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Re: Understandable Confusion in the Diagnosis Process
Terry:
Thank you so much for taking time out to address this issue in some detail - I'm very grateful. I'm seeking a second opinion in a couple of weeks at a different hospital (UCLH with Mark Emberton) Since they're involved in the higher accuracy MRI scanning (prostate mapping.com)he may suggest a further MRI - or he may be able to make a better analysis of the existing scan. I'm also going to discuss HIFU with him, as this gets beyond the interpretation of the results within the surgery/radiotherapy dialectic.
I asked the oncologist I saw for a second opinion on the biopsy. I cited the migration upwards of Gleasons over the years. He didn't agree that this was happening. He also said that the pathologist they use is one of the world's leading experts, but they could ask one of the others to look. However, since the WLE also trained all the others, we're likely to come up with the same answer. Perhaps I should be content with the 3+4 - not least because of the natural tendency to want to see a lower result. It is probably better to be safe than sorry.
Your story and the gap between possible interpretations (and therefore decisions) is astonishing, though probably not uncommon. I suppose I have to remember that they're doing the job as best they can.
I think I know what's going to happen next though: without giving me warning, they took a PSA. I'm sure the inevitable rise will exercise them and I'll be urged to make a decision - if they'd asked I would have told them that I'd been on my bike 3 days in a row, and me and my wife had finally found some 'us' time two nights before the surprise test!!
Re: Understandable Confusion in the Diagnosis Process
David,
Good to see that: you figured out early that surgery is a coin toss wrt side effects, and that you will be seeing Mark Emberton who will likely expand your range of treatment options.
I think that we all go into this wanting to come out cured, potent and continent. You may decide that you want to trade some amount of cure for a better chance of coming away with less (if any) side effects. What (if any) treatment you receive is up to you - you are the one who is going to live with the outcomes.
