From: utopia1@attglobal.net (Jesse)
Suppose there were suspicion of prostate cancer, but no biopsy yet.
Would you proceed with planned PVP? If there is cancer, is it in a
different section of the prostate outside of the area cored out by PVP?
Would PVP vaporize tissue making cancer diagnosis impossible? Would PVP
spill cancer cells?

Jesse

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From: Bruce@BruceSiegel.com
Hi Jesse,
I can't answer your questions. But since I just saw my uro (Dr. Laub in
Santa Barbara) this week with similar concerns, I can offer a few
relevant tidbits that might be of interest.
Once a PVP has been performed, two possible cancer interventions are no
longer feasible: brachytherapy (seeds), and cryo-ablation. So Dr. Laub
wanted me to have a PSA test before we proceed with PVP. So I had the
test and sweated the results. Fortunately, though my PSA has risen to
4.99, the rate of change in the past 2 years is consistent, he feels,
with BPH symptoms, and my large prostate. My free PSA (18) was also high
enough for him to say that he felt a biopsy was optional.

Bruce

============

hi jesse and bruce - i thought i would answer some of your questions,
and bruce brought something up that i've not heard before.  more on that
later.

jesse - you comment was if they found prostate cancer should you have
the PVP done.  the answer usually is the prostate not a divided organ in
that sense.  yes, you have different zones and cancer normally starts on
the back two lobes, but if you have prostate cancer in either of those
lobes, that, if you pull the prostate out and put it on the path table,
it will clearly show that prostate cancer cells were through the entire
organ.   so, with that being said, if you should have a biopsy to clear
the way for the PVP - in my opinion.

-----bruce - your situation is different yet.  your psa is 4.99 and your
free psa is 18.   the rule of thumb is if the free psa is over 25%, then
the chances of you having prostate cancer is minimal, while if the free
psa has dropped to a level below 15%, the chances of prostate cancer are
high.  having an 18 is in the gray area but is pretty close to the 15
cutoff.   perhaps, a small waiting period would be in order to see
what's going on.  take the tests again and see if the numbers have
moved.

the other thing that i've not heard of is having a PVP removes the
options of radiation and cryo
options as treatment of pca.  the reason is that a PVP operates in the
median zone well inside the prostate and since seeds are placed inside
at particular points where the cancer is, i don't understand that one.
freezing the whole prostate into an ice ball should have no effect if
one has had a PVP, but again.  i've not seen any information on this.
if you can give some reference materials or sites to go to, i'd sure
appreciate it.

~ curtis

for what it's worth,  my psa was only 5.79 and after a two week
treatment of levaquin, my psa dropped to 4.80.  still, the biopsy showed
that i had prostate cancer in both lobes of the prostate.  i never had a
free psa test ran, so have no figures for that.

just passed my 3year post op date and just got my psa test results.
undetectable and cancer free for the time being.

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