Re: To watch, or not to watch........?

January 2, 2007

Abe,

Your

PSA movements are more typical of movements associated with infection or

disease other than prostate cancer. Generally speaking it would be very

unusual for prostate cancer related PSA to bounce around. I can’t

recall if I referred you to the experiment I ran some years back when I had

daily PSA tests to see just how much variance there was, but if I didn’t

and if you’re interested, the results are here http://tinyurl.com/cxwj6

If you

are seriously considering another biopsy then I’d suggest you head

up to see Dr Fred Lee who isn’t too far from you. He is considered

in expert in the Color Doppler technique that has a high rate of success

in identifying suspicious areas and directing biopsy needles to where they

might be most effective. There is also a doctor in New York with a good reputation for

this technique whose name eludes me for the moment – if you’re

interested in pursuing this I’ll hunt his name down in my memory

banks (or my computer’s).

I’d

say if a surgeon is suggesting a ‘wait and see’ approach then

the chances are high that this may well be a good one for you. It isn’t

often that this is done!! Of course I am prejudiced in that I decided

against surgery more than ten years ago and am still happy with that

decision, so my view is that you are not delaying the inevitable and that

you may well be a tad ‘knife happy’. But that’s my view

and you must do what suits you best. Just a point to ponder. Many men say

that they would find the prospect of ‘looking over their shoulder’

all the time if they chose to go to Active Surveillance more than they

could handle. The piece below throws an interesting light on this aspect.

The psychological effects of living

for many years with untreated cancer are a potential concern. Does the

cumulative effect, year after year, of knowing one is living with untreated

cancer lead to depression or other adverse effects? The best data on this comes

from a companion study to the Holmberg randomized trial of surgery vs. watchful

waiting in Sweden.

It found absolutely no significant psychological difference between the two

groups be after five years. Worry, anxiety, depression, all were equal between

the two arms. While surveillance may be stressful for some men, the reality is

that most patients with prostate cancer, whether treated or not, are concerned

about the risk of progression. Anxiety about PSA recurrence is common among

both treated and untreated patients. It is hoped that with education patients

will begin to understand the very indolent natural history of most good-risk

prostate cancers and, with the realization that the disease is not

life-threatening, may avoid much of this anxiety.

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. Nov '06

PSA 31.4

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 Abe

Sent: Wednesday, 3 January 2007 3:11 AM

To: ProstateCancerSupport

Subject: To watch, or not to watch........?

Hi friends,

I just got a call from my Doc who told me that my last PSA dropped

down to 3.99 from its spike of 6.43 about a month ago, up from 4.3

from about a month before that. Despite my Gleason of (3+3)6 and some

MRI abnormalities, his advice is still wait and see. He would like to

redo the biopsy focusing on the abnormal MRI areas since my first 12

core biopsy 2 months ago showed less that 5% cancer.

My Doc (a surgeon) seems to want to wait and see if the problem is a

problem that requires a more aggresive approach. While I can see

rationale in this approach - I can't help but feel that I am just

delaying the inevitable; or am I just being trigger (knife) happy?

I would appreciate any and all feed back from those that have gone, or

are going through, or have thoughts on the " wait and see " approach.

Thanks, and I hope all recovered from ushering in the New Year :-)

Abe-)

January 2, 2007

Terry, thanks for your feed back which ia always helpful.

You indeed gave me the reference before, and I reviewed it.

Yes, if you can, please do hunt down the contact information

of the the two biopsy docs you are refering to.

Thanks again.

Abe-)

2. If you are seriously considering another biopsy then I'd

suggest you

> head up to see Dr Fred Lee who isn't too far from you. He is

considered in

> expert in the Color Doppler technique that has a high rate of

success in

> identifying suspicious areas and directing biopsy needles to where

they

> might be most effective. There is also a doctor in New York with a

good

> reputation for this technique whose name eludes me for the moment -

if

> you're interested in pursuing this I'll hunt his name down in my

memory

> banks (or my computer's).

January 2, 2007

Abe,

The only address I can find at the moment

are these – Duke Bahn worked with Dr Lee and is in California. I simply cannot remember the NY

doctor’s name. No doubt it will pop out of my head at about 3.00 am

tomorrow morning, if it does, I’ll let you know.

Dr. Fred Lee

Ultrasonographer

Rochester

Urology,

Crittenton Medical Professional

Building

1135 West University Drive, Suite

420

Rochester Hills, MI 48307

For appointments, call

His hours are 7:00am to 3:30pm Wednesdays and Thursdays, and twice a month on

Saturdays.

Dr Duke K. Bahn

168 N. Brent St, Ste 402

Ventura, Ca

93003

Tel:

Fax:

dbahn@....