Our man in Moscow, Igor Ananiev, has had a struggle to get on the AS train. He has a Gleason 3+4, the blessing of Dr. Laurence of Klotz and the will to do AS. But Moscow was a tough town for AS. Igor finally found a doctor willing to help him on AS. Congrats to Igor.
Here's his update:
Hi Howard,
Thank you, with much interest I read your newsletter as usual.
As you know, my PC story is a little different because I haven't gotten DRE for about 10 years.
Last summer, in July 2022 my local urologist found some suspicious areas in my prostate gland at the transrectal US test and sent me for MRI scan where it was found a tumor of the right side PIRADS 4. After that, I was sent to MRI–ultrasound guided Fusion targeted biopsy in the hospital.
After the prostate biopsy I have been diagnosed with PC of both sides of the prostate gland, stage 2 with a Gleason score 3+4=7. The number of prostate samples/cores in the biopsy is 16 and the only ONE sample has a Gleason score of 4 (about 6% of the total number of cores), the other cores have grade 3 or cancer-free.
Therefore, Dr. Klotz in Toronto during our phone consultation last month said that given my age (78) AS is very appropriate treatment because patients with Gleason 3+4 and minimal proportion of pattern 4 in most cases in fact have artifactual upgrading and their true score is 3+3. Thus AS is warranted. You have a copy of his written confirmation.
In the meantime, I've found in Moscow a group of urologists at the First Moscow medical university (Sechenov university) who are studying AS protocol for low and intermediate PC risk patients in Europe and the US. See link below. So, we already agreed with a leader of this group, Dr. Enikeev to meet and discuss my PC case at the end of March when I get a new PSA test.
Phil Segal, of Prostate Cancer Support Canada, says this about Digital Rectal Exams (DREs): "I agree with Dr Marks assessment re DRE
Unfortunately I also agree with the view that the DRE is preventing many men from watching their prostate health more carefully."
Some guys find DREs intrusions that make them physically uncomfortable. Some consider DREs as homosexual acts.
Personally, I find DREs NBDs (No Big Deals).
Not a lot of evidence to support them. But on occasion they do find advanced cancers.
From now on, I will call them Dilemmatic Rectal Exams because, like everything else in this area, there are dilemmas, and yes dilemmatic is a real word.
Good friend Phil Segal. of Prostate Cancer Support Canada, suggests that Ira Lieb's cartoon prostate be called Stubby. Unfortunately, Prosty is trademarked as a monster-like cartoon prostate. Maybe Prostie would work? Any copyright lawyers out there with free advice?
Rick Davis, of AnCan fame, suggests Ira Lieb's character, be called Wally as in Walnut. We also have Mr. Prosti. Tate. Stubby. A=ny other ideas?
Thanks, David. we'll have to have Ira contribute more. Mr. Prosti is good. Phil Segal suggested Stubby. Any other ideas out there in AS-land?
I like Ira Lieb’s cartoon.
Mr.Prosti?
I like the addition of the cartoon and the art and the photos.
– David Keller
Our man in Moscow, Igor Ananiev, has had a struggle to get on the AS train. He has a Gleason 3+4, the blessing of Dr. Laurence of Klotz and the will to do AS. But Moscow was a tough town for AS. Igor finally found a doctor willing to help him on AS. Congrats to Igor.
Here's his update:
Hi Howard,
Thank you, with much interest I read your newsletter as usual.
As you know, my PC story is a little different because I haven't gotten DRE for about 10 years.
Last summer, in July 2022 my local urologist found some suspicious areas in my prostate gland at the transrectal US test and sent me for MRI scan where it was found a tumor of the right side PIRADS 4. After that, I was sent to MRI–ultrasound guided Fusion targeted biopsy in the hospital.
After the prostate biopsy I have been diagnosed with PC of both sides of the prostate gland, stage 2 with a Gleason score 3+4=7. The number of prostate samples/cores in the biopsy is 16 and the only ONE sample has a Gleason score of 4 (about 6% of the total number of cores), the other cores have grade 3 or cancer-free.
Therefore, Dr. Klotz in Toronto during our phone consultation last month said that given my age (78) AS is very appropriate treatment because patients with Gleason 3+4 and minimal proportion of pattern 4 in most cases in fact have artifactual upgrading and their true score is 3+3. Thus AS is warranted. You have a copy of his written confirmation.
In the meantime, I've found in Moscow a group of urologists at the First Moscow medical university (Sechenov university) who are studying AS protocol for low and intermediate PC risk patients in Europe and the US. See link below. So, we already agreed with a leader of this group, Dr. Enikeev to meet and discuss my PC case at the end of March when I get a new PSA test.
https://www.clinical-genitourinary-cancer.com/article/S1558-7673(20)30116-6/fulltext#%20
Best regards,
Igor Ananyev,
Igor stick with it. And be an Active Surveillor.
Phil Segal, of Prostate Cancer Support Canada, says this about Digital Rectal Exams (DREs): "I agree with Dr Marks assessment re DRE
Unfortunately I also agree with the view that the DRE is preventing many men from watching their prostate health more carefully."
Some guys find DREs intrusions that make them physically uncomfortable. Some consider DREs as homosexual acts.
Personally, I find DREs NBDs (No Big Deals).
Not a lot of evidence to support them. But on occasion they do find advanced cancers.
From now on, I will call them Dilemmatic Rectal Exams because, like everything else in this area, there are dilemmas, and yes dilemmatic is a real word.
What do you think? Index fingers Up? Or Down?
Good friend Phil Segal. of Prostate Cancer Support Canada, suggests that Ira Lieb's cartoon prostate be called Stubby. Unfortunately, Prosty is trademarked as a monster-like cartoon prostate. Maybe Prostie would work? Any copyright lawyers out there with free advice?
Or about Tate the toon prostate?