RE: I Hate All Of This - How Do You Get Through It?

[Guest guest]

Hi Ann - My husband's gut reaction was that quality of life was more

important to him that quantity. I was stunned, couldn't believe that

he could feel that way. But after reading and researching I found

that he was not alone in his response. The thought of incontenence

for the rest of his life was as depressing as the thought of impotence.

However, since people in our area have found out what he's up against

the outpouring of support and friendship has been overwhelming. Folks

that he counted as casual friends have come by and called, offered

assistance, etc. It has been heartwarming and strengthening.

He has just recently started feeling the effects of hormone therapy

and has taken them much better than I anticipated. I think since the

onset of the symptoms has been slow, symptoms that may remain with him

indefinately - I don't know --, he has had a change of heart and mind.

I feel that we are at the beginning of our trek through PCa and

eliminating it or at least controlling it I don't know exactly how his

body will respond/react but I know that we're going to do what it

takes to get him through it.

I have been a lurker for several months and this is really my first

contribution rather than question. Just reading the posts here and

seeing the strength and compassion of others has been great for me. I

would recommend checking your area for a support group.

Kate

[Guest guest]

Ann

I had RRP in 1996 and whilst I wear a pad that I change daily after an evening bath - hey life is good! I had 6 months with an external catheter which was time consuming. I dried up enough to the point I only lose a few drops a day.

ED can be helped with injections and pumps. Life is never the same, but we have done things we might not have done ever. We have been to the States twice, to the Greek Islands, to Teneriffe, to India. I have trained parish councillors and clerks, including a Lord!

Life will be good, but honest if the doc has felt a lump, then the active surveillance may not be for your hubby.

I know men who have had full scale treatments who have little or no side effects. Very few of them come on groups like this - cos they are doing well and don't need our help!

I hope he gets a biopsy soon so that you know for certain the path to choose!

Best wishes

I Hate All Of This - How Do You Get Through It?

My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy.

Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper?

Please help me with this because I am not coping well.

Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice.

[Guest guest]

Well I guess one has to set priorties in life. If sex and a normal body functions is what you want then wait. However if you wait too long you may pass up the chance to get rid of the disease. If so, the end isnt gonna be pretty for your man. So the way i see it its a trade off. Sex for a few years, then the messy pants and a bad ending laying in bed with a morphine drip for 6 months or take the chance to get rid of it now and live longer. Thats the long and short of it right now. Wait too long and there is no cure!Ann Meili wrote: My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr.

Krongrad Miami. Since the first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy. Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper? Please help me with this because I am not coping well. Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with

Voice.

The prostate cancer facts, a forum for survival stats, end of life, and other issues we normally don't discuss. So if your looking for this type of support information stop on by.

Browse Archives at groups.google.com

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[Guest guest]

Ann,

Most surgeons will do their best to avoid harming the sphincter and the nerves. I had RRP 13 months ago and had some incontinence for about a month. Unfortunately, the cancer had left the capsule and also was in one of the seven lymph nodes the surgeon removed. I was quickly put on hormone therapy and as a result, have no idea whether the impotence is permanent or not. The surgeon told me he was able to spare one of the nerves and when I get off the hormone therapy I'll find out. My Gleason was a nine and I'm not taking any chances. All I can do, I'm going to do. Like most other cancers, PCa is best treated early on and aggressively.

Good luck in your journey,

Jim Pryor

I Hate All Of This - How Do You Get Through It?

My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy.

Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper?

Please help me with this because I am not coping well.

Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice.

[Guest guest]

Hi Ann. I can certainly understand your feelings. When my husband was diagnosed on January 24th we went into a bit of a tail-spin initially. Then I became an Internet-aholic and discovered so much information. And this site has been fabulous. Yes, I was troubled by the side effects of both brachytherapy and full-out surgery and we are in the final stages of decision making - we have one more appointment with the Dr who specializes in brachy and one more appointment with the surgeon who would do a full out prostectomy. I guess our thoughts are that we need to get through this, together, with love, and then get on with life. I would rather be together, dealing with incontinence and ED, than to be alone without him. Decisions are not easy but as everyone here will tell you, become informed, and stay in touch. We are all here to help each other. AnitaAnn Meili

wrote: My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy. Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while

running to the toilet or wearing a pad or diaper? Please help me with this because I am not coping well. Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice.

Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

[Guest guest]

The only option we are looking at is laproscopic surgery. The doctor in Miami, Krongard, that is all he does. He was one who pioneered the surgery. He does not take most insurance and the cost is $18,000. But he seems to be the best for this type of surgery. One night in the hospital, maybe 10 days with a catheter and after that I guess one hopes for the best. Helga Wendt wrote: Hi Ann. I can certainly understand your feelings. When my husband was diagnosed on January 24th we went into a bit of a tail-spin initially. Then I became an Internet-aholic and discovered so much information. And this site has been fabulous. Yes, I was troubled by the side effects of both brachytherapy and full-out surgery and we are in the final stages of decision making - we

have one more appointment with the Dr who specializes in brachy and one more appointment with the surgeon who would do a full out prostectomy. I guess our thoughts are that we need to get through this, together, with love, and then get on with life. I would rather be together, dealing with incontinence and ED, than to be alone without him. Decisions are not easy but as everyone here will tell you, become informed, and stay in touch. We are all here to help each other. AnitaAnn Meili wrote: My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the

first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy. Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper? Please help me with this because I am not coping well. Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice. Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

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[Guest guest]

Hi Ann & Anita: My husband is 54 and was also diagnosed with PCa in January of this year. He had a severe urinary tract infection and prostatis in December. His urologist felt a hard spot on his prostate during a DRE and recommended a biopsy just to rule out cancer. At the time I thought this was all overkill as his PSA a year earlier was .72. Any way one core out 16 came back positve. At first we were devistated but as time went on we realized how lucky we were that it was diagnosed at such an early stage. After consulting with a renown at UCLA Medical center my husband had one of two choices, bracytherapy or surgery. It wasn't much of a choice for him, he wanted the cancer out and he had a radical prostatecomy on 3/6/06. I too agonized over how we would deal with the side effects of surgery. How did we get through it? To be honest, hasn't been nearly as

bad as we thought it would be. Two nights in the hospial and 10 days with a catheter. Yes he was extremely sore and he hated the catheter, but thats all a bad memory now. It's been six weeks and the incontinence is almost gone - just a few dribbles during the day. Erections are only partial, but we're doing lots of experimenting and are willing to try whatever it takes. Orgasm seems to be better than before. He's getting bored at home and is ready to go back to work. We're getting through this together and are keeping a very positive outlook for the future. KAnn Meili wrote: The only option we are looking at is laproscopic surgery. The doctor in Miami, Krongard, that is all he does. He was one who pioneered the

surgery. He does not take most insurance and the cost is $18,000. But he seems to be the best for this type of surgery. One night in the hospital, maybe 10 days with a catheter and after that I guess one hopes for the best. Helga Wendt wrote: Hi Ann. I can certainly understand your feelings. When my husband was diagnosed on January 24th we went into a bit of a tail-spin initially. Then I became an Internet-aholic and discovered so much information. And this site has been fabulous. Yes, I was troubled by the side effects of both brachytherapy and full-out surgery and we are in the final stages of decision making - we have one more appointment with the Dr who specializes in brachy and one more appointment with the surgeon who would do a full out prostectomy.

I guess our thoughts are that we need to get through this, together, with love, and then get on with life. I would rather be together, dealing with incontinence and ED, than to be alone without him. Decisions are not easy but as everyone here will tell you, become informed, and stay in touch. We are all here to help each other. AnitaAnn Meili wrote: My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the first Dr was not too keen on information we decided that investigation was better than a quick response to anything, including a biopsy. Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper? Please help me with this because I am not coping well. Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice. Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates. Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

[Guest guest]

Ann,

I am at a loss to understand why you

should be making decisions as to what treatment your husband should have and

where before he is even diagnosed and before you have any information as to the

suitability of the treatment.  One slightly elevated PSA reading and a positive

DRE is not a PCa diagnosis.

Dr Strum, who works tirelessly to

provide excellent advice on the P2P Mailing List and who is co-author of the

best book on PCa A Primer on Prostate Cancer has always emphasized the

importance of gathering all the base data available BEFORE making a treatment

decision. This is an extract from a recent posting he made:

<SNIP> I am always perplexed when I

see such little evidence of ANALYSIS prior to such a life-altering invasive

procedure.  We mandate by law that the content of carbohydrate, protein &

fat be indicated on the foods we eat but we have no legislation of basic

requirements to ASSESS the STATUS of a man before he has his prostate removed. 

Years ago, when women started complaining about all the mastectomies that were

being performed after a diagnosis of breast cancer, legislation was passed that

required women to be seen by a medical oncologist prior to any surgery. I

believe that this changed the course of how we treated a woman with breast

cancer. However, for some unexplainable reason, my fellow medical oncologists

are overwhelmed by the urologists and accept their role as physicians who only

see the man with PC when he has advanced disease. My impressions after 40 years

in cancer medicine is that medical oncologists--internists who specialize in

cancer, will spend more time in analyses of a patient prior to recommending an

invasive procedure.

Maybe this has changed but I think not. I

believe the present setting of having a man diagnosed by a urologist leads far

too many men to having inappropriate RPs. Of course there are exceptions like

Pat Walsh who was always very selective about the men he choose to operate on

(and was criticized by his " peers " for being so selective). Yet, that

is why his results were so superior to others--he selected patients appropriate

for a local therapy such as RP. We blow this concept in all oncology patients

when we fail to pay sufficient attention to the importance of STAGING--the

determination of extent of disease.

And, then to top things off, what happens

to men who are analyzed as best as possible using predictive tools like

nomograms & ANN (artificial neural nets) and who are found to be at

significant risk for ECE(extra-capsular extension), SV(seminal vesicle

involvement) or LN(lymph node involvement)?

They are reflexly advised, again by

urologists, to have a CT abdomen & pelvis & a 99Tc bone scan.  Yet,

these radiologic studies are so insensitive in their detection of PC in this

context that you could flip a coin & be more accurate in your assessment.

The consequences of using imaging that is so insensitive and so misleading are

monumental:

1. Men are understaged & hence

misdirected as to the best treatment they should have.

2. Healthcare costs are inflated to an

amount that close to $500,000,000 worldwide each year. ($350 million USA & at

least $150 million elsewhere) <SNIP>

All the best

Terry Herbert

in Melbourne Australia

Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason

3+3=6: No treatment. June '04: TURP. Mar '06 PSA 17.40 fPSA 23%

My site is at www.prostatecancerwatchfulwaiting.co.za

It is a tragedy of the world that no one

knows what he doesn’t know, and the less a man knows, the more sure he is

that he knows everything.   Joyce Carey

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ]

On Behalf Of Ann Meili

Sent: 20 April 2006 12:59 AM

To: ProstateCancerSupport

Subject: Re: I Hate All Of This - How Do You Get Through

It?

The only option we are looking at is laproscopic surgery. The

doctor in Miami,

Krongard, that is all he does. He was one who pioneered the

surgery. He does not take most insurance and the cost is $18,000.

But he seems to be the best for this type of surgery. One night in the

hospital, maybe 10 days with a catheter and after that I guess one hopes for

the best.

Helga Wendt wrote:

Hi Ann. I can certainly understand your

feelings. When my husband was diagnosed on January

24th we went into a bit of a tail-spin initially. Then I became an

Internet-aholic and discovered so much information. And this site has been

fabulous. Yes, I was troubled by the side effects of both brachytherapy

and full-out surgery and we are in the final stages of decision making - we

have one more appointment with the Dr who specializes in brachy and one more

appointment with the surgeon who would do a full out prostectomy. I guess

our thoughts are that we need to get through this, together, with love, and

then get on with life. I would rather be together, dealing with

incontinence and ED, than to be alone without him. Decisions are not easy

but as everyone here will tell you, become informed, and stay in touch.

We are all here to help each other.

Anita

Ann Meili wrote:

My husband has a PSA of 9.5, he had a DRE and the

Dr. said he may have felt something. We have made two additional

appointments with specialists. One at Stanfor in California and the other with Dr.

Krongrad Miami. Since the first

Dr was not too keen on information we decided that

investigation was better than a quick response to anything, including a biopsy.

Still no biopsy is scheduled pending the scheduled appointments.

We are more than likely putting off everything. I cannot stand any of

this. Reading

of incontenence, impotence, blood in the urine etc to me is worse than almost

anything else. Why is everyone so against just waiting to see where the

PSA goes? What kind of quality of life does one have while running

to the toilet or wearing a pad or diaper?

Please help me with this because I am not coping

well.

Blab-away for as little as 1¢/min. Make PC-to-Phone

Calls using Yahoo! Messenger with Voice.

Yahoo!

Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

Yahoo!

Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

[Guest guest]

One answer is simple....medical retirement or not. With RP he can keep his job with anything else he cannot. Terry, you know what he does for a living...I do not want to make it public. IF and a big If it comes to a dx then we only have one choice for treatment.... The other alternative is to watch and wait... anything else is eliminated by the powers that be.Terry Herbert wrote: Ann, I am

at a loss to understand why you should be making decisions as to what treatment your husband should have and where before he is even diagnosed and before you have any information as to the suitability of the treatment. One slightly elevated PSA reading and a positive DRE is not a PCa diagnosis. Dr Strum, who works tirelessly to provide excellent advice on the P2P Mailing List and who is co-author of the best book on PCa A Primer on Prostate Cancer has always emphasized the importance of gathering all the base data available BEFORE making a treatment decision. This is an extract from a recent posting he made: <SNIP> I am always perplexed when I see such little evidence of ANALYSIS prior to such a life-altering invasive procedure. We mandate by law that the content of carbohydrate, protein & fat be indicated on the foods we eat but we have no legislation of basic requirements to ASSESS the STATUS of a man before he has his prostate removed. Years ago, when women started complaining about all the mastectomies that were being performed after a diagnosis of breast cancer, legislation was passed that required women to be seen by a medical oncologist prior to any surgery. I believe that this changed the course of how we treated a woman with breast cancer. However, for some unexplainable reason,

my fellow medical oncologists are overwhelmed by the urologists and accept their role as physicians who only see the man with PC when he has advanced disease. My impressions after 40 years in cancer medicine is that medical oncologists--internists who specialize in cancer, will spend more time in analyses of a patient prior to recommending an invasive procedure. Maybe this has changed but I think not. I believe the present setting of having a man diagnosed by a urologist leads far too many men to having inappropriate RPs. Of course there are exceptions like Pat Walsh who was always very selective about the men he choose to operate on (and was criticized by his "peers"

for being so selective). Yet, that is why his results were so superior to others--he selected patients appropriate for a local therapy such as RP. We blow this concept in all oncology patients when we fail to pay sufficient attention to the importance of STAGING--the determination of extent of disease. And, then to top things off, what happens to men who are analyzed as best as possible using predictive tools like nomograms & ANN (artificial neural nets) and who are found to be at significant risk for ECE(extra-capsular extension), SV(seminal vesicle involvement) or LN(lymph node involvement)? They are reflexly advised, again by urologists, to have a CT abdomen & pelvis & a 99Tc bone scan. Yet, these radiologic studies are so insensitive in their detection of PC in this context that you could flip a coin & be more accurate in your assessment. The consequences of using imaging that is so insensitive and so misleading are monumental: 1. Men are understaged & hence misdirected as to the best treatment they

should have. 2. Healthcare costs are inflated to an amount that close to $500,000,000 worldwide each year. ($350 million USA & at least $150 million elsewhere) <SNIP> All the best Terry Herbert in

Melbourne Australia Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '04: TURP. Mar '06 PSA 17.40 fPSA 23% My site is at www.prostatecancerwatchfulwaiting.co.za It is a tragedy of the world that no one knows what he doesn’t know, and the less a

man knows, the more sure he is that he knows everything. Joyce Carey From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Ann MeiliSent: 20 April 2006 12:59 AMTo: ProstateCancerSupport Subject: Re: I Hate All Of This - How Do You Get Through It? The only option we are looking at is laproscopic surgery. The doctor in Miami, Krongard, that is all he does. He was one who pioneered the surgery. He does not

take most insurance and the cost is $18,000. But he seems to be the best for this type of surgery. One night in the hospital, maybe 10 days with a catheter and after that I guess one hopes for the best. Helga Wendt wrote: Hi Ann. I can certainly understand your feelings. When my husband was diagnosed on January 24th we went into a bit of a tail-spin initially. Then I became an Internet-aholic and discovered so much information. And this site has been fabulous. Yes, I was troubled by

the side effects of both brachytherapy and full-out surgery and we are in the final stages of decision making - we have one more appointment with the Dr who specializes in brachy and one more appointment with the surgeon who would do a full out prostectomy. I guess our thoughts are that we need to get through this, together, with love, and then get on with life. I would rather be together, dealing with incontinence and ED, than to be alone without him. Decisions are not easy but as everyone here will tell you, become informed, and stay in touch. We are all here to help each other. AnitaAnn Meili wrote: My husband has a PSA of 9.5, he had a DRE and the Dr. said he may have felt something. We have made two additional appointments with specialists. One at Stanfor in California and the other with Dr. Krongrad Miami. Since the first Dr was not too keen on

information we decided that investigation was better than a quick response to anything, including a biopsy. Still no biopsy is scheduled pending the scheduled appointments. We are more than likely putting off everything. I cannot stand any of this. Reading of incontenence, impotence, blood in the urine etc to me is worse than almost anything else. Why is everyone so against just waiting to see where the PSA goes? What kind of quality of life does one have while running to the toilet or wearing a pad or diaper? Please help me with this because I am not coping well. Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice. Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates. Yahoo! Messenger with Voice. PC-to-Phone calls for ridiculously low rates.

Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less.

[Guest guest]

Dear Ann,

I didn’t mean to criticize your

choice of treatment directly. You have highlighted a very important point in

the decision making process. BUT it is also even more important to establish as

much information as possible about the nature and extent of the disease IF

indeed there is any because otherwise all you might do is delay the medical

retirement issue and limit the effectiveness of other, more suitable treatment.

To put that more clearly: If surgery is

not the best treatment for a fully diagnosed tumour and as a result the

treatment fails, necessitating secondary treatment, you will be faced with the

medical retirement issue anyway and may have reduced the possibility of long

term management of the disease.

I am not saying this to frighten you or to

stop you doing what you must. But I can see no reason why, IF you decide to go

ahead with the biopsy and IF the result is positive, you should not have the battery

of tests that Strum and others recommend BEFORE deciding on a treatment option.

All the best

Terry   

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ]

On Behalf Of Ann Meili

Sent: 20 April 2006 06:24 AM

To: ProstateCancerSupport

Subject: RE: I Hate All Of This - How Do You Get Through

It?

One answer is simple....medical retirement or not. With RP he can

keep his job with anything else he cannot. Terry, you know what he does

for a living...I do not want to make it public. IF and a big If it comes

to a dx then we only have one choice for treatment.... The other

alternative is to watch and wait... anything else is eliminated by the powers

that be.

Terry Herbert

wrote:

Ann,

I am at a loss to understand why you

should be making decisions as to what treatment your husband should have and

where before he is even diagnosed and before you have any information as to the

suitability of the treatment. One slightly elevated PSA reading and a

positive DRE is not a PCa diagnosis.

Dr Strum, who works tirelessly to

provide excellent advice on the P2P Mailing List and who is co-author of the

best book on PCa A Primer on Prostate Cancer has always emphasized the

importance of gathering all the base data available BEFORE making a treatment

decision. This is an extract from a recent posting he made:

<SNIP> I am always perplexed when I

see such little evidence of ANALYSIS prior to such a life-altering invasive

procedure. We mandate by law that the content of carbohydrate, protein

& fat be indicated on the foods we eat but we have no legislation of basic

requirements to ASSESS the STATUS of a man before he has his prostate

removed. Years ago, when women started complaining about all the

mastectomies that were being performed after a diagnosis of breast cancer, legislation

was passed that required women to be seen by a medical oncologist prior to any

surgery. I believe that this changed the course of how we treated a woman with

breast cancer. However, for some unexplainable reason, my fellow medical

oncologists are overwhelmed by the urologists and accept their role as

physicians who only see the man with PC when he has advanced disease. My

impressions after 40 years in cancer medicine is that medical

oncologists--internists who specialize in cancer, will spend more time in

analyses of a patient prior to recommending an invasive procedure.

Maybe this has changed but I think not. I

believe the present setting of having a man diagnosed by a urologist leads far

too many men to having inappropriate RPs. Of course there are exceptions like

Pat Walsh who was always very selective about the men he choose to operate on

(and was criticized by his " peers " for being so selective). Yet, that

is why his results were so superior to others--he selected patients appropriate

for a local therapy such as RP. We blow this concept in all oncology patients

when we fail to pay sufficient attention to the importance of STAGING--the

determination of extent of disease.

And, then to top things off, what happens

to men who are analyzed as best as possible using predictive tools like

nomograms & ANN (artificial neural nets) and who are found to be at

significant risk for ECE(extra-capsular extension), SV(seminal vesicle

involvement) or LN(lymph node involvement)?

They are reflexly advised, again by urologists,

to have a CT abdomen & pelvis & a 99Tc bone scan. Yet, these

radiologic studies are so insensitive in their detection of PC in this context

that you could flip a coin & be more accurate in your assessment. The

consequences of using imaging that is so insensitive and so misleading are

monumental:

1. Men are understaged & hence

misdirected as to the best treatment they should have.

2. Healthcare costs are inflated to an

amount that close to $500,000,000 worldwide each year. ($350 million USA

& at least $150 million elsewhere) <SNIP>

All the best

Terry Herbert

in Melbourne Australia

Diagnosed ‘96: Age

54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '04: TURP. Mar '06

PSA 17.40 fPSA 23%

My site is at

www.prostatecancerwatchfulwaiting.co.za

It is a

tragedy of the world that no one knows what he doesn’t know, and the less

a man knows, the more sure he is that he knows everything. Joyce

Carey

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ]

On Behalf Of Ann Meili

Sent: 20 April 2006 12:59 AM

To: ProstateCancerSupport

Subject: Re: I Hate All Of This - How Do

You Get Through It?

The only option we are looking at is laproscopic surgery. The

doctor in Miami, Krongard, that is

all he does. He was one who pioneered the surgery. He does not take

most insurance and the cost is $18,000. But he seems to be the best for

this type of surgery. One night in the hospital, maybe 10 days with a

catheter and after that I guess one hopes for the best.

Helga Wendt wrote:

Hi Ann. I can certainly understand your

feelings. When my husband was diagnosed on January 24th we went into a bit of a

tail-spin initially. Then I became an Internet-aholic and discovered so

much information. And this site has been fabulous. Yes, I was troubled by

the side effects of both brachytherapy and full-out surgery and we are in the

final stages of decision making - we have one more appointment with the Dr who

specializes in brachy and one more appointment with the surgeon who would do a

full out prostectomy. I guess our thoughts are that we need to get

through this, together, with love, and then get on with life. I would

rather be together, dealing with incontinence and ED, than to be alone

without him. Decisions are not easy but as everyone here will tell you,

become informed, and stay in touch. We are all here to help each other.

Anita

Ann Meili

wrote:

My husband has a PSA of 9.5, he had a DRE and the

Dr. said he may have felt something. We have made two additional

appointments with specialists. One at Stanfor in California

and the other with Dr. Krongrad Miami. Since the first Dr

was not too keen on information we decided that investigation was better than a

quick response to anything, including a biopsy.

Still no biopsy is scheduled pending the scheduled

appointments. We are more than likely putting off everything. I

cannot stand any of this. Reading

of incontenence, impotence, blood in the urine etc to me is worse than almost

anything else. Why is everyone so against just waiting to see where the

PSA goes? What kind of quality of life does one have while running

to the toilet or wearing a pad or diaper?

Please help me with this because I am not coping

well.

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