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Prostate cancer most often
is a disease without symptoms
but with a lot of numbers. It's
an administrative disease. Let's
have a short look at the 3 main
numeric parameters, PSA, grade
and T stage.
PSA
For example PSA 4,8 ng/ml. In
Terry's famous experiment of 28
consecutive daily readings we
see huge swings. For example
a 4,8 ng/ml on day 14 became a 4,5
ng/ml on day 15. On day 16 it
was 5,3 ng/ml. So what was Terry's
real PSA? You may tell it. When
you go to Pubmed and search for
PSA variability you get quite
a few references, but not on
a daily basis such as in Terry's
unique experiment.
Gleason score
For example Gleason 6. This is
what pathologist A documented as
3+3. Giving the same sample to
pathologist B, yields a Gleason
7 (3+4), pathologist C reports
the same but pathologist D finds
a 7 (4+3). Lastly we have
pathologist E who notes a Gleason
5 (3+2). What is the right score?
The majority, in this case 7
(3+4)? Does it satisfy you?
T stage.
For example T2a. This is what
urologist U feels. Urologist V
however feels nothing special
and says T1. Urologist W is
confident and writes down T3a.
So what is it? Shall we ask
urologist X? In Dr Gublers
book, Le Grand Secret, about
the prostate cancer of president
Mitterand 3 different top notch
urologists were flied in. All
reported different findings on
the digital rectal exam. (Dr Gubler
was the private physician of M.)
Based on these numbers the patient
is rolled in some treatment mode,
in which a new array of confusing
numbers will enter the files. The
crab of the quality of all these
numbers alone is already enough
to take an expectant approach and
wait for the only true signs of
disease which are symptoms.
