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Re: Is surgery best reserved for first-line treatment of higher-risk prostate cancers
Obviously which of any method is best and for what type of patient, or even w.w. or refusing treatments is also someones personal choice?
Since the experts cannot agree on even about what is the better testing proceedures even as a screening type of protocol, we are left grabbing at straws and listening to biased advice from most all sources.
Based on what limited knowledge I have on PCa, our PCa screening choices as to having a measurable value for ascertaining right now...what are you dealing with:
1. psa tests (history needed, velocity needed)
2. fpsa testing or other types (data needed)
3. PCa-3 testing (atleast know the possible results)
4. guided biopsies (assuming you have PCa present)
5. have pathology reviewed by experts, maybe 2 of them
6. pay for pathology ploidity testing or other data
7. consider scans beyond the ct and bone scans (usually those are not worthy enough), consider color doppler ultrasound for possible location of PCa.
8. consider going to Holland for Combidex scanning to find location(s) of PCa, possiblly detect lymphnodes envolved and more precise data (needed to assess)
8/9. see Partin tables, bluestein, narayan, nomograms
9. another consideration is lymphendectomy/sampling of a few nodes for PCa (does have risks too)
10. then consider looking at all possible protocols including non-invasive, so (what drugs or other protocols are found useful?)
11. then decide on your course of action of your hopefully educated...plan of action and life style.
12. then monitor for life and still question everything, but atleast know you did your best.
Robert Young called it (the "jungle"), I am adding it is the "twilight zone" and patients living with PCa usually find themselves living in "limbo-land" you don't know for certain where you stand (recurrence is possible even after 10+ yrs.)...PCa is a "dragon"
This is how it appears in my experiences.
