Uropathologist Jonathan Epstein presents update on prostate biopsies May 17

By Howard Wolinsky

Renowned uropathologist Jonathan Epstein, MD, is presenting a free program entitled, “What you need to know about your prostate biopsy--the new news.”

The Active Surveillor newsletter is hosting the event. Co-sponsors are Active Surveillance Patients International and AnCan.

The program will be on from noon to 1:30 p.m. Eastern on Saturday, May 17.

Register for the meeting: https://us02web.zoom.us/meeting/register/JwtdomJnT3mJttTI8urvuQ

Please send questions in advance to: Howard.wolinsky@gmail.com

Dr. Epstein will speak for about 40 minutes and then will field questions.

He said the program primarily will be aimed at patients on or considering Active Surveillance. However, patients who have had radiation therapy or radical prostatectomy are welcome.

Dr, Jonathan Epstein..

Dr. Epstein recently launched Advanced Uropathology of New York: Global Consultation Services in New York City after nearly 40 years on the faculty at Johns Hopkins University School of Medicine. Advanced Uropathology is affiliated with Integrated Medical Professionals, PLLC, (IMP) (https://www.imppllc.com/about-imp-2/), a subsidiary of Solaris Health.

You can reach Dr. Epstein at https://advanceduropathology.com/consultation/

Letter from a Buddhist on Active Surveillance: ‘Balancing co-morbidities’ and chakras

By Howard Wolinsky

D, was one of the original subscribers to The Active Surveillor three years ago. He reached out to me when he started a paid subscription to support the newsletter.. (I’m always happy to hear about your cancer journeys.)

D. shared his gratitude about how TheActiveSurveillor.com and various webinars and support groups I participated in had helped him.

He started by saying “Hello my good friend” and then went on to say “I deeply appreciate all of the wisdom & good works that you offer.”

He went on AS 11 years ago and remains on on a de-intensified version as he heads into his 86th birthday.

D. said in his own style of punctuation: “Thanx for all that you are & do,” he told me. “I am JOYfullly participating in multiple diseases of aging, including 11+ years of Active Surveillance with 2 cores of G6 & 1 of G7 (3+4).”

I’ve heard of balancing chakras, or energy centers, through meditation and other techniques. But D. told me he was balancing his comorbidities.

Like many of us as he has aged, D, has accumulated a long list of comorbidities.on his medical rap sheet.

He said: “Comorbidities include, two heart attacks/heart failure, COPD, prostate cancer, macular degeneration in both eyes (shots in the eyes every 2-3 months & polyps in my nose.”

“Current PSA range 5-6; free PSA 2.4 39.3% ( I get either 3 or 4 PSA checks/yr & avoid anymore insults to my prostate -addtl biopsies & DREs). I also have BPH, huge size prostate,” he wrote.

Prostate cancer (3+4) is at the bottom of his list of medical concerns.

But D. is sticking with a de-intensified AS—as he stays away from biopsies and digital rectal exams.

“I take lots of recommended supplements & have the most expensive urine in my county LMAO,” he said.

Despite his list of illnesses, D, said, “other than that, I am amazing well & Celebrate each day starting with my Ancient Japanese Morning meditation: Great Day Just Come.”

D. said: “Thanx again for all you are & do for all of us; we are NOT two; we are One.”

And thanz to you, D.

AI’s view of AS-Buddhism connection

By Howard Wolinsky

I queried Gemini AI about possible links between Active Surveillance for low-risk prostate cancer and Buddhism.

Here’s what I got:

Several core Buddhist principles can influence a Buddhist individual's approach to medical decisions like choosing Active Surveillance:

• The Four Noble Truths: These truths form the foundation of Buddhist teachings:

  • Dukkha (Suffering): Recognizing that suffering is inherent in life, including the suffering caused by illness, fear, and anxiety related to a cancer diagnosis.

  • Samudaya (The Origin of Suffering): Understanding that suffering arises from attachment, craving, and ignorance. In the context of illness, this might include attachment to a particular outcome or fear of the unknown.

  • Nirodha (The Cessation of Suffering): Believing that suffering can cease by overcoming attachment and ignorance. In healthcare, this can relate to finding peace and acceptance regardless of the chosen path.

  • Magge (The Path to the Cessation of Suffering): Following the Eightfold Path, which includes wisdom (right understanding and right thought), ethical conduct (right speech, right action, and right livelihood), and mental discipline (right effort, right mindfulness, and right concentration). Mindfulness plays a significant role in observing one's thoughts and emotions related to the diagnosis and treatment options.

• Impermanence (Anicca): Recognizing that all things are subject to change and impermanence, including one's health and the nature of the cancer. This understanding can foster acceptance of the present situation and the potential for change in the future.

• Non-Attachment (Aparigraha): Cultivating a detachment from specific outcomes and clinging to a particular state of health. This doesn't mean indifference but rather a balanced perspective that allows for making decisions without being overwhelmed by fear or desire.

• Compassion (Karuna) and Non-Harm (Ahimsa): These principles emphasize kindness, empathy, and avoiding harm to oneself and others. In the context of medical decisions, this could involve weighing the potential harm and benefits of different treatment options, including the side effects of immediate treatment versus the anxiety of Active Surveillance. It could also extend to considering the impact of one's choices on loved ones.

• Mindfulness (Sati): Paying close attention to the present moment without judgment. This practice can help individuals observe their physical sensations, emotions, and thoughts related to their condition and treatment options, leading to more informed and thoughtful decisions.

• The Middle Way: Seeking a balanced approach that avoids extremes. In healthcare, this might involve carefully considering all options and choosing a path that aligns with one's values and understanding without being swayed by fear or overly aggressive interventions.

• Karma: Understanding the principle of cause and effect, where actions have consequences. This might lead some individuals to consider the karmic implications of their healthcare choices, although interpretations can vary widely.