Prostate Cancer Survivors

 

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Re: The more things change, the more they stay the same

A Big Change

Earlier this week I invited one the countrie's leading PCa oncologist to talk at a support group meeting. When asked about AS she said this is definitly a treatment, but she insists on the following
1. PSA test every 4 months together with a DRE
2. Any changes in the PSA or DRE then a saturated biopsy
3. Every 2 years a biopsy.

Anybody to do AS as her patient must sign that they agree to the above conditions

Anothe interesting comment she made was by all means look at alternative ways, but do it under a medical doctor who has changed sides.

So Terry somethings can change!

Lenny

Israel

Re: The more things change, the more they stay the same

(Hi ya Lenny)
Some USA docs are using color doppler sonography to help a baseline and followup sonographies to try and capture the suspecious areas, they show up in red (I hear) and can show changes for suspecious blood flow areas for possible PCa advancing (is the theory or such). But needs to be done by docs whom are very good at analyzing this, and so is also used in A.S. concepts for management.
You can get these doppler guided biopsies to just the suspecious areas, if a doc wishes to go that route.
Dr. Lee and Dr. Bahn are amongest the best, there are some others perhaps in that league or close to it.

With Ralph Blum's/ Dr. Scholz book out- The Prostate Snatchers....A.S./W.W. will be a hotter topic than in the past, as can be seen on some forums right now. Just know the book is Ralph's doing and his biography or a 20 yr. journey and also entertainment with humor additions..doesn't mean alot of men can do A.S. for 20 yrs. safely and the cost of doing as he did would be prohibitive for many average men ( lots of travel, multiple docs, multiple opinions, various testings). He even admits some his journey is luck, prayer and such things. Has useful information in the book and I personally like Dr. Scholz and his tailoring treatments to the patient, I know of a few of his patients getting better findings or results. I support A.S. as my brother is in year 6 as doing such, without psa change and found with defined 'indolent PCa', alot to be considered in PCa issues.

A Big Change

Lenny,

You're absolutely right that there ARE changes in attitude among many of the enlightened doctors, but interestingly, there was a report recently that implied that the number of men choosing AS was dropping, not increasing, despite the evidence accumulating regarding the prevlence of Low Risk or indolent disease.

One thing that DOES bother me a little is that where a Gleason 6 was clearly likely to be a Low Risk disease, the 'migration' of Gleason Scores, which started in 2005 is ikely to continue, so there will, over time be more an more men with graded higher Gleason Scores than they would have in the past, thus making them ineligible for AS.

In passing I wondered what change in a PSA level would trigger a saturation biopsy in your expert's protocol? Given the variances possible in PSA scores, I'd hope it was a very clear and continous increase that triggered this dratsic move.

All the best

Terry

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