apr 2008 03:19 GMT
As with everyone else, I believe that the figures quoted of
80% and 100% are unjustifiable.  However that wouldn't
automatically say that this doctor is not an excellent
surgeon.

What was the rest of your impression of him?  Have you
met with other surgeons?  Do you have anything to compare
him against.

His experience level - 200 surgeries performed at two per
week - puts him in the class of professional prostate
surgeons.  Doctors with that level of experience generally
do better.

However, even if you go with him, I think you need a
second opinion on whether to get adjuvant radiation.

   Alan
Dwight - 22 Apr 2008 20:23 GMT
> As with everyone else, I believe that the figures quoted of
> 80% and 100% are unjustifiable.  However that wouldn't
[quoted text clipped - 4 lines]
> met with other surgeons?  Do you have anything to compare
> him against.

Nothing to compare to yet.  I did feel slightly marketed to, which put
me off.

> His experience level - 200 surgeries performed at two per
> week - puts him in the class of professional prostate
[quoted text clipped - 3 lines]
> However, even if you go with him, I think you need a
> second opinion on whether to get adjuvant radiation.

Hopefully no radiation would be required.  I do have a persistent dull
pain in my lower back now that is causing me a little bit of concern
though.  It could just be from hiking, or having sex (that's
definitely new), but I've not had it from hiking in the past.  And why
it would only be on one side from sex....

Near the spine, on the left side, maybe below the kidneys.  The tumor
found is on the left side of the prostate.   I have a doctor's
appointment on Thurs to get it checked out.  Likely nothing, but I
don't feel like waiting to find out it is something.
I.P. Freely - 22 Apr 2008 20:33 GMT
> Near the spine, on the left side, maybe below the kidneys.

That's THE most common site of garden variety lower back pain. Unless
exams prove it to be a met, the primary cure is exercise (especially
your core muscles) and stretching. Chiropracty can apply an immediate
bandaid, but won't cure it and if repeated too often can exacerbate the
problem.

I.P.
Dwight - 22 Apr 2008 21:05 GMT
On Apr 22, 12:33 pm, "I.P. Freely" <fuhgheddabou...@noway.nohow>
wrote:

> > Near the spine, on the left side, maybe below the kidneys.
>
[quoted text clipped - 5 lines]
>
> I.P.

I've got a bone spur down there too.  But, it just seems to be unusual
in its persistence, and location.  It's one inch off the center
line.    I have other spots that are more normal reactions to
exercise.

But, again, I've got my "cancer filter" on.  You know, when all you've
got is cancer, everything looks like a tumor.

Voice over from Arnie "It's not a TOOOMAAH".

Anyway, ignore me on this.  I'll have more feedback soon.

Thanks for the input.

Dwight
I.P. Freely - 22 Apr 2008 21:23 GMT
> I've got a bone spur down there too.  But, it just seems to be unusual
> in its persistence, and location.  It's one inch off the center
> line.    I have other spots that are more normal reactions to
> exercise.

My back has ached at my waist two inches left of my spine (sacro-iliac
joint OA) for decades. When it "goes out", I'm on my hands and knees for
a few days and still bumping the 9.0 on the pain meter once or twice a
year. Since learning the proper stretches it hasn't gone into spasm in 8
years now, and core strengthening has stopped even the chronic ache.
Whether they could stop bone spur problems depends on where the spur is.
Simply switching from sitting to standing when at my computer and other
desk tasks has helped a great deal.

I.P.
Dwight - 22 Apr 2008 22:36 GMT
> > I've got a bone spur down there too.  But, it just seems to be unusual
> > in its persistence, and location.  It's one inch off the center
[quoted text clipped - 11 lines]
>
> I.P.

I get sharp twinges once in  a while too, usually when my back has
gone out.  The bone spur has caused no previous pain that I know of.
This is just in a new spot, a different type of pain (generally a dull
ache), etc, etc.

I won't know what this is until I get it looked at.  As with
everything else in this new phase of my life, it's put into the "we'll
see" box, with a light icing of "I wish I knew what the f.ck was going
on in there".
Alan Meyer - 23 Apr 2008 00:01 GMT
I agree with I.P. on all counts about the back pain:

It's extremely unlikely to be cancer mets.

Stretching can help.

Exercise can help.

Check out a book on back pain from the library to get
stretching and exercise recommendations.  Back pain
is such a common problem that public libraries often have
a good selection of books on it.

   Alan
Alan Meyer - 23 Apr 2008 00:03 GMT
> ...
> I did feel slightly marketed to, which put me off.
> ...

I hate when they do that.

   Alan
 
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