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Pete,
I suppose the kinds of questions one asks reflect the ways of thinking that one carries, in a broad sense.
For me, the obvious approach is to ask what the doc thinks is the current situation in my body with regard to the cancer. Like please map it out. Where does he think cancer cells are located and how are they likely to progress. Based on that, then what are the treatment options and what outcomes can I expect from each. And maybe ask him about prior patients he has seen who might have been somewhat comparable. How were they treated and what have been the outcomes of that treatment?
On top of that you could ask what is his confidence level (50%, 90%?) in the situation truly being as he has depicted. If not very confident, then what other situation could it reasonably be, and how to treat that and so forth.
If you then go see another oncologist and approach him in a similar way then you'll have a good basis on which to form your own opinions and choices.
I know many doctors would not be particularly inclined to pursue this way of discussing things, they might just say "we really don't know" and go no further. That's unfortunate.
If you go to MAILING LISTS and page down you will find how to join the Physician to Patient - P2P Mailing List. Dr Strum deals with queries posted on that List, PROVIDED you provide your data in the required format.
From my point of view I think that the situation described by Dr Strum in his book as
“Low PSA levels may be seen despite significantly high tumor volumes in situations where the PC has mutated to an aggressive cell type; this is characterized by a high Gleason Score of 8-10,....”
does not apply in your case. You did not have a very low PSA count and you did not have a high tumour volume.
The tests referred to by Dr Strum are ones that he suggests are carried out before making a treatment decision to gain a better appreciation of the extent of the disease. To the best of my knowledge there are very few doctors who agree with him on this issue, categorising the tests as unneccessary and old science.
You should ask for him to recommend an experienced radiation oncologist near your home.....Always remember, urologists are surgeons and like the American Cancer Study proved, those who are trained to cut, like to cut. You must expect he will recommend surgery for he has been trained that surgery is the best treatment for cancer....It's not and a host a men have had their sex lives butchered by urologists who with little training and even less experience claim that they will spare your nerve bundles....oops.
I did IMRT=ADT and have come out of it in fine shape, no leaking, no diapers, no colon problems, no ED, no ejaculating blood or urine, no pain....talk to a radiation oncologist.
Patrick Cape Cod, USA
You should ask for him to recommend an experienced radiation oncologist near your home.....Always remember, urologists are surgeons and like the American Cancer Study proved, those who are trained to cut, like to cut. You must expect he will recommend surgery for he has been trained that surgery is the best treatment for cancer....It's not and a host a men have had their sex lives butchered by urologists who with little training and even less experience claim that they will spare your nerve bundles....oops.
I did IMRT=ADT and have come out of it in fine shape, no leaking, no diapers, no colon problems, no ED, no ejaculating blood or urine, no pain....talk to a radiation oncologist.
Patrick Cape Cod, USA
After removal of my prostrate gland by robotic methody histopathology report was pT3aN1Mx.What exactly that denotes?
